The female athlete body project study: 18-month outcomes in eating disorder symptoms and risk factors
Open accessAbstract
OBJECTIVE: To evaluate the efficacy of the Female Athlete Body project (FAB) in reducing eating disorder (ED) symptoms and risk factors. METHOD: This study was a community participatory three-site, two-arm, cluster randomized controlled trial (RCT). Female collegiate athletes (N = 481) were randomly assigned by team to the FAB intervention, a behavioral ED risk factor reduction program, or a waitlist control condition. Primary analyses examined 18-month effects for ED pathology. Secondary analyses examined risk factors and correlates (e.g., thin-ideal internalization, negative mood, Female Athlete Triad knowledge, and body mass index [BMI]). RESULTS: Linear mixed effects models with team as a cluster level variable and study condition as a between-subjects variable revealed significantly reduced dietary restraint in FAB teams relative to control teams. FAB teams also reported significantly fewer objective and subjective binge episodes than control teams. Finally, FAB teams showed significantly lower thin-ideal internalization and increased BMI at 18-months. No other significant differences were found. DISCUSSION: This RCT examined the effects of a short intervention on ED pathology and risk factors in female collegiate athletes through 18-month follow-up. This trial is one of only three trials with female athletes that have shown long-term reductions in any ED symptoms or produced positive effects on ED risk factors. The present study is the first to find such effects with athletes using a brief (i.e., 4 hr) intervention at 18-month follow-up. Although small effects were found, the current trial provides valuable lessons about future design and implementation of similar trials with athletes. TRIAL REGISTRATION: Clinical trials NCT01735994.
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Short-term education programmes have been shown to improve nutritional knowledge and reduce signs of dieting and body image concerns in female and male athletes.
“Short-term education programmes, using various delivery methods and focusing on factors associated with EDs, DE behaviours, and REDs have been shown to improve nutritional knowledge and reduce signs of dieting and body image concerns in female and male athletes.70 152-158”
From 2023 international olympic committee's (IOC) consensus statement on relative energy deficiency in sport (REDs) (2023) · cites this paper as [152]
The Results (page unavailable) report reduced dietary restraint and thin-ideal internalization after the brief intervention, supporting the dieting and body-image portions of the claim. But the study enrolled only female collegiate athletes, not male athletes, and its Results report greater Female Athlete Triad knowledge in the control group rather than an improvement in the intervention group. Nutritional knowledge was not established as an improved outcome. (LLM, conf=0.90)
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- Authors
- Stewart, T. M., Pollard, T., Hildebrandt, T., Wesley, N. Y., Kilpela, L. S., & Becker, C. B.
- Affiliations
- Pennington Biomedical Research Center (US)
- Mount Sinai Hospital (US)
- The University of Texas at San Antonio Health Science Center (US)
- Trinity University (US)
- Corresponding author
- Stewart, Tiffany M.
- ORCID
- Venue
- International Journal of Eating Disorders
- Publisher
- Wiley
- Published
- 2019-07-27
- Volume
- 52
- Issue
- 11
- Pages
- 1291-1300
- ISSN
- 0276-3478 (ISSN-L)
- 1098-108X
- PMC
- PMC7089677
- OpenAlex
- W2964993576
- Cited by
- 52
- References
- 30
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 9 · 2023: 12 · 2022: 9 · 2021: 3 · 2020: 3
- FWCI
- 4.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Eating Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Commons - Trinity University (Trinity University) (submittedVersion)
- Funders
- National Institute of Mental Health (NIMH 1 R01 MH094448‐01A1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Health Professions › General Health Professions › Health and Lifestyle Studies
- Keywords
- eating disorders, female athletes, eating disorder risk factors, thin-ideal internalization, dietary restraint, binge eating, female athlete triad, body mass index, collegiate athletes, behavioral interventions, long-term outcomes
- MeSH terms
- Adolescent, Adult, Feeding and Eating Disorders, Female, Humans, Risk Factors, Time Factors, Treatment Outcome, Young Adult, Athletes
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