Vol. 14, Issue 1, June 2018.



Nenad Ponorac1, Mira Spremo2 & Tanja Šobot1

1University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia&Herzegovina
2University clinical centar of Republic of Srpska, Banja Luka, Bosnia&Herzegovina

Original scientific paper
UDC: 796.012




The number of women who actively participate in sports has drastically increased in the last few decades, which is a trend followed by many health benefits and serious harmful health side effects as well. The Female Athlete Triad stands out among these as a condition which includes eating disorders, menstrual disorders and osteoporosis. Eating disorders are the first link to which all other disorders are later attached, while the risk for their development remains undetected despite the specificities of certain sports. They often develop out of eating restrictions (diets) or out of an unhealthy eating habit. The aims of this paper were to detect the risks for the development of eating disorder by 1) determining body composition parameters and harmful eating habits and 2) identifying risk factors suggested by American Academy of Family Physicians. The sample of examinees was comprised of elite female athletes (111) divided into three groups (sports that use a ball, dance and athletics), each with different risks for the development of eating disorder. The control group (27) consisted of non-athletic female students. The examinees were measured body composition, BMI and they answered a questionnaire which estimates risks for the development of eating disorder in primary health care. Based on the answers to screening questions and eating habits, the results showed significantly bigger risks for the development of eating disorder in the athletes’ group, compared to the control group. Low BMI of less than 18.5, as direct criteria for energy deficiency, was also more present (p<0,05) in the athletes’ group. Therefore, based on body index values and key screening questions, we conclude that active participation in sports carries a bigger risk for the development of eating disorder.


Key words: Female Athlete Triad, eating disorders in sports, body composition.

FULL TEXT (.pdf)


Cameselle, J. A., Sossin K., & Quatromoni, P. (2017). A qualitative analysis of factors related to eating disorder onset in female collegiate athletes and nonathletes. Eating Disorders, 25(3), 199-215. [Cross Ref]
Dosil, J. (2008). Eating Disorders in Athletes. Chichester, UK: John Wiley and Sons, Ltd. [Cross Ref]
Drinkwater B., Loucks A., Sherman, R. T., Sundgot-Borgen, J., & Thompson, R. A. (2005). IOC Medical Comissission Working Group: Position Stand on The Female Athlete Triad. Retrived from httc://www.olympic.ogr.
Dummer, G. M., Rosen, L. W., & Heusner, W. W. (1988). Patogenic weight-control behaviors of young competetive swimmers. Phys Sportsmed, 15, 75-86. [Cross Ref]
Johnsom, C., Powers, S. P., & Dick, R. (1999). Athletes and eating disordrers: The National collegiate athletic association study. International Journal of Eating Disorders, 26, 179-188<179::AID-EAT7>3.0.CO;2-Z [Cross Ref]
Joy, E., Kussman, A., & Nattiv, A., (2016). Update on eating disorders in athletes: A comprehensive narrative review with a focus on clinical assessment and management. British Journal of Sports Medicine, 50, 154–162. [Cross Ref]
Mountjoy, M. L. (2015). Handbook of Sports Medicine and Science: The Female Athlete. New Jersey, USA: International Olympic Committee published by Wiley Blackwell.
Mountjoy, M., Sundgot-Borgen, J. K., Burke, L. M., Ackerman, K. E., Blauwet, C., Constantini, N., Lebrun, C., Lundy, B., Melin, A. K., Meyer, N. L., Sherman, R. T., Tenforde, A. S., Torstveit, M., & Budgett, R.  (2018). IOC consensus statement on relative energy deficiency in sport (RED-S): Update. British Journal of Sports Medicine, 52, 687-697. [Cross Ref]
Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., Meyer, N., Sherman, R., Steffen, K., Budget, R., Ljungqvist, A. (2014). The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine, 48, 491–497. [Cross Ref]
Nativ, A., Loucks, A., Manore, M., Sanborn, C., Sundgot-Borgen, J., & Warren, M. (2007). ACSM Position Stand; The Female Athlete Triad. Medicine and Science in Sports and Exercise, 39, 1867-1882.
Otis, C. L., Drinkwater, B., Johnson, M., Loucks, A., & Wilmore, J. (1997). American College of Sports Medicine: Position stand; The female athlete triad. Medicine and Science in Sports and Exercise.  29, 5-16.
Plateau, C. R., Arcelus, J., McDermott, H. J., & Meyer, C. (2015). Responses of track and field coaches to athletes with eating problems. Scand J Sci Sport, 25(2), 240-50. [Cross Ref]
Pritts, D. S. (2003). Diagnosis of eating disorders in primary care. American Family Physicians. 67, 297-304.
Publication Manual of the American Psychological Association (2013). (Second Edition).  Diagnostic and statisticl manual of mental disorders DSM-V in: Diagnostic and statisticl manual of mental disorders DSM-V. Washington, USA: American Psychological Association.
Rome, S. E. (2003). Eating disorders. Obstet Gynecol Clin N Am, 30, 353-377. [Cross Ref]
Rosen, L. W., & Hough, D. O. (1988). Patogenic weight control behavior in female college gymnasts. Physicians and Sports Medicine, 16, 141-146. [Cross Ref]
Sherman, R. T., & Thompson, R. (2005). NCAA coaches survey: The role of the coach in identifying athletes with disorderd eating. Eating Disorders. 13, 447-466. [Cross Ref]
Sundgot-Borgen, C., Bratland-Sanda, S., Engen K. M. E., Pettersen, G., Friborg, O., Torstveit, M. K., Kolle, E., Piran, N., Sundgot-Borgen, J., & Rosenvinge J. H. (2018). The Norwegian healthy body image programme: study protocol for a randomized controlled school-based intervention to promote positive body image and prevent disordered eating among Norwegian high school students.  BMC Psychol, 6(1), 1-9. [Cross Ref]
Sundgot-Borgen, J. (1994). Risk and trigger factors for the development of eating disorders in female elite athletes. Med Sci Sports Exerc, 26, 414-419. [Cross Ref]
Sundgot-Borgen, J., & Torstveit, M.  (2004). Prevalence of eatin disorders in elite athletes is higher than in the general population. Clinical Journa of Sports Medicine, 14, 25-32. [Cross Ref]
Thorsveit, M., & Sungot- Borgen, J. (2005). The female tahlete triad: Are elithe athletes in increased risk? Medicine and Science in Sports and Exercise, 37, 184-193.
Williams, N. I., Statuta, S. M., & Austin, A.  (2017). Female Athlete Triad Future Directions for Energy Availability and Eating Disorder Research and Practice. Clinical Sports Medicine, 36, 671-686. [Cross Ref]

To cite this article:
Ponorac, N., Spremo, M., Šobot, T.& Vojvodić, M. (2018). Body composition, eating habits and risk factors for the development of eating disorder in female elite athletes. Sportlogia, 14 (1), 66-77. doi:10.5550/sgia.181401.en.pss


Received: : 10.05.2018.
Accepted: 28.06.2018.

Correspondence Author:
Ponorac Nenad, PhD.
University of Banja Luka,
Faculty of Medicine, Banja Luka, Bosnia&Herzegovina