Eating disorders are among the four leading causes of disease that may lead to disability or death (2). Eating disorders have the highest mortality rate of any mental health illness (41). Approximately nine million Americans suffer from an eating disorder with a lifetime prevalence rate of 0.9%-4.5% and approximately 10% of college women suffer from a clinical or near clinical eating disorder (19,22).
Body image refers to the self-perception and attitudes an individual holds with respect to his or her body and physical appearance. Body image is a complex synthesis of psychophysical elements that are perpetual, emotional, cognitive, and kinesthetic. Cash and Fleming (10) defined body image as "one's perceptions and attitudes in relation to one's own physical characteristics" (p. 455). Body dissatisfaction focuses on body build and is often operationalized as the difference between ideal and current self selected figures (7).
Body dissatisfaction is a significant source of distress for many females. Gender is reported to be a convincing risk factor for disordered eating since females are 10 times more likely to develop an eating disorder compared to males (14). Research shows that the size of the "ideal" woman is far smaller than the size of the average woman (25). "The overwhelming evidence of female gender as a risk factor for the development of an eating disorder highlights the importance of determining the factors that put women at risk, particularly the sociocultural context in which these disorders develop" (31, p. 766).
Risk factors that accompany eating disorders are multi-factorial in nature. Research has revealed that sociocultural, developmental, personality, athletic, trauma, familial, and biological factors are critical identifiable areas that house potential eating disorder risk factors (31). Within these specific areas, body image dissatisfaction and low self-esteem are two situational aspects typically associated with individuals who are at risk for developing an eating disorder. In an early study on body dissatisfaction (5), 23% of the women expressed dissatisfaction with various parts of their body. The particular areas problematic for women were the abdomen, hips, thighs, and overall weight. When the study was replicated in the mid-1980s (11), the percentage of females dissatisfied with their body increased to 38%, with the same general body areas being defined by the participants. These same general body areas were also identified in a more recent study (16) in 56% of women.
Considerable scientific attention has been directed toward the potential role that sport involvement play in an athletes' development of attitudes and behaviors about disordered eating. Female athletes experience a higher rate of eating disorders than non-athletes (4,24,43). Female athletes have an eating disorder prevalence of 15% to 62% compared to 0.5% to 3% in late adolescent and young adult female non-athletes (21). Researchers (33) assessed disordered eating in female collegiate athletes (N = 204) from three NCAA universities. The responses to the Questionnaire for Eating Disorder Diagnoses (Q-EDD) found 72.5% (n = 148) of the female athletes were asymptomatic, 25.5% (n = 52) symptomatic, and 2.0% (n = 4) eating disorder (29). Compared to recent research (8,39), this research study found a higher percentage of female athletes who were symptomatic. Athlete's prevalence rate is an important factor, but understanding variables associated with increasing or decreasing risk factors for disordered eating is significant etiological information that should be evaluated (32).
Athletic factors promoting eating disorder development were first identified through research that began in the 1980s, which found particular sports induced higher rates of disordered eating behaviors (1,17). Even though physical activity may develop self-esteem and encourage physical and emotional well-being, there is verification that female athletes are at greater risk for developing disordered eating than their peers who are non-athletes (6). Female athletes encounter the same sociocultural pressures that of non-athletes, however the increased demand of sport-related pressures may independently or dependently increase their risk of eating disordered attitudes and behaviors (40). Coaches, sponsors, and families may all play a role in influencing an athlete's weight and shape. Negative comments from those that surround and evaluate the athlete may trigger the onset of abnormal eating behaviors leading to an eating …