Sport-Specific Factors and Values Leading to Normalisation of Disordered Eating Behaviours in Elite Sport: A Scoping Review.

BACKGROUND

Disordered eating behaviours (DEBs) can be normalised by elite sports values and norms, obscuring risk for DEBs.

OBJECTIVES

This scoping review mapped (1) how DEBs are conceptualised in elite sport, (2) the values, norms, and institutional mechanisms that normalise them, and (3) the barriers that obstruct recognition and care.

METHODS

The search was conducted using Joanna Briggs Institute (JBI) methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist, encompassing eight databases with no date limits. A protocol was registered; 3497 records were screened (1153 duplicates were removed), 283 full texts were reviewed, and 128 studies were included.

RESULTS

Study designs are largely crosssectional, based on self-report, and variably specific to particular sports. (1) DEBs are framed as a continuum ranging from functional practices to pathology, with tipping points linked to seasonality, injury and selection processes. (2) Normalisation mechanisms of DEBs stem from sports-specific values and norms, constituting an elite sporting ethic, body ideals, coach/team culture, institutional surveillance and public/media scrutiny. (3) Barriers for assessment and help-seeking include the moralisation of restrictive behaviours, stigma, 'toughness' norms, knowledge gaps, coach gatekeeping, organisational constraints and gendered assumptions.

CONCLUSIONS

System-level safeguards are needed and athlete-centred, protective initiatives should be prioritised over performance-oriented outcomes. Future research should prioritise longitudinal designs, elite sports-sensitive measures, and equity-oriented sampling.