Eating disorders (EDs) are a significant public health concern associated with psychiatric, physical, and functional impairments. Athletes experience elevated ED prevalence compared to non-athletes, with rates up to 19% in men and 45% in women. Among athletes, EDs present additional concerns including increased injury risk, impaired performance, prolonged illness, and potential premature athletic career termination. Dysfunctional exercise—a maladaptive pattern characterized by rigid rules, guilt, compulsivity, and inability to stop despite harm—is common in this population and linked to poorer outcomes. Despite increasing recognition of these risks, few studies have systematically evaluated athlete-focused interventions in higher levels of care. This study examined the feasibility and preliminary effectiveness of specialized athlete programming within partial hospitalization and intensive outpatient ED treatment programs. Participants included 182 adolescent and adult patients who self-identified as athletes and attended at least four athlete-focused therapy groups. Outcomes included dysfunctional exercise symptoms (EPSI), ED symptoms (EDE-Q), ED-related impairment (CIA), depression (PHQ-9), and anxiety (STAI). Linear mixed-effects models evaluated changes across admission, mid-treatment, discharge, and 6- and 12-month follow-ups. Pairwise comparisons of estimated marginal means were conducted using Tukey-adjusted contrasts to identify significant decreases between specific time points. Significant decreases were observed in dysfunctional exercise, ED symptoms, ED-related impairment, depression, and anxiety. The steepest improvements occurred between admission and mid-treatment for all outcomes except anxiety, which remained stable at first and declined sharply by discharge; all outcomes showed stabilization through 12-month follow-up. Findings provide preliminary empirical support for the feasibility and clinical utility of integrating athlete-focused programming into higher-level ED care, highlighting the importance of addressing the unique challenges and treatment needs of athletes.
Dunbar et al. (2026) studied this question.