Caroline Anderson: APNM Undergraduate Research Excellence Award Winner

October 2, 2017

Canadian Science Publishing sponsors the Applied Physiology, Nutrition, and Metabolism Undergraduate Research Excellence Awards, which are awarded in partnership with the Canadian Society for Exercise Physiology and the Canadian Nutrition Society. Award winner Caroline Anderson shares her research on eating disorders, muscle dysmorphia, and exercise addiction.

By Caroline Anderson

This past year I had the opportunity to work with Dr. Kyly Whitfield, Assistant Professor in the Department of Applied Human Nutrition at Mount Saint Vincent University, on my undergraduate honours thesis, Eating disorders, muscle dysmorphia and exercise addiction among competitive male bodybuilders in Nova Scotia – an exploratory pilot study. Dr. Whitfield is a role model for me as she empowered me to pursue research in an area I am passionate about. Since 2015, I have been employed as a Personal Trainer, Group Fitness Instructor, and Yoga Instructor at the Canada Games Centre in Halifax, Nova Scotia. My involvement in this line of work prompted my interest in the topic of eating disorders among male bodybuilders.


Bodybuilders: an at-risk group

Eating disorders are commonly considered "female disorders" and tend to be overlooked among males, leaving them vulnerable to lack of diagnoses and affiliated treatments. Specifically, male competitive bodybuilders may be at risk.
Current literature shows a strong association among eating disorders, muscle dysmorphia (an obsessive preoccupation with increasing muscle mass, even if one is significantly muscular), and exercise addiction (characterized by several exercise sessions per day for longer periods than recommended, obsessions with exercise, foregoing responsibilities in order to exercise, and scheduling daily activities around exercise). 

Bodybuilders meticulously follow rigorous resistance training and dietary practices to achieve an ideal physique putting them at increased risk for these associated negative health outcomes. 

Little research to date has focused on competitive bodybuilders as a risk group for eating disorders, muscle dysmorphia, and exercise addiction. In Atlantic Canada, there is currently a lack of knowledge surrounding the prevalence of muscle dysmorphia and exercise addiction as well as the potential of underlying eating disorders among male bodybuilders. 

The primary objective of our research was to develop a new online survey tool to explore the prevalence of, and associations among, eating disorders, muscle dysmorphia, and exercise addiction among competitive male bodybuilders in Nova Scotia, Canada. The secondary objective was to pilot test the survey to gather and examine participant feedback regarding its effectiveness to improve the survey for future research.

The making of the survey 

Survey questions were created based upon various resources. Questions concerning eating disorders were based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for eating disorders, and question wording mirrored the language used in the actual diagnostic criteria. Although there are several existing eating disorder assessment tools, new questions were created, reducing the amount language surrounding thinness, as literature suggests that eating disordered males do not necessarily tend to strive for thinness, but for muscularity and leanness. Questions concerning muscle dysmorphia were created based on Pope’s suggested DSM-V criteria for muscle dysmorphia, and question wording also mirrored the language used in the suggested criteria. Questions concerning exercise addiction were drawn from the Exercise Addiction Inventory, a previously validated questionnaire, as it is brief and appropriate to include as an aspect of a more comprehensive survey. Responses to questions were pre-determined and participants were asked to select the most appropriate response. 

We had seven participants test the online survey and provide feedback for its improvement and effectiveness in future research. In this pilot study, the actual participant questionnaire responses were not statistically analyzed, as the sample size was too small to gather conclusive information on the topic.

Valuable feedback

Based on participant ratings of survey length, difficulty, level of comfort, and repetitiveness, the survey appears to be comprehensive with respect to eating disorders, muscle dysmorphia, and exercise addiction. Four of seven participants provided written feedback for the improvement of the survey, which may indicate that these participants feel strongly about this area of research and that it merits further investigation. These comments are an asset to this research, as the comments provide information that the researchers had not previously considered. Although the number of participants who provided written feedback is not as high as we expected, the feedback is somewhat consistent, indicating some information is missing from the questionnaire. 

"The question about ‘continuing to work out, follow diet, take drugs despite negative consequences…’ is too broad, especially relating to pre-contest. The last week or two of prep is incredibly difficult, therefore, certainly has a negative effect on health, both physical and mental, and does not come without an extreme amount of suffering. But this suffering is necessary in the competition field."
-Participant 2

"The question regarding calories per day while prepping or while not prepping is very difficult to answer as for most competitors, this number changes vastly weekly, sometimes daily. Consider revising that question and maybe separating it into 3 separate ones (what do you eat in the first 1/3 of your prep, 2/3 of prep, 3/3 of prep"
-Participant 4

Scaling up the research 

It is evident that additional research is necessary to determine the actual prevalence and associations among eating disorders, muscle dysmorphia, and exercise addiction among competitive male bodybuilders in Atlantic Canada. Findings from this pilot-scale research will be utilized to make improvements upon the survey tool for its implementation in my Master’s thesis project. I will conduct a cross-sectional study to determine the prevalence and associations among the domains of eating disorders, muscle dysmorphia, and exercise addiction among competitive male bodybuilders in Nova Scotia. The use of tools such as online surveys may improve detection and diagnoses of negative health outcomes, not only among male bodybuilders but also among other athletes, male and female.

Caroline Anderson graduated with an Honours Bachelor of Science in Applied Human Nutrition from Mount Saint Vincent University. She is currently pursuing her Masters of Science in Applied Human Nutrition under the supervision of Dr. Kyly Whitfield. 

Filed Under: Applied Physiology Nutrition and Metabolism

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