Abstract
und: the aim of this study was to determine the factors that affect the occurrence of behaviors related to possible eating disorders in Spanish high-performance Olympic wrestling athletes. (2) Methods: The sample consisted of 22 elite female wrestlers selected through purposive sampling with inclusion criteria of (i) having been a national champion, (ii) having been part of the Spanish team, and (iii) suffering or having suffered from an eating disorder. The semistructured interviews were conducted online and lasted between 20 and 40 min. A statistical analysis was performed with NVivo10 software. (3) Results: the athletes showed a series of issues grouped into three main themes, which were divided into the following categories rstly, the reasons why wrestlers lose weight; secondly, the inadequate procedures they use; and, nally, the reference persons involved in the process. (4) Conclusions: The training conditions in high-performance sports have psychological and behavioral effects on wrestlers. Wrestlers have to move down to lower categories; however, they do not take into account how this
were divided into the following categories rstly, the reasons why wrestlers lose weight; secondly, the inadequate procedures they use; and, nally, the reference persons involved in the process. (4) Conclusions: The training conditions in high-performance sports have psychological and behavioral effects on wrestlers. Wrestlers have to move down to lower categories; however, they do not take into account how this practice in uences their health when using inadequate procedures. Rapid and signi cant weight loss produces negative effects, especially in the female population, generating an incidence of eating disorders. The information obtained provided elements of interest for re ection on possible solutions to prevent existing eating disorders. Keywords:psychological aspects; Olympic wrestling; female wrestlers; eating disorders; qualitative research 1. Introduction Eating disorders (EDs) are severe disturbances in eating, weight control behaviors, and body image. In addition to so-called unspeci ed EDs, the American Psychiatric Association [1] distinguishes three types of clinical eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder. EDs have been on the rise in recent years due to many factors, including changes in our society in relation to health and sports [2]. According to the American Psychiatric Association (2014) [3], EDs are determined by a persistent disturbance in eating or eating-related behaviors that leads to a signi cant impairment in physical health or psychosocial actions. Although these health problems can affect the entire population, athletes are at an increased risk of developing EDs and inadequate exercise behaviors [4]. In this line, Moriarty and Moriarty (1993) [5] and Martinez (2012) [6] considered the psychological characteristics of the athlete and the pressures from society, one's coach, one's teammates, and the sport itself as factors that can facilitate the appearance of EDs. Additionally, these EDs can have adverse consequences on athletic performance, well-being, health, and athlete identity [7,8]. Regarding sports, weight category sports are those in which weight de nes the partic- ipant's category. In this line, the previous literature has shown that weight category sports Int. J. Environ. Res. Public Health2023,20, 2441.
athletic performance, well-being, health, and athlete identity [7,8]. Regarding sports, weight category sports are those in which weight de nes the partic- ipant's category. In this line, the previous literature has shown that weight category sports Int. J. Environ. Res. Public Health2023,20, 2441.
Int. J. Environ. Res. Public Health2023,20, 2441 2 of 17 (e.g., judo, wrestling, rowing, and boxing), sports related to body aesthetics (e.g., gym- nastics, skating, and synchronized swimming), and endurance sports (e.g., long distance athletics) seem to be susceptible to an increased risk of developing EDs [9]. However, other studies have reported differences between the athletes of weight category sports and the athletes of other sports in their scores on validated questionnaires related to EDs, such as the Eating Attitudes Test or the Eating Disorder Inventory [10]. Inside weight category sports, we can nd the Olympic wrestling sport. Olympic wrestling is a combat sport in which each wrestler attempts to defeat his/her opponent without the use of strikes. Olympic wrestling is one of the oldest sports on record, and, throughout history, it has included some rules to allow sports standardization. One of these rules is the division of wrestlers into age and weight categories to create a level playing eld [11]. In consequence, it is often observed that wrestlers aim to be in the lowest weight category possible. Thus, athletes usually think that they will have a relative advantage when facing lighter and less strong competitors [8]. In addition, Engels et al. (2003) [12] found that wrestlers scored high on weight loss tendency, dietary restraint, and purging behaviors compared to other athletes in other sports. In order to lose weight, some wrestlers attempt to lose weight rapidly, most often through drastic weight drops or pathological weight loss practices with subsequent uncon- trolled intake, and they complete their weight loss plan by using some form of purging (vomiting, the use of laxatives or diuretics, or even excessive exercise) or by using dehy- dration methods (saunas, sauna suits, or salt baths) [13]. Moreover, there seems to be a relationship in wrestling and combat sports between inadequate weight loss practices and physical, athletic, and cognitive performance problems [14,15]. Thus, the studies in this area have even pointed to a high risk of having EDs reaching a prevalence of 26% [16]. Regarding gender, studies state that the number of EDs has increased in recent
Moreover, there seems to be a relationship in wrestling and combat sports between inadequate weight loss practices and physical, athletic, and cognitive performance problems [14,15]. Thus, the studies in this area have even pointed to a high risk of having EDs reaching a prevalence of 26% [16]. Regarding gender, studies state that the number of EDs has increased in recent years, especially in women [9]. In general, it seems that the prevalence is higher in women than in men [17]. This fact could be related to factors such as low self-esteem, body image, social networks, or the pressure received both by themselves and by their own environment [8]. Accordingly, the behaviors of athletes, such as the manipulation of food and the use of inadequate weight control methods, may contribute to the development of EDs and serious health problems. The previous literature revealed that 46.15% of female wrestlers presented some type of ED, such as anorexia or bulimia, suggesting the need for more training and intervention programs to improve the health of these athletes [18]. Although EDs can have serious consequences on athletes' present and future, there seems to be scarce literature that explains in depth the causes of their appearance and the process in which EDs are developed in athletes, especially in high-performance female Olympic wrestlers. In consequence, the main objective of this study was to determine the factors that affect the appearance of behaviors related to possible EDs in Spanish high-performance Olympic wrestling athletes. 2. Materials and Methods 2.1. Study Design An important methodological issue in the study of EDs is the fact that individuals may be dishonest about themselves because they experience feelings of shame, self-blame, or fear and, therefore, attempt to hide their inappropriate eating and dieting patterns [19]. In fact, evidence of signi cant underreporting of EDs among athletes has been found when comparing questionnaire data with clinical interviews. In this regard, various studies have pointed to the appropriateness of qualitative methodology. Studies state that a descriptive phenomenology approach focuses on describing the participant's lived experience to better understand a phenomenon [20]. Research design from a
patterns [19]. In fact, evidence of signi cant underreporting of EDs among athletes has been found when comparing questionnaire data with clinical interviews. In this regard, various studies have pointed to the appropriateness of qualitative methodology. Studies state that a descriptive phenomenology approach focuses on describing the participant's lived experience to better understand a phenomenon [20]. Research design from a phenomenological paradigm can help to better understand the beliefs and motivations that govern subjects' behaviors from their personal experience and perspective. It also seems essential for researchers to develop trusting relationships with subjects in order to obtain quality information [21].
Int. J. Environ. Res. Public Health2023,20, 2441 3 of 17 2.2. Participants National coach of the Spanish women's Olympic wrestling team was contacted, and she provided us with the contact details of the 30 elite Spanish female wrestlers who were members of the of cial national team at that moment. Of the total number of athletes, 2 of them declined the invitation, and 6 of them were discarded according to the inclusion criteria or because they had never suffered an ED or had never had an unhealthy rela- tionship with food, leaving a nal sample of 22 female wrestlers. After conducting the 22 interviews, there was no need to conduct more because the saturation level was amply reached. The mean age at the time of data collection was 20.82 2.79 years old. The rest of the participants' descriptive characteristics are shown in Table. Table 1.Participant characteristics. Participant Age Height Age Competition Category Weight Competition Category (kg) Current Weight (kg) Years of Wrestling Practice Years of Competition Frequency of Training (Hours per Week) Educational Level (Finished) L01 21 159 UNDER 23 50 53.5 18 10 14 High school L02 26 162 SENIOR 57 63 8 7 18 University master's degree L03 19 174 JUNIOR 65 66 4 4 20 High school L04 20 165 UNDER 23 57 59.5 8 7 22 Middle school L05 17 164 JUNIOR 57 59 5 5 16 Middle school L06 20 176 JUNIOR 76 84 8 8 18 High school L07 24 170 SENIOR 62 64.5 15 15 20 High school L08 22 174 UNDER 23 72 73 10 10 14 High school L09 21 170 UNDER 23 55 56 18 10 14 High school L10 19 166 JUNIOR 68 65.5 11 7 10 High school L11 23 167 UNDER 23 72 76.5 13 11 6 High school L12 18 162 JUNIOR 59 65.5 2 2 24 Middle school L13 23 169 UNDER 23 53 57.5 12 10 12 Middle school L14 21 165 UNDER 23 65 69 12 10 14 High school L15 26 158 SENIOR 65 65 14 12 20 University Degree L16 21
L11 23 167 UNDER 23 72 76.5 13 11 6 High school L12 18 162 JUNIOR 59 65.5 2 2 24 Middle school L13 23 169 UNDER 23 53 57.5 12 10 12 Middle school L14 21 165 UNDER 23 65 69 12 10 14 High school L15 26 158 SENIOR 65 65 14 12 20 University Degree L16 21 164 UNDER 23 68 73 12 9 20 High school L17 17 165 JUNIOR 53 54 5 4 12 Primary school L18 16 159 JUNIOR 50 51 13 4 20 Middle school L19 18 176 JUNIOR 76 83.5 6 6 6 Middle school L20 20 154 UNDER 23 50 50.9 8 8 18 High school L21 24 158 SENIOR 50 55.5 8 7 20 University degree L22 22 157 UNDER 23 59 62 9 9 25 High school Three inclusion criteria were used to identify subjects who could provide relevant information to answer the research questions due to having a broad perspective of the situation [19]: (1) being elite, or having been champion of Spain in any age category, and (2) having been part of the Spanish national team, participating in at least one international championship, and suffering or having suffered from an ED. 2.3. Material and Data Collection A semistructured interview (Appendix) was developed by two of the authors, the rst being a high-level professional female wrestler with many years of experience in the eld and with a background in qualitative research and the second being a sports scientist specialized in qualitative methodology and a professor of this subject with many years of experience in qualitative research, and it was helped by using the triangulation strategy with an expert external to the study in order to be able to gain in-depth insight into the personal experience of the female wrestlers [22]. It was developed from themes and questions based on previous research related to EDs in high-performance female athletes. The script was structured around three blocks. First, introduction and general warm-up questions. In the second block, the interviewee was asked to talk about her personal history:
gain in-depth insight into the personal experience of the female wrestlers [22]. It was developed from themes and questions based on previous research related to EDs in high-performance female athletes. The script was structured around three blocks. First, introduction and general warm-up questions. In the second block, the interviewee was asked to talk about her personal history:
Int. J. Environ. Res. Public Health2023,20, 2441 4 of 17 her personal experience in terms of her ED, Olympic wrestling, other in uential factors, help received, possible solutions, etc. Finally, in the third block, they were asked to indicate what measures they thought should be taken to avoid future cases and what would be the appropriate steps to solve the cases that already exist. Prior to the start of the study, two pilot interviews were conducted with volunteer wrestlers to adjust the questions and the script. These were conducted jointly by the lead author and another author, a sports scientist specializing in qualitative methodology and a professor of this subject with many years of experience in qualitative research, for supervision. All the interviews in the study were conducted by the lead author, who had experience as an interviewer in previous studies, in order to guarantee the stability of the data during the research [23]. All interviews were conducted by the lead author, who had experience as an inter- viewer in previous studies. The pilot interview was conducted jointly with another author, a sports scientist specializing in qualitative methodology and a professor of this subject with many years of experience in qualitative research, for supervision. All participants were given a signed consent form, and it was explained to them that participation was strictly con dential and voluntary. The interviews were conducted online by video call due to the special conditions caused by the COVID-19 pandemic and lasted between 20 and 40 min, and we used audio recording. Before starting the interview, the main objective of the research was explained to the wrestlers so that they knew the type of research in which they were going to participate. The voluntary and con dential nature of the study was repeated, and it was explained to them that they could withdraw from the study at any time without any consequences. They were asked for permission to record the interview, and it was made clear to them that any details that could lead to the disclosure of their identity would be excluded from the results.
dential nature of the study was repeated, and it was explained to them that they could withdraw from the study at any time without any consequences. They were asked for permission to record the interview, and it was made clear to them that any details that could lead to the disclosure of their identity would be excluded from the results. In addition, explicit mention was made of the possibility of consulting the rst author or having access to a psychologist from the Spanish Federation after participation in case the participants had any questions or needed professional support. All the aforementioned information was recorded on the informed consent form that was signed by all the participants. The interview was conducted following a phenomenological approach [24]. Phe- nomenological research uses qualitative and naturalistic approaches to inductively and holistically understand human experience in speci c contexts [25]. In this study, this concerned the development of athletes' EDs in the contexts of everyday life and sports. Whenever participants appeared to hold back or give noncommittal responses, probing and detail-oriented questions were asked to help identify in uences on their eating. Field notes were taken right after the interview. The protocol for this study was approved by the Ethics Committee of the Universidad Polit²cnica de Madrid. To ensure anonymity, speci c identifying details of participants and clubs were withheld. 2.4. Data Analysis Each of the audio-recorded interviews was transcribed by the principal investigator with the collaboration of two qualitative researchers external to the study onto a Word ® document. Thematic analysis method [26] was conducted to analyze the data. First, a super cial reading of the documents was carried out in order to become familiar with the data and to determine the recording units. Then, labelling was carried out with an open and inductive coding system, searching for the main themes emerging from the participants' discourse and locating all the recording units obtained. The total number of coded recording units was 1140. Themes initially set out were discussed, modi ed, and reorganized until stability was checked and a consensus was reached on all themes and
labelling was carried out with an open and inductive coding system, searching for the main themes emerging from the participants' discourse and locating all the recording units obtained. The total number of coded recording units was 1140. Themes initially set out were discussed, modi ed, and reorganized until stability was checked and a consensus was reached on all themes and dimensions. This process of triangulation, or convergent validation, was carried out in various meetings of the research team in order to guarantee the validity of the results and
Description
The research explores the psychological and behavioral effects of training conditions on female wrestlers.