Evidence suggests that disordered eating (DE) is a growing problem among adolescent athletes, with a negative impact on both physical and mental health. Additionally, DE can progress to eating disorders, which have the highest mortality rate of any mental illness. Multiple organizations—including the American College of Sports Medicine, the National Athletic Trainers Association, and the International Olympic Committee—have recommended regular screening for DE using a screening tool designed specifically for athletes. Unfortunately, there is currently no screening tool for DE in athletes that can be used for all genders, sports, ages, and levels of competition. With the goal of creating a brief screening tool that could be quickly and easily administered to a group of athletes or a single athlete, my colleagues and I developed the Disordered Eating Screen for Athletes (DESA-6), a 6-item screening tool designed to identify athletes of both genders at risk for DE.
We first tested the concept of the DESA-6 in a population of adult athletes at a local sports medicine clinic. After promising results in this early stage, we were able to conduct research to validate the DESA-6. Preliminary results were published in the Journal of the American Academy of Child & Adolescent Psychiatry. In Phase I, more than 300 high school athletes completed demographic questions, anthropometric questions, the DESA-6, and the Eating Attitudes Test (EAT-26). In Phase II of the study, athletes with positive EAT-26 and DESA-6 scores and a control group completed the Eating Disorder Examination. From this phase, we found the DESA-6 had a specificity of 87.5% and a sensitivity of 92%.
With only 6 questions, the DESA-6 takes less than 1 minute to complete and less than 1 minute to score. As a brief screening tool, the DESA-6 could be given prior to a sports physical or by an athletic trainer or other health professional to screen a single athlete or an entire team. Early identification of DE or eating disorders facilitates early intervention, which leads to improved treatment rates. My research team and I plan to continue to validate the DESA-6 in additional athlete populations.
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