Investigating coaches' recognition of symptoms of eating disorders in track athletes.

Objective: To determine the extent to which athletics coaches can identify evidence of an eating disorder in track athletes and what treatment advice they would provide. Methods: Vignettes depicting athletes portraying symptoms consistent with anorexia nervosa (AN) and bulimia nervosa (BN) were developed and used to survey 185 UK and Irish athletics coaches (and a community sample of 105 non-coaches) regarding their ability to recognise and respond to symptoms of an eating disorder. Results: Coaches were no more likely than the community sample to correctly identify an eating disorder but were more likely to suggest professional treatment for an athlete experiencing symptoms of AN (OR 1.82, 95% CI 1.02 to 3.29). For both eating disorders, higher levels of mental health literacy (AN: OR 1.06, 95% CI 1.02 to 1.11, BN: OR 1.08, 95% CI 1.04 to 1.14) and more years of coaching experience (AN: OR 1.12, 95% CI 1.03 to 1.24, BN: OR 1.07, 95% CI 1.01 to 1.16) also increased the likelihood of suggesting professional help. When considering the whole sample, participants were more likely to correctly identify an eating disorder (OR 4.67, 95% CI 2.66 to 8.20) and suggest professional treatment for AN than BN (OR 1.76, CI 1.04 to 2.97). Further, symptoms of AN were more likely to be correctly identified in female than male athletes (OR 2.26, 95% CI 1.28 to 4.06). Conclusions: Although coaches were more likely than community members to recommend professional treatment to an athlete exhibiting symptoms of an eating disorder, they were no more likely to correctly identify an eating disorder in the first instance. Further work is required to enhance coaches' capacity to identify symptoms of eating disorders to ensure athletes receive appropriate interventions.