Eating disorder and menstrual dysfunction screening, education, and treatment programs

To describe the nature, scope, and perceived effectiveness of selected National Collegiate Athletic Association (NCAA) Division 1 programs for the screening, education, and treatment of eating disorders (ED) and menstrual dysfunction (MD).

Surveys were mailed to the team physician or the head athletic trainer of all NCAA Division 1 schools currently supporting at least two of the following women's sports: cross-country/track, swimming, and gymnastics. The survey contained closed- and open-ended questions to ascertain the types of ED and MD screening, education, and treatment programs and their perceived effectiveness.

A total of 170 surveys were sent, and 81% were returned. Although 79% of schools reported screening for MD, only 24% used a comprehensive menstrual history questionnaire. An MD treatment protocol was used by 33% of schools, and 7% reported withholding those with MD from athletic participation. Screening for ED was reported by 60% of schools, but less than 6% used a structured interview or a validated ED questionnaire. Athletes with confirmed ED were withheld from athletic participation by 21% of the schools; athletes with suspected ED were withheld by 9%. Education about ED and MD was made available to athletes by 73% of the schools, and 61% of the schools made this education available to coaches. However, less than 41% of schools made such education a requirement. Thirty-five percent of respondents perceived their MD screening programs to be successful or very successful, compared with 26% for ED screening programs.

These results indicate a pressing need for more standardized ED and MD screening, prevention, and treatment programs among NCAA Division 1 schools. At the very least, all NCAA-member institutions should implement mandatory ED and MD education for all athletes and athletic personnel.