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Cultural and environmental associations with body image, diet and well-being in NCAA DI female distance runners: a qualitative analysis
  1. Traci Lyn Carson1,
  2. Troy Tournat1,
  3. Kendrin Sonneville2,
  4. Ronald F Zernicke3,
  5. Carrie Karvonen-Gutierrez1
  1. 1 Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
  2. 2 Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
  3. 3 School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Ms Traci Lyn Carson, University of Michigan School of Public Health, Ann Arbor, Michigan, USA; tlcars{at}


Objective We aimed to describe current and former National Collegiate Athletic Association (NCAA) Division One (DI) female distance runners’ experiences of perceived norms of body image and disordered eating in their sport, as well as the emergence and influence of coach–athlete power dynamics.

This manuscript reports a qualitative research study (consisting of interviews and thematic analysis) of women athletes’ experiences of perceived norms of body image and disordered eating in their sport. We also report athletes’ experiences of coach–athlete power dynamics.

Methods The study sample included 29 current and former female NCAA DI female distance runners, defined as competing in 800-metre distance or greater. Interviews were conducted, audio-recorded and hand transcribed. A thematic analysis was performed and presented.

Results Two major themes emerged: (1) sport body ideals and body image norms and myths that exist in the sport, and (2) the power dynamic between athletes and coaches. It is not clear whether sport body ideals and culture of running influences coaching culture, or whether the coaches—who maintain positions of power in the sport—perpetuate the culture. These themes likely feed into each other and reinforce the existing and dominant mentalities of the sport.

Conclusion Sport body image ideals and the power dynamic between coach and athlete may contribute to female athlete’s risk of disordered eating and body image disturbance. We call for the NCAA and athletic departments to develop and implement prevention and intervention programmes to prevent eating and body image disorders in this high-risk population.

  • eating disorder
  • female athlete triad
  • running
  • women in sport
  • qualitative

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  • Contributors The first author, TC, completed all data collection and the majority of writing of this manuscript. All coauthors contributed substantially to the conception and design of the study, provided important revisions and approved the manuscript. All authors understand that they are accountable for all aspects of the work and ensure the accuracy or integrity of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the University of Michigan Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Please contact Traci Carson ( for inquiries about this qualitative dataset.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.