Table 4

A nutrition assessment of the athlete with possible DE includes information on a range of issues

  • Current eating patterns

  • Eating behaviour history

  • Special diets followed, particularly if the diet involves avoidance of certain foods and/or if the range of foods to be avoided has increased over time

  • Specific food restrictions in place, whether for medical or for personal reasons

  • Food rules and beliefs

  • Flexibility or rigidity around food or nutrient intake

  • Current and past nutritional supplement use

  • Social interaction with food and meals (any isolation or withdrawing)

  • Compensatory behaviours (eg, vomiting, laxative use, diet pills, etc.)

  • Pathogenic weight control practices

  • Adequacy of current dietary intake including overall energy, macronutrients and micronutrients

  • Current and past history of weight and body composition (are these stable or do they fluctuate)

  • Active pursuit of changes in body composition, including the time course and methods of achieving these changes

  • Training load and phase

  • Food security

  • Review of biochemistry, haematological and hormonal profiles

  • Food allergies and intolerances

  • Menstrual history, current menstrual pattern

  • Bone health

  • Injury/illness patterns

  • Medication (including combined contraceptive pill)

  • Gastrointestinal complications

  • Family history of dieting, eating disorders, mental health issues, relationship with food

  • EA assessment (with various methods including RMR and DXA body composition for FFM)

  • Food and eating attitudes

  • Current and past relationship with food and body

  • Amount of time spent thinking about food, weight and body image

  • Body image, past and present (considering both athlete and general population body image)

  • Mental health comorbidities (depression, anxiety, personality disorders, substance abuse, self-harm and suicidal ideation)

  • DE, disordered eating; DXA, dual-energy X-ray absorptiometry; RMR, resting metabolic rate.