Editorial Type: research-article
 | 
Online Publication Date: 22 Sept 2025

Health-Related Quality of Life in Adolescent Athletes: Correlations with Energy Availability, Disordered Eating, and Compulsive Exercise Behaviors

MD,
BS,
BA,
MD,
MS, RDN,
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PhD
Article Category: Research Article
DOI: 10.4085/1062-6050-0016.25
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Abstract

Context:

Low energy availability, disordered eating, and/or compulsive exercise behaviors may negatively impact health-related quality of life (HRQOL), and this has not been studied specifically in adolescent athletes.

Objective:

Assess the correlations of HRQOL with energy availability, disordered eating, and compulsive exercise in adolescent athletes.

Design:

Cross-sectional

Setting:

A single sports medicine center and local athletic partnerships

Participants:

13-18-year-old male and female athletes who were actively engaged in at least one organized sports team at the time of study participation

Main Outcome Measures:

Participants completed the Pediatric Quality of Life Inventory (PedsQL), the Eating Disorder Examination Questionnaire (EDE-Q), the Compulsive Exercise Test (CET), and seven days of exercise monitoring (via wrist-worn heart rate activity monitor) and dietary intake reporting to assess energy availability.

Results:

Sixty-four participants (n=39 female, mean age=15.5±1.5 years) completed the study. There were no significant associations between energy availability (β= −0.07, 95% CI= −0.32, 0.19, p= 0.56) or CET scores (β= −0.28, 95% CI= −1.28, 0.72, p= 0.58) and PedsQL scores, but there was a significant association between EDE-Q scores (β= −4.78, 95% CI= −8.53, −0.76, p=0 0.01) and PedsQL scores, after adjusting for participant sex. We observed a significant association between female sex and lower PedsQL scores (β= −6.43, 95% CI= −12.1, −0.76, p=0.03).

Conclusion:

Adolescent athletes who reported more significant disordered eating behaviors demonstrated worse HRQOL. Female athletes reported worse HRQOL overall compared to the male athletes. This highlights the importance of screening and early intervention for disordered eating behaviors to prevent the potential negative impact on HRQOL, as well as the consideration of sex-specific differences regarding HRQOL in adolescent athletes.

Contributor Notes

Corresponding Author: Aubrey Armento, MD. Sports Medicine Center, Children's Hospital Colorado; Department of Orthopedics, University of Colorado School of Medicine. Address: 13123 E. 16th Avenue, B060 Aurora, CO 80045. Email: Aubrey.Armento@childrenscolorado.org.
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