Emotion Regulation and Eating Disorders in Sports: A Systematic Review

TL;DR

This review explores how emotion regulation strategies affect eating disorders in athletes, finding that adaptive strategies reduce risk while dysfunctional ones increase it.

Contribution

The study systematically examines the link between emotion regulation and eating disorders specifically in athletic populations.

Findings

Adaptive strategies like cognitive reappraisal are linked to lower eating disorder symptoms and body dissatisfaction.

Dysfunctional strategies such as emotional suppression are associated with higher ED risk and restrictive eating behaviors.

Emotional factors like anxiety and perfectionism increase vulnerability to EDs in sports with aesthetic or weight demands.

Abstract

Background: Emotion regulation refers to the processes through which individuals influence their emotional experiences, including how emotions are generated, experienced, and expressed. Difficulties in emotion regulation have been identified as a relevant factor in the development and maintenance of Eating Disorders (EDs). In the sports context, high physical and performance demands may intensify emotional challenges, potentially increasing vulnerability to eating disorder symptomatology among athletes. Objectives: This systematic review aimed to examine the relationship between emotion regulation and EDs in athletic populations, with a particular focus on emotion regulation strategies and related emotional processes. Methods: The PICO model was used, and PRISMA guidelines were followed. The Redalyc, Dialnet, SpringerLink, and PubMed databases were searched from inception to April 2025, with an update in November 2025. After the selection process, nine studies involving athletes from different disciplines and competitive levels were included. Methodological quality and risk of bias were assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists. Results: The findings indicate that adaptive emotion regulation strategies, such as Cognitive Reappraisal and emotional identification, are associated with lower levels of eating disorder symptomatology, body dissatisfaction, and greater resilience to sport-related pressures. In contrast, dysfunctional strategies, including expressive suppression, emotional unawareness, and difficulties in emotion management, were consistently associated with restrictive eating behaviors, bulimic symptomatology, excessive weight control, and increased ED risk. Additional emotional factors, including anxiety, perfectionism, low self-esteem, and body image dissatisfaction, were also related to higher vulnerability to EDs, particularly in sports with high aesthetic or weight-related demands. Conclusions: Emotional regulation is closely associated with ED risk in athletes. Adaptive emotion regulation strategies may serve as protective factors, whereas dysfunctional strategies are associated with increased risk.

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