mental health in fitness instructors

Conditions: Mental Health Wellness 1; Depression, Anxiety; Eating Disorders; Eating Behavior; Body Image; Sexual Harassment; Exercise Addiction; Weight Change, Body; Weight Loss; Weight Gain; Leanness; Amenorrhea; Dietary Habits; Body Image Disturbance; Thinness

Summary: the aim of this project is to improve the evidence-base regarding lifestyle and mental health symptoms among fitness instructors. a national cohort of fitness instructors will be invited to participate in this study by responding to an online questionnaire. the questionnaire will consist of items regarding exercise, nutrition, eating disorders, the menstrual cycle, depression, anxiety, body dissatisfaction and satisfaction, drive for muscularity and leanness, and experiences of sexual harassment. findings from this study will provide an evidence-base for initiatives to improve/optimize mental health among fitness instructors, and also in the process of developing fitness centres to a core partner in public health and health promotion work.

previous research has shown that prevalence of self-reported eating disorders vary from 5-40% among group fitness instructors. most of these studies were conducted more than 10 years ago, hence the potential impact of social media on the fitness instructors' body image and mental health symptoms has therefore not been taken into account. recent studies reveal that social media is a significant contributor for perceived body image and for eating and exercise-related disturbances. a more recent norwegian study from 2015 found a prevalence of self-reported eating disorders of 4.8% and 4.3% among female and male group fitness instructors, respectively. however, major limitations with this previous study was the low sample size (n=107), few men included, not being national representative (i.e. only recruiting from a smaller geographical area), and the lack of instruments assessing body awareness of muscularity and leanness instead of thinness. the fitness industry has great potential as a public health collaborator, and to improve physical activity level and public health status. however, this potential can be flawed by instructors complying with a culture idealizing unhealthy attitudes, motivation and behaviour with regards to nutrition, exercise and body image. this is a culture also potentially being underlined by the new exercise concepts and titles brought forward by the fitness industry, emphasizing body ideals and appearance, and body weight control. an additional concern to the mental health of fitness instructors, are the increase in reports of sexual harassment. the high prevalence of perceived negative body image and disordered eating among fitness instructors, reports of sexual harassment, and the focus on appearance and control of body shape in the fitness industry, causes concern for the mental health of the employees (i.e. fitness instructors). hence, this cohort study aims to map the prevalence of mental health symptoms in a national cohort of fitness instructors.

Eligibility criteria:
inclusion criteria: * operating as a fitness instructor (personal trainer or group instructor) during autumn 2019 * age above 18 years * living and operating in norway * understanding and communicating with norwegian language exclusion criteria: * not engaged as a fitness instructor at recruitment time (autumn 2019) * age below 18 years of age * not living and/or operating in norway * only speaking/communicating in foreign language (i.e. not norwegian language)

Keywords: mental health eating disorders depression anxiety body dissatisfaction body image thinness leanness muscularity compulsive exercise eating behavior dieting exercise sexual harassment