Allison Smith

Date of Award

Spring 2021

Document Type

Open Access Dissertation


Exercise Science

First Advisor

Toni M. Torres-McGehee


The sport of cheerleading has grown immensely over the recent decades. The current sport requires full body athletic abilities like gymnastics, ballet, and swimming and diving. These sports have previously reported high rates of eating disorder (ED) risk, body image dissatisfaction, and Female Athlete Triad (Triad) components (low energy availability with or without and eating disorder, menstrual cycle dysfunction, and low bone mineral density). Scientific research examining these factors within cheerleaders has been limited. The purpose of this study was to examine overall ED risk across cheerleading team type (All-Star, college), squad type (all-girl, coed), and by position (flyer, base, back spot). A secondary purpose was to determine differences between clothing type (daily clothing, midriff uniform, full-length uniform) and self-perceptions for perceived body image (PBI) and desired body image (DBI), and the perceptions from their meta-perceptions (peers, parents, coaches). The final purpose was to examine individual and combined Triad components within a sample of college cheerleaders. ED risk was assessed through an online survey which included the Eating Attitudes Test-26, and supplemental pathogenic behavior questions. Body image for self-perceptions and meta-perceptions were assessed through the Sex-Specific Figural Stimuli Silhouettes. Triad components were assessed through an in person measures which included anthropometric measurements, health history questionnaire, resting metabolic rate, the Eating Disorder Inventory (EDI-3), the EDI-3 symptom checklist, blood sample, DXA scan, and a 7 day dietary and exercise log. The results of the study indicated significant differences were found between team type for age (All-Star: 16.0±2.4 vs. college: 19.8±1.3 years; p ≤ .001) with 34.4% overall being at risk for and ED. Body image perceptions were different across different clothing types in cheerleaders, F(2.301, 586.879)=126.784, p < 0.0001 η2=.332. Body image perceptions showed statistically significant differences across meta-perceptions F(3.397, 550.346)=19.110, p < 0.001, η2=.106). Overall, 47.7% presented with one Triad component, 52.6% demonstrated two Triad components using self-reported menstrual data, and 10.5% demonstrated two Triad components using hormonal assessments. All cheerleaders demonstrated LEA for days they participated in cheerleading practice (n=3 days), 52.6% demonstrated LEA with the risk of ED, and 47.4% demonstrated LEA with no risk of ED, 52.6% self-reported menstrual dysfunction, 14% experienced menstrual dysfunction via hormonal assessment, and 0% demonstrated low BMD. Cheerleaders are at risk for EDs, BID, and multiple Triad components. There is a need for increased education surrounding the topic of overall health and well-being for cheerleaders of all ages.


© 2021, Allison Smith