ClinicalTrials.gg
CompletedNCT04135729Updated Jun 12, 2020

Mental Health in Fitness Instructors

An observational study in Mental Health Wellness 1, Depression, Anxiety and Eating Disorders, sponsored by Norwegian School of Sport Sciences. Completed at 1 site in Norway. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-06-12.

Sponsored by Norwegian School of Sport Sciences · Observational

Study type
Observational
Model
Cohort
Time perspective
Cross-sectional
Enrollment
304
Ages
18 Years and older
Sex
All
01

Study 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.

Read the detailed description

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.

02

Conditions studied

  • 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

Keywords

  • Mental health
  • Eating disorders
  • Depression
  • Anxiety
  • Body dissatisfaction
  • Body image
  • Thinness
  • Leanness
  • Muscularity
  • Compulsive exercise
  • Eating behavior
  • Dieting
  • Exercise
  • Sexual harassment
03

In context

Depression

8,577 studies on the registry are indexed under Depression; 1,720 are open to participants now.

This study's enrollment of 304 is above the median of 175 across 1,257 observational studies indexed under Depression.

Browse Depression studies →

Lead sponsor

Norwegian School of Sport Sciences is the lead sponsor of 46 studies on the registry; 6 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Sampling method
Probability sample

Study population

All operating fitness instructors working at fitness facilities/gym's in Norway during autumn 2019 are recruited by information in social media, by information given directly to CEO/administration of facilities listed by the cooperative in Norway, Virke Trening, and by information given directly to gym facilities identified by other means in Norway.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

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

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)
05

Study design

Observational model
Cohort
Time perspective
Cross-sectional
Enrollment
304 participants (actual)
Patient registry
No

Groups and cohorts

  • Personal trainer (PT)

    Cross-sectional study on mental health symptoms in personal trainers

  • Group instructors (GI)

    Cross-sectional study on mental health symptoms in group instructors

  • Combined instructors (PT + GI)

    Cross-sectional study on mental health symptoms in personal trainers

06

What researchers measure

Primary outcomes

  1. Body image

    Body image in fitness instructors (personal trainers and group instructors) by Body Appreciation Scale-2 (BAS-2). The scale comprises 10 items rated on a 5-point scale, ranging from 1 (Never) to 5 (Always), with higher total scoring indicating more positive body appreciation.

    Time frame: Autumn 2019

  2. Eating disorders

    Prevalence of eating disorders in fitness instructors (personal trainers and group instructors) by Eating disorders Examination questionnaire (EDE-q). The questionnaire has 6 items with open scorings reporting frequency of symptoms, and 22 items scored on a likert scale from 0-6 (no days - all days). The questionnaire has a total score and four subscales, with higher scorings (ranging from 0-6) indicative of higher severity.

    Time frame: Autumn 2019

Secondary outcomes

  1. Depression

    Symptoms of depression in fitness instructors (personal trainers and group instructors) by Beck Depression Inventory (BDI-1a). It consists of 21 items scored on a 4-point Likert scale ranging from 0 (not at all) to 3 (extreme). Total score range is 0-63, and a cutoff score of ≥21 is recommended for use to detect a clinically significant episode of major depression.

    Time frame: Autumn 2019

  2. Mental health symptoms

    Symptoms of mental health symptoms in fitness instructors (personal trainers and group instructors) by Symptom Check List (SCL-10). The 10-item questionnaire measures symptoms of anxiety and depression with a likert scale ranging from 0-4 (not at all - very much), with higher scoring meaning higher clinical severity.

    Time frame: Autumn 2019

  3. Drive for leanness

    Symptoms of drive for leanness in fitness instructors (personal trainers and group instructors) by Drive for Leanness scale. It constitutes 6 questions scored by a 6 point scale ranging from never (1) to always (6) with a possible total score 0-36, and in which higher score is indicative of greater investment in leanness.

    Time frame: Autumn 2019

  4. Drive for muscularity

    Symptoms of drive for muscularity in fitness instructors (personal trainers and group instructors) by Drive for Muscularity Scale. It constitutes seven questions scored on a 6 points scale ranging from (1) always to (6) never, uses a reversed coding in analysis, and has a total score of 15-90 (high score means higher DM).

    Time frame: Autumn 2019

  5. Compulsive Exercise

    Symptoms of compulsive exercise in fitness instructors (personal trainers and group instructors) by Compulsive exercise test (CET). CET is a 24-item instrument scored on a 5-point Likert scale (0 = never true, 5 = always true), and evaluated with five different subscale mean scores (avoidance and rule driven behaviour, weight control exercise, mood improvement, lack of exercise enjoyment, and exercise rigidity), and a global score summing the means of subscales (score range 0-30).

    Time frame: Autumn 2019

  6. Drive for thinness

    Symptoms of drive for thinness in fitness instructors (personal trainers and group instructors) by Drive for Thinness subscale (DT) of Eating Disorder Inventory (EDI-3). The subscales constitutes 7 of the totally 91 questions in the EDI-3, and is scored on a likert scale from 0-4, with higher scoring meaning higher clinical severity, and a suggested clinical cutoff of 14.

    Time frame: Autumn 2019

  7. Sexual harassment

    Experience of sexual harassment in professional work by fitness instructors (personal trainers and group instructors). This is screened by questions on experiences of harassment of different character (comments, characteristic bodily movements, or physical touch or abuse), and scored on a scale by alternatives; never, yes-by collegues, yes-by clients, yes-by leaders.

    Time frame: Autumn 2019

  8. Sociocultural Attitudes Towards Appearance Questionnaire

    Sociocultural Attitudes Towards Appearance in fitness instructors (personal trainers and group instructors). The questionnaire has subscales that assess internalization (general, athlete), pressures, and information, and is scored from 1-5 (def. disagree - def. agree), with higher scorings indicating higher clinical severity.

    Time frame: Autumn 2019

  9. Eating behavior

    Symptoms of eating behavior in fitness instructors (personal trainers and group instructors) by Three Factor Eating Questionnaire (TFE-q 21). TFE-q measures symptoms of cognitive restrictive eating (RE, 6 items), emotional eating (EE, 6 items), and uncontrolled eating (UE, 9 items). It constitutes 20 questions rating agreements to different assertions by score of 1-4, and one question rating agreement by 1-8 points. The total subscale scores may be presented as raw scores, or as transformed scores (scale 0-100), and higher scorings means higher clinical severity.

    Time frame: Autumn 2019

Other outcomes

  1. Body weight history

    Body weight history (i.e. body weight fluctuations) in fitness instructors, reported by selfreported minimum and maximum adult bodyweight.

    Time frame: Autumn 2019

  2. Dieting behavior

    Dieting behavior: questions on whether they aim to reduce og gain body weight, and by which methods (several choices), by what guidance (several choices), what frequency of meal intake per day, and whether they use supplements (and if so: which supplements).

    Time frame: Autumn 2019

  3. Diagnosis of eating disorder

    selfreported history of eating disorders by fitness instructors

    Time frame: Autumn 2019

  4. Experiences of body image idealization

    Personal experiences of body image idealization in professional career by fitness instructors. Do they experience body image idealization (yes/no), in what areas of professional work (by clients, by colleagues, by the work facility culture), does it affect them positively or negatively, do they recognize any preventive or awarness-raising work from the administration/workplace, is this procedure actually complied with.

    Time frame: Autumn 2019

  5. Social Media

    Use of, and experienced influence by, social media in fitness instructors. Selfreported use of social media (which social media), their motivation in doing so, and for what purposes/motivations social media is followed by oneself.

    Time frame: Autumn 2019

07

Study locations

1 site
  • Norwegian school of sport sciences
    Oslo, 0806, Norway
08

References and documents

Individual participant data

Plan to share: No — Data is held within the group of scientists, but sharing may be evaluated on request.

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 12, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04135729
Lead sponsor
Norwegian School of Sport Sciences
Collaborators
Ostfold University College, University College of Southeast Norway
Responsible party
Professor Jorunn Sundgot-Borgen (Professor, Norwegian School of Sport Sciences) — Principal investigator
First posted
Oct 23, 2019
Start date
Nov 1, 2019
Primary completion
Apr 30, 2020
Completion
May 30, 2020
Last update
Jun 12, 2020

Study contacts

Jorunn Sundgot-Borgen, PhD
principal investigator · Norwegian School of Sport Sciences

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jun 2020. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion