Table 1 Vulnerability factors and potential individual and systemic remedies

Vulnerability

Individual (therapy style, one on one intervention)

Systemic (system level adjustment)

Compulsiveness

Perspective taking, balanced life goals

Athletes as a person, not result-generating device

Single mindedness

Self-esteem work: winner vs. worthwhile, self-respecting person

Career transition (i.e. life after sport)

Risk aversion

Communicate the risk: health, legal, financial, social, psychological

Support independent research re toxicity of PE methods to established standard

Expediency

Value system, collaborative work

Replace prohibition with mandatory informed consent and supervision Incentives for fair play