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A systematic review, meta-analysis, and meta-regression of the prevalence of self-reported disordered eating and associated factors among athletes worldwide
Abstract
Background: The purpose of this meta-analysis was to provide a pooled prevalence estimate of self-reported disordered eating (SRDE) in athletes based on the available literature, and to identify risk factors for their occurrence. Methods: Across ten academic databases, an electronic search was conducted from inception to 7th January 2024. The proportion of athletes scoring at or above predetermined cutoffs on validated self-reporting screening measures was used to identify disordered eating (DE). Subgroup analysis per country, per culture, and per research measure were also conducted. Age, body mass index (BMI), and sex were considered as associated/correlated factors. Results: The mean prevalence of SRDE among 70,957 athletes in 177 studies (132 publications) was 19.23% (17.04%; 21.62%), I2 = 97.4%, τ 2 = 0.8990, Cochran's Q p value = 0. Australia had the highest percentage of SRDE athletes with a mean of 57.1% (36.0%-75.8%), while Iceland had the lowest, with a mean of 4.9% (1.2%-17.7%). The SRDE prevalence in Eastern countries was higher than in Western countries with 29.1% versus 18.5%. Anaerobic sports had almost double the prevalence of SRDE 37.9% (27.0%-50.2%) compared to aerobic sports 19.6% (15.2%-25%). Gymnastics sports had the highest SRDE prevalence rate, with 41.5% (30.4%-53.6%) while outdoor sports showed the lowest at 15.4% (11.6%-20.2%). Among various tools used to assess SRDE, the three-factor eating questionnaire yielded the highest SRDE rate 73.0% (60.1%-82.8%). Meta-regression analyses showed that female sex, older age, and higher BMI (all p < 0.01) are associated with higher prevalence rates of SRDE. Conclusion: The outcome of this review suggests that factors specific to the sport affect eating behaviors throughout an athlete's life. As a result, one in five athletes run the risk of developing an eating disorder. Culture-specific and sport-specific diagnostic tools need to be developed and increased attention paid to nutritional deficiencies in athletes.
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“Mostly, EDs rates were highest among female athletes compared to male athletes (143, 153).”
From Junior athletes’ nutritional demands: a narrative review of consumption and prevalence of eating disorders (2024) · cites this paper as [143]
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“a cutting-edge global meta-analysis review by Ghazzawi et al. (143), involving over 70,000 athletes of all ages, sport types, and levels of competition, reported that 19% (1 out of 5) athletes were engaged in DE behaviors such as self-induced vomiting, purging, excessive exercising, and dietary restrictions, especially in endurance, esthetic, and weight-dependent sports.”
From Junior athletes’ nutritional demands: a narrative review of consumption and prevalence of eating disorders (2024) · cites this paper as [143]
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Cited by
Amawi, A., Khataybeh, B., Al Aqaili, R., Ababneh, N., Alnimer, L., Qoqazeh, A., Oukal, F., Jahrami, H., Mousa Ay, K., Al Saoud, H., et al. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1390204 · Cited by 26
Self-citationJeppesen, J. S., Hellsten, Y., Melin, A. K., & Hansen, M. (2025) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/sms.70089 · Cited by 22
Metadata
- Authors
- Ghazzawi, H. A., Nimer, L. S., Haddad, A. J., Alhaj, O. A., Amawi, A. T., Pandi-Perumal, S. R., Trabelsi, K., Seeman, M. V., & Jahrami, H.
- Venue
- Journal of Eating Disorders
- Published
- 2024-02-07
- Volume
- 12
- Issue
- 1
- ISSN
- 2050-2974
- Cited by
- 64
- References
- 10
- Language
- en
- Licence
- creativecommons.org/licenses/by/4.0 (tdm)
- creativecommons.org/licenses/by/4.0 (vor)
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How to cite
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- This page
- CoChat. (2026). Citation check: A systematic review, meta-analysis, and meta-regression of the prevalence of self-reported disordered eating and associated factors among athletes worldwide. https://app.cochat.ai/papers/10.1186/s40337-024-00982-5
- The paper
- Ghazzawi, H. A., Nimer, L. S., Haddad, A. J., Alhaj, O. A., Amawi, A. T., Pandi-Perumal, S. R., Trabelsi, K., Seeman, M. V., & Jahrami, H. (2024). A systematic review, meta-analysis, and meta-regression of the prevalence of self-reported disordered eating and associated factors among athletes worldwide. Journal of Eating Disorders. https://doi.org/10.1186/s40337-024-00982-5
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.