Abstract
BACKGROUND: Eating disorders and low energy availability independently and negatively impact eating behaviors and attitudes and overall health. Screening provides early identification of athletes suffering from these conditions, yet few studies have evaluated both simultaneously, and none have investigated eating disorder and low energy availability in the context of sex or sport type. This study determined the prevalence of eating disorder and low energy availability risk in collegiate athletes at a large National Collegiate Athletic Association (NCAA) Division 1 university and the variation of prevalence by sport, sport type, and sex. METHODS: This cross-sectional study of NCAA Division 1 athletes used a self-administered survey to collect demographic data and assessed risk using the Eating Disorder Screen for Athletes, Low Energy Availability in Females Questionnaire, and Low Energy Availability in Males Questionnaire. Variations in prevalence were assessed using chi-square tests and variations in mean screening tool scores were assessed using t-tests and ANOVA. Significance was set at p < 0.05. RESULTS: Out of 220 athletes (76 males, 144 females) across 19 sports, 38.18% were at risk for an eating disorder and 47.17% were at risk for low energy availability, while 22.73% were at risk for both conditions. Females had a higher distribution of positive screens for an eating disorder (p = 0.002) and low energy availability (p < 0.001) than males. Aesthetic sport athletes had the highest proportion of eating disorder risk (p = 0.016)-but low energy availability (p = 0.871) did not vary by sport type. Dance team athletes had the highest prevalence of eating disorder risk by sport (p < 0.001), while women's gymnasts had the highest prevalence of low energy availability risk (p < 0.001) by sport. CONCLUSIONS: A high percentage of athletes were at risk for an eating disorder and low energy availability. Screening protocols can identify eating disorders and low energy availability earlier, leading to quicker treatment and prevention of severe consequences.