Table 1 Comparison of DE prevalence between Lean vs Non-Lean sports

Rousselet et al., 2017 [27]

High level French athletes over the age of 12 (n = 340)

Lean vs Non-lean

Positive result was measured as one or more positive assessment after three consecutive clinical interviews performed by healthcare professionals. Multivariate analysis used to detect difference between groups.

Lean sport athletes had a significantly higher prevalence of clinician-detected DE (p < 0.01)

Strong correlation between lean sports and increased prevalence of DE

Wells et al., 2015 [28]

United States Division I female college athletes (n = 83)

Lean Sports: cheerleading, cross country/track, swimming, volleyball

Non-lean Sports: basketball, softball, swimming, golf

Athletes were administered the ATHLETE questionnaire. Results were then analyzed using one-way ANOVA.

No statistically significant difference between individual sports, but when grouped into Lean vs No-Lean, lean sports had a higher prevalence of DE

Positive correlation between lean sports and increased prevalence of DE

Martinsen et al., 2010 [8]

Norwegian first year elite sport high school athletes (n = 606) and control high schools students (n = 355)

Lean vs Non-lean

Athletes were administered a questionnaire measuring subscales from the Eating Disorders Inventory (EDI). Leanness results detected using regression analysis.

Higher prevalence of DE was found in female athletes of lean sports when compared to boys in lean sports p < 0.001, but not across sport groups

Lean sports correlated with higher prevalence of DE, however, the author included a wide range of non-traditional sports classified as a lean sport which may not have been an appropriate fit

Torstveit et al., 2008 [3]

National athletes of junior or senior level (n = 186) and a control sample (n = 145)

Lean vs Non-lean

Athletes screened positive if had a positive screen using the EDI-DT or EDI-BD. Results detected using t-test and X² analysis.

Lean athletes (47.7% positive) were found to have significantly higher prevalence of DE than Non-lean athletes (19.8% positive) and controls (21.4% positive) p < 0.001

Lean sports strongly correlated with higher prevalence of DE

Vardar et al., 2007 [29]

Turkish female athletes with a mean age of 19.59 (n = 243)

Lean (n = 72) vs Non-lean (168)

Athletes were administered the EAT-40 questionnaire. Results were then analyzed using t-test and X² analysis.

No statistically significant difference found in prevalence of DE in lean vs non-lean sports

No correlation between lean sports and higher prevalence of DE

Rosendahl et al., 2009 [30]

German athletes (n = 576) and non-athletes aged 14–18 (n = 291)

Lean (n = 228) vs Non-lean (n = 245)

Endurance, Aesthetic, Weight dependent, Antigravitation, Technical, Ball Game, Power

Athletes were administered the EAT-26 questionnaire. Results were then analyzed using logistic regression, unpaired t-test and X² analysis.

Lean sports had a higher prevalence of DE in males and no significant difference in females.

The only sport types with significant increase in prevalence of DE were “Antigravitation” when comparing males and “Power” when comparing females.

Lean sports correlated with higher prevalence of DE in males

Kong et al., 2015 [15]

Australian female athletes aged 17 to 30 years regularly participating in sports. (n = 320)

Lean (n = 174) vs Non-lean (146)

Athletes were administered the EAT-26 questionnaire. Results were then analyzed using ANOVA.

Lean athletes scored higher on the EAT-26 than non-lean athletes

Higher prevalence of DE among lean athletes

Of note, 60.9% of the lean group competed in aesthetic sports, thus those athletes could have a larger effect on the sample