A systematic review, meta-analysis, and meta-regression of the prevalence of self-reported disordered eating and associated factors among athletes worldwide

Ghazzawi, Hadeel A.; Nimer, Lana S.; Haddad, Areen Jamal; Alhaj, Omar A.; Amawi, Adam T.; Pandi-Perumal, Seithikurippu R.; Trabelsi, Khaled; Seeman, Mary V.; Jahrami, Haitham

doi:10.1186/s40337-024-00982-5

Journal of Eating Disorders

Table 1 Characteristics of the studies involved in the systematic review and meta-analysis about the prevalence of disordered eating in Athletes

From: A systematic review, meta-analysis, and meta-regression of the prevalence of self-reported disordered eating and associated factors among athletes worldwide

SN	REF	Study	Country	Sample Characteristics	Design	Measure
1	[59]	Abbott et al., 2021	Multiple	Female sex = 30.8%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
2	[46]	Akesdotter et al., 2022	Sweden	Female sex = 68%; mean age 23.5 years; mean BMI NR Kg/m²	Cohort study	RD
3	[48]	Al-Jumayan et al., 2021	Saudi Arabia	Female sex = 48.9%; mean age 31 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
4	[60]	Alwan et al., 2022	UK	Female sex = 100%; mean age 29 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
5	[61]	Anderson and Petrie 2012	USA	Female sex = 100%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	QEDD
6	[62]	Armento et al., 2023	Colorado	Female sex = 70%; mean age 40.9 years; mean BMI 22.8 kg/m²	Cross-sectional study	EDEQ
7	[63]	Barrack et al., 2008	USA	Female sex = 100%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	EDEQ
8	[64]	Barrack et al., b 2023	USA	Female sex = 100%; mean age 15.7 years; mean BMI 22.0 kg/m²	Cross-sectional study	EDEQ
9	[65]	Beals and Hill, 2006	USA	Female sex = 100%; mean age 19.5 years; mean BMI 22.9 kg/m²	Cross-sectional study	EDEQ
10	[66]	Beals and Manore 2002	USA	Female sex = 100%; mean age 19 years; mean BMI 22.5 kg/m²	Cross-sectional study	M1 = EAT-26 M2 = EDI-3
11	[67]	Beals, 2002	USA	Female sex = 100%; mean age 15.8 years; mean BMI 22.2 kg/m²	Cross-sectional study	EDI
12	[68]	Beekley et al., 2009	USA	Female sex = 14%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
13	[69]	Borgelt and Burmeister 2022	USA	Female sex = 100%; mean age 22 years; mean BMI 23.26 kg/m²	Cross-sectional study	EAT-26
14	[70]	Borowiec et al., b 2023	Poland	Female sex = NR%; mean age 23.2 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
15	[71]	Brook et al., a 2019	Multiple	Female sex = 42.3%; mean age 31.7 years; mean BMI NR Kg/m²	Cohort study T1 & T2	EDEQ
16	[47]	Brown et al., 2014	USA	Female sex = 100%; mean age 22 years; mean BMI 20.88 kg/m²	Cross-sectional study	RD
17	[72]	Brown et al., 2020	USA	Female sex = 100%; mean age 20.15 years; mean BMI 23.29 kg/m²	Cohort study	EAT-26
18	[73]	Burrows et al., 2007	Canada	Female sex = 100%; mean age 31.1 years; mean BMI NR Kg/m²	Cross-sectional study	SIAB-S
19	[74]	Byrne and McLean 2002	Australia	Female sex = 59%; mean age 19.55 years; mean BMI 21.25 kg/m²	Cross-sectional study	EDI-2
20	[75]	Carvalhais et al., 2019	Portugal	Female sex = 100%; mean age 20.8 years; mean BMI NR Kg/m²	Cross-sectional study	EDEQ
21	[76]	Chatterton and Petrie 2013	USA	Female sex = 0%; mean age 19.9 years; mean BMI 24.3 kg/m²	Cross-sectional study	QEDD
22	[77]	Checa Olmos et al., b 2023	Spain	Female sex = 35.9%; mean age 14.1 years; mean BMI NR Kg/m²		SCOFF
23	[78]	Cobb et al., 2003	USA	Female sex = 100%; mean age 21.75 years; mean BMI 21.35 kg/m²	Cross-sectional study	EDI
24	[79]	Coelho et al., a 2013	Brazil	Female sex = 100%; mean age 14.77 years; mean BMI NR Kg/m²	Cross-sectional study	M1 = EAT-26 M2 = BITE M3 = BSQ
25	[80]	Cox et al., 1997	USA	Female sex = 92%; mean age 19.3 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
26	[81]	De Borja et al., a 2021	USA	Female sex = 100%; mean age 19.8 years; mean BMI 22.86 kg/m²	Cross-sectional study	M1 = BEDA-Q M2 = RD M3 = ESP
27	[82]	Dervish et al., b 2023	USA	Female sex = 100%; mean age NR years; mean BMI NR Kg/m²	Cross-sectional study	FAST
28	[83]	Devrim et al., 2018	Turkey	Female sex = 0%; mean age 28.25 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-40
29	[84]	Doyle-Lucas et al., 2010	USA	Female sex = 100%; mean age 24.3 years; mean BMI 18.9 kg/m²	Cross-sectional study	EAT-26
30	[85]	Escobar-Molina et al., 2015	Spain	Female sex = 46%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-40
31	[86]	Ferrand and Brunet 2004	France	Female sex = 0%; mean age 21.8 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
32	[87]	Filaire et al., 2011	France	Female sex = 50%; mean age 19.5 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
33	[88]	Flatt et al., 2021	Multiple	Female sex = 92%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	RD
34	[22]	Fortes et al., 2014	Brazil	Female sex = 20%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
35	[20]	Ghazzawi et al., 2022	Jordan	Female sex = 41%; mean age 31 years; mean BMI 25 kg/m²	Cross-sectional study	EAT-26
36	[89]	Gibson et al., 2019	New Zealand	Female sex = 0%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	EDI-3
37	[1]	Giel et al., 2016	German	Female sex = 44%; mean age 16.3 years; mean BMI NR Kg/m²	Cross-sectional study	SCOFF
38	[90]	Glotz et al., a 2013	Brazil	Female sex = 0%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	M1 = EAT-26 M2 = BITE
39	[91]	Godoy-Izquierdo and Díaz 2021	Spain	Female sex = 100%; mean age 20.9 years; mean BMI 23.1 kg/m²	Cross-sectional study	EAT-26
40	[92]	Gouttebarge and Kerkhoffs, a 2017	Multiple	Female sex = 0%; mean age 22 years; mean BMI NR Kg/m²	Cohort study	RD
41	[93]	Gouttebarge et al., 2017	Multiple	Female sex = 64%; mean age 27.3 years; mean BMI NR Kg/m²	Cross-sectional study	RD
42	[94]	Gouttebarge et al., 2017	Multiple	Female sex = 50%; mean age 33 years; mean BMI NR Kg/m²	Cohort study	RD
43	[95]	Greenleaf et al., 2009	USA	Female sex = 100%; mean age 20 years; mean BMI 23 kg/m²	Cross-sectional study	QEDD
44	[53]	Gullivera et al., 2015	Australia	Female sex = 53%; mean age 24.9 years; mean BMI NR Kg/m²	Cross-sectional study	SCOFF
45	[96]	Hauck et al., 2020	German	Female sex = 56.4%; mean age 36.44 years; mean BMI 22.83 kg/m²	Cross-sectional study	EDDS
46	[97]	Hoch et al., 2011	USA	Female sex = 100%; mean age 23.2 years; mean BMI 19 kg/m²	Cohort study	EDEQ
47	[98]	Hoch et al., 2009	USA	Female sex = 100%; mean age 16.5 years; mean BMI 21.6 kg/m²	Cross-sectional study	EAT-26
48	[99]	Hopkinson and Lock, a 2004	USA	Female sex = 48%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	M1 = EAT-26 M2 = EDEQ
49	[100]	Hulley and Hill 2001	UK	Female sex = 100%; mean age 28.5 years; mean BMI 21.05 kg/m²	Cross-sectional study	EDEQ
50	[101]	Janout and Janoutová c 2004	Czech Republic	Female sex = 100%; mean age 22 years; mean BMI 18 kg/m²	Cross-sectional study	EAT-26
51	[102]	Joubert et al., 2022	USA	Female sex = 100%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	RD
52	[103]	Joubert et al., 2020	Multiple	Female sex = 23.1%; mean age 32.5 years; mean BMI 22.4 kg/m²	Cross-sectional study	EAT-26
53	[104]	Junge and Hauschild 2023	German	Female sex = 55.8%; mean age NR years; mean BMI NR Kg/m²	Cross-sectional study	EDE-QS
54	[105]	Kampouri et al., 2019	Greece	Female sex = 100%; mean age 23.66 years; mean BMI 22.07 kg/m²	Cross-sectional study	EDEQ
55	[106]	Karlson et al., 2001	USA	Female sex = 100%; mean age 19.89 years; mean BMI 20.21 kg/m²	Cross-sectional study	EDEQ
56	[107]	Karlsson et al., 2023	Sweden	Female sex = 100%; mean age 32.4 years; mean BMI NR Kg/m²	Cross-sectional study	EDEQ
57	[108]	Kennedy et al., 2017	USA	Female sex = 52.11%; mean age 40.3 years; mean BMI 23.7 kg/m²	Cross-sectional study	EAT-26
58	[109]	Kristjánsdóttir et al., a 2019	Iceland	Female sex = 68.9%; mean age 24.8 years; mean BMI NR Kg/m²	Cross-sectional study	M1 = EDEQ M2 = BULIT-R
59	[110]	Lauder et al., 1999	USA	Female sex = 100%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	EDI
60	[111]	Lauder et al., 1999	USA	Female sex = 100%; mean age 27.5 years; mean BMI 23.5 kg/m²	Cross-sectional study	EDI
61	[56]	Lichtenstein et al., 2021	Denmark	Female sex = 51%; mean age 19.3 years; mean BMI 21.55 kg/m²	Cross-sectional study	SCOFF
62	[112]	Marshall and Harber 1996	Canada	Female sex = 100%; mean age 20.8 years; mean BMI 23.5 kg/m²	Cross-sectional study	EDI
63	[113]	Martínez Rodríguez et al., 2015	Spain	Female sex = 35%; mean age 20.9 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
64	[114]	Martinovic et al., 2022	China	Female sex = 45%; mean age 24.2 years; mean BMI 24.2 kg/m²	Cross-sectional study	ORTO-15
65	[115]	McLester et al., 2014	Multiple	Female sex = 100%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	EDI-2
66	[116]	Meng et al., b 2020	China	Female sex = 100%; mean age 20 years; mean BMI 18.6 kg/m²	Cross-sectional study	EDI-3
67	[117]	Michaels et al., 2023	USA	Female sex = 92.9%; mean age NR years; mean BMI NR Kg/m²	Cross-sectional study	RD
68	[118]	Monthuy-Blanc et al., a 2010	France	Female sex = 100%; mean age 14.1 years; mean BMI 19.3 kg/m²	Cross-sectional study	EDI-3
69	[54]	Muros et al., b 2020	Spain	Female sex = 15.5%; mean age 34.54 years; mean BMI 22.85 kg/m²	Cross-sectional study	SCOFF
70	[43]	Neves et al., a 2017	Brazil	Female sex = 100%; mean age 13.1 years; mean BMI NR Kg/m²	Cohort study T1& T2 & T3	EAT-26
71	[119]	Nichols et al., 2006	Multiple	Female sex = 100%; mean age 15.7 years; mean BMI 21.8 kg/m²	Cross-sectional study	EDEQ
72	[120]	Nieves et al., 2016	USA	Female sex = 100%; mean age 18.4 years; mean BMI 22.8 kg/m²	Cohort study	EDI
73	[121]	O'Connell et al., 2024	Canada	Female sex = 66.1%; mean age 20.1 years; mean BMI NR Kg/m²	Cross-sectional study	DESA-6
74	[122]	O'Connor et al., 1995	Georgia	Female sex = 100%; mean age 19.8 years; mean BMI NR Kg/m²	Cross-sectional study	EDI-2
75	[42]	Okano et al., c 2004	Multiple	Female sex = 100%; mean age 22 years; mean BMI 20.8 kg/m²	Cross-sectional study	EAT-26
76	[123]	O'Leary et al., b 2023	UK	Female sex = 100%; mean age NR years; mean BMI NR Kg/m²	Cross-sectional study	M1 = BEDA-Q M2 = FAST
77	[124]	Pallotto et al., 2022	USA	Female sex = 100%; mean age 19.9 years; mean BMI 22.4 kg/m²	Cross-sectional study	EAT-26
78	[125]	Peklaj et al., 2022	Slovenia	Female sex = 51%; mean age 22 years; mean BMI 21.6 kg/m²	Cross-sectional study	RD
79	[126]	Pensgaard et al., 2021	Norway	Female sex = 40%; mean age 26.86 years; mean BMI NR Kg/m²	Cross-sectional study	EDEQ
80	[127]	Pernick et al., 2006	USA	Female sex = 100%; mean age 15.7 years; mean BMI NR Kg/m²	Cross-sectional study	EDEQ
81	[15]	Petisco-Rodríguez et al., a 2020	Spain	Female sex = 100%; mean age 17.29 years; mean BMI 20.59 kg/m²	Cross-sectional study	M1 = EAT-40 M2 = SCOFF
82	[128]	Petrie et al., 2009	USA	Female sex = 100%; mean age 19.7 years; mean BMI 22.6 kg/m²	Cross-sectional study	QEDD
83	[129]	Pettersen et al., c 2016	Norway	Female sex = 100%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	EDI-2
84	[130]	Poucher et al., d 2022	Canada	Female sex = 50%; mean age 22 years; mean BMI NR Kg/m²	Cohort study	EAT-26
85	[131]	Prather et al., 2016	USA	Female sex = 100%; mean age 16.4 years; mean BMI 20.8 kg/m²	Cross-sectional study	EAT-26
86	[132]	Pritchett et al., 2021	Multiple	Female sex = 50%; mean age 27 years; mean BMI NR Kg/m²	Cross-sectional study	EDEQ
87	[133]	Rauh et al., 2010	USA	Female sex = 100%; mean age 15.7 years; mean BMI 21.7 kg/m²	Cohort study	EDEQ
88	[134]	Ravaldi et al., b 2003	Italy	Female sex = 0%; mean age 19.6 years; mean BMI 22.1 kg/m²	Cross-sectional study	EDE-12
89	[135]	Ravi et al., 2021	Finland	Female sex = 100%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	RD
90	[136]	Reinking and Alexander, b 2005	USA	Female sex = 100%; mean age 19.8 years; mean BMI NR Kg/m²	Cross-sectional study	EDI-2
91	[137]	Reinking, 2006	USA	Female sex = 100%; mean age 19.3 years; mean BMI 22.9 kg/m²	Cohort study	FAST
92	[138]	Riebl et al., 2007	USA	Female sex = 0%; mean age 31.6 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
93	[52]	Robbeson et al., b 2015	USA	Female sex = 100%; mean age 19 years; mean BMI 21.2 kg/m²	Cross-sectional study	TFEQ
94	[139]	Roberts and Kreipe 2003	USA	Female sex = 100%; mean age 14.9 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
95	[55]	Rogers et al., 2021	Australia	Female sex = 100%; mean age 19 years; mean BMI NR Kg/m²	Cross-sectional study	SCOFF
96	[31]	Rosendahl et al., 2009	German	Female sex = 36.5%; mean age 15.7 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
97	[140]	Rousselet et al., 2017	France	Female sex = 37.3%; mean age 16.8 years; mean BMI NR Kg/m²	Cross-sectional study	EDI
98	[141]	Rouveix et al., 2007	France	Female sex = 50%; mean age 22 years; mean BMI 21 kg/m²	Cross-sectional study	EAT-26
99	[142]	Schtscherbyna et al., a 2009	Brazil	Female sex = 100%; mean age 14.6 years; mean BMI NR Kg/m²	Cross-sectional study	M1 = EAT-26 M2 = BITE M3 = BSQ
100	[143]	Sharps et al., a 2022	UK	Female sex = 100%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	M1 = FAST
101	[144]	Smith et al., 2020	Multiple	Female sex = 26.5%; mean age 20 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
102	[145]	Sophia et al., 2022	USA	Female sex = 100%; mean age 30.8 years; mean BMI 19.41 kg/m²	Cross-sectional study	LEAF-Q
103	[146]	Staal et al., 2018	Denmark	Female sex = 50%; mean age 24.8 years; mean BMI 20.2 kg/m²	Cross-sectional study	EDI-3
104	[147]	Stackeov et al., 2023	Prague, Czechia	Female sex = 79%; mean age NR years; mean BMI NR Kg/m²	Pilot study	EAT-26
105	[148]	Sundgot-Borgen 1993	Norway	Female sex = 100%; mean age 20.3 years; mean BMI 21.9 kg/m²	Cross-sectional study	EDI
106	[149]	Sundgot-Borgen 1994	Norway	Female sex = 100%; mean age 20 years; mean BMI 21 kg/m²	Cross-sectional study	EDI
107	[150]	Sundgot-Borgen and Torstveit 2004	Norway	Female sex = 93%; mean age 22.3 years; mean BMI 22.6 kg/m²	Cross-sectional study	EDI
108	[151]	Sundgot‐Borgen et al., 2003	Norway	Female sex = 100%; mean age 21.4 years; mean BMI NR Kg/m²	Cross-sectional study	EDI
109	[152]	Syed et al., 2022	Pakistan	Female sex = 100%; mean age 23.57 years; mean BMI 21.97 kg/m²	Cross-sectional study	EAT-26
110	[153]	Teixidor-Batlle et al., 2021	Spain	Female sex = 51.08%; mean age 16.7 years; mean BMI 21.25 kg/m²	Cross-sectional study	EAT-26
111	[154]	Tenforde et al., 2022	Multiple	Female sex = 40.7%; mean age 13.2 years; mean BMI 19.2 kg/m²	Cross-sectional study	EDEQ
112	[155]	Terry et al., 1999	UK	Female sex = 43%; mean age 23.9 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
113	[156]	Thein-Nissenbaum et al., 2011	USA	Female sex = 100%; mean age 15.4 years; mean BMI 21.1 kg/m²	Cohort study	EDEQ
114	[157]	Thein-Nissenbaum et al., 2014	USA	Female sex = 100%; mean age 15.3 years; mean BMI 21.1 kg/m²	Cohort study	EDEQ
115	[158]	Thiel et al., 1993	German	Female sex = 0%; mean age 21.1 years; mean BMI 21.05 kg/m²	Cross-sectional study	EDI
116	[159]	Thompson 2007	USA	Female sex = 19.6%; mean age 20.5 years; mean BMI NR Kg/m²	Cross-sectional study	RD
117	[160]	Thompsonnet al., a 2017	USA	Female sex = 100%; mean age 19.24 years; mean BMI 22.55 kg/m²	Cohort study	QEDD
118	[161]	Torres-McGehee et al., 2009	USA	Female sex = 100%; mean age 19.2 years; mean BMI 22.5 kg/m²	Cross-sectional study	EAT-26
119	[162]	Torres-McGehee et al., 2011	USA	Female sex = 100%; mean age 19.88 years; mean BMI 22.6 kg/m²	Cross-sectional study	EAT-26
120	[163]	Torres-McGehee et al., 2023	Columbia	Female sex = 69.3%; mean age 19.8 years; mean BMI 22.6 kg/m²	Cross-sectional study	EAT-26
121	[164]	Torstveit and Sundgot-Borgen 2005	Norway	Female sex = 100%; mean age 21.3 years; mean BMI 21.6 kg/m²	Cross-sectional study	EDI
122	[165]	Torstveit et al., 2008	Norway	Female sex = 100%; mean age 22.2 years; mean BMI 21.7 kg/m²	Cross-sectional study	EDI
123	[166]	Uriegas et al., a 2021	USA	Female sex = 69%; mean age 19.6 years; mean BMI 23.6 kg/m²	Cross-sectional study	M1 = EAT-26 M2 = ORTO-15
124	[167]	Uriegas et al., 2023	Columbia	Female sex = 69.6%; mean age 19.8 years; mean BMI 22.5 kg/m²	Cross-sectional study	EAT-26
125	[168]	Vardar et al., 2005	Turkey	Female sex = 100%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-40
126	[169]	Vardar et al., 2007	Turkey	Female sex = 100%; mean age 19 years; mean BMI 20 kg/m²	Cross-sectional study	EAT-40
127	[170]	Walberg and Johnston 1991	USA	Female sex = 100%; mean age 22 years; mean BMI NR Kg/m²	Cross-sectional study	EDI
128	[171]	Waryasz et al., 2020	USA	Female sex = 100%; mean age 26.9 years; mean BMI NR Kg/m²	Cross-sectional study	RD
129	[172]	Wheeler et al., 1986	Canada	Female sex = 50%; mean age 33.6 years; mean BMI NR Kg/m²	Cross-sectional study	EAT-26
130	[29]	Whitehead et al., d 2020	Australia	Female sex = 100%; mean age 32.9 years; mean BMI 22.9 kg/m²	Cross-sectional study	M1 = TFEQ M2 = EDI
131	[173]	Wollenberg et al., 2015	USA	Female sex = 100%; mean age 19.5 years; mean BMI 22.1 kg/m²	Cross-sectional study	EAT-26
132	[174]	Wu et al., 2022	Multiple	Female sex = 40.6%; mean age 13.2 years; mean BMI 19.1 kg/m²	Cross-sectional study	EDEQ

ANIS Anorexia Nervosa Inventory for Self-Rating, BEDS-7 Binge Eating Disorder Screener-7, DEBQ Dutch Eating Behavior Questionnaire, EAT-26 Eating Attitudes Test-26, EAT-40 Eating Attitudes Test-40, EDDS The Eating Disorder Diagnostic Scale, EDE-Q Eating Disorder Examination- Questionnaire, EDI Eating Disorder Inventory-I/II, FEDS feeding and eating disorders, ORTO-11 ORTO-11, ORTO-15 ORTO-15, QEDD Questionnaire for Eating Disorder Diagnoses, SCOFF Sick, Control, One Stone, Fat, Food, SD Self-developed, TFEQ The Three-Factor Eating Questionnaire, WCS The Weight Concern Scale

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