Associations between disordered eating, body dissatisfaction, and low energy availability in women collegiate athletes

Background Collegiate women athletes face unique challenges regarding nutrition, body image, and athletic performance, which increase their risk for low energy availability (LEA). This risk may be further compounded if there are underlying disordered eating (DE) and body dissatisfaction (BID) behaviors. Therefore, the objective was to examine the prevalence of and relationships between LEA, ED risk and behaviors, and BID among women collegiate athletes from a variety of sports.Methods National Collegiate Athletic Association women athletes (n = 115) participated from the following sports: basketball (n = 11), cross country (n = 23), lacrosse (n = 33), soccer (n = 18), volleyball (n = 8), and wrestling (n = 22). Athletes completed the low energy availability for females questionnaire (LEAF-Q), eating attitudes test (EAT-26), muscularity-oriented eating test (MOET), and body dissatisfaction items from the eating disorder examination questionnaire (EDE-Q) to assess LEA risk, DE behaviors, and BID, respectively. A Kruskal–Wallis H test assessed differences in LEAF-Q and EAT-26 scores by sport, and a Mann–Whitney U test determined differences in EAT-26, MOET, BID, and BMI by LEA status. Pearson correlation coefficients and linear regression analysis were used to examine relationships between LEA risk, ED risk, DE behaviors, and BID (p < 0.05).Results A total of 64% athletes were considered at risk for LEA with the highest prevalence observed in volleyball (100%) followed by wrestling (68%), cross country (57%), and soccer (56%). There was no difference in LEA risk across sport (p = 0.067), but risk of ED was highest in volleyball (12.5%) and wrestling (23%). Further, 81% and 84% athletes reported dissatisfaction with their body weight and shape, respectively. No differences were observed in EAT-26 (p = 0.131), MOET (p = 0.051), BID (p = 0.077), or BMI (p = 0.332) according to LEA risk. Very strong positive relationships existed between MOET and EAT-26 (p < 0.001, r = 0.760), MOET and BID (p < 0.001, r = 0.723), and EAT-26 and BID (p < 0.001, r = 0.707). Moderate positive relationships existed between MOET and BMI (p < 0.001, r = 0.329), EAT-26 and BMI (p < 0.05, r = 0.318), and BID and BMI (p < 0.001, r = 0.414). BID positively predicted EAT-26 (p < 0.001, R2 = 0.49) and MOET (p < 0.001, R2 = 0.50) scores.Conclusion A high prevalence of LEA and BID was observed across collegiate women’s sports, with DE behaviors strongly linked to body image concerns. Despite a high LEA risk among athletes, clinical eating disorder risk remained low, suggesting that undereating may often be unintentional. It is recommended educational interventions directed at proper nutritional practices be developed and improvements in physical and psychological well-being be focused on to enhance athletic performance and optimize health-related quality of life.