{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T07:56:21Z","timestamp":1792569381184,"version":"4.5.0"},"reference-count":213,"publisher":"BMJ","issue":"14","funder":[{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"crossref","award":["#313241\/2022-8"],"award-info":[{"award-number":["#313241\/2022-8"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior - Brasil","doi-asserted-by":"crossref","award":["Finance code 001"],"award-info":[{"award-number":["Finance code 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2026,6,1]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the prevalence of eating disorders (EDs) and disordered eating (DE) among athletes across training levels and assessment methods and to identify moderators associated with prevalence estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review, meta-analysis and meta-regression conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>PubMed\/MEDLINE, Scopus, Web of Science and SportDiscus were searched from inception to December 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria for selecting studies<\/jats:title>\n                    <jats:p>Studies were eligible if they included active athletes of any sex, age, sport discipline or training level and reported the prevalence of ED and\/or DE using standardised assessments, including clinical diagnoses or structured diagnostic interviews for ED, and self-report instruments with established cut-off values for DE. Studies were excluded if they involved retired athletes, participants with pre-existing ED diagnoses, included fewer than 25 participants, reused data or were non-peer-reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 1582 identified records, 190 studies (58\u2009335 athletes, 34\u2009628\u2009women) were included in the systematic review and 127 high-quality studies (43\u2009006 athletes) in the meta-analysis. The pooled prevalence of ED\/DE was 20.0% (95% CI 17.0% to 23.0%). Subgroup analyses showed no significant differences according to training level or screening method (clinical interview or diagnosis vs self-reported instruments). However, prevalence varied significantly by instrument: Eating Disorder Examination yielded the lowest prevalence estimates (11.9%), whereas Eating Disorder Inventory yielded the highest (28.3%). Meta-regression showed that a higher proportion of women and more recent publication years were associated with higher prevalence estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Approximately one in five athletes experience ED or DE, underscoring the magnitude of this issue in sport. These findings highlight the need for validated, athlete-specific screening instruments and tailored prevention and intervention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2025-110678","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:20:57Z","timestamp":1783012857000},"page":"1051-1063","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence of eating disorders and disordered eating in athletes: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2536-2182","authenticated-orcid":false,"suffix":"MSc","given":"Stella Nabuco","family":"Nasser","sequence":"first","affiliation":[{"name":"Department of Psychiatry - Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8252-8815","authenticated-orcid":false,"suffix":"PhD","given":"Camila Bertini","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Universidade Federal de Sao Paulo (UNIFESP), S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca Macedo","family":"Cavalcante","sequence":"additional","affiliation":[{"name":"Escola Paulista de Medicina, Universidade Federal de Sao Paulo (UNIFESP), S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5929-6614","authenticated-orcid":false,"suffix":"MD","given":"F\u00e1bio Augusto Do Prado","family":"Marmirolli","sequence":"additional","affiliation":[{"name":"Department of Psychiatry - Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0209-9409","authenticated-orcid":false,"suffix":"MD, PhD","given":"Ang\u00e9lica De Medeiros","family":"Claudino","sequence":"additional","affiliation":[{"name":"Department of Psychiatry - Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3555-5228","authenticated-orcid":false,"suffix":"MD, PhD","given":"Thiago Marques","family":"Fidalgo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry - Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"2026070802451449000_60.14.1051.1","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/S2215-0366(21)00040-7","article-title":"The hidden burden of eating disorders: an extension of estimates from the Global Burden of Disease Study 2019","volume":"8","author":"Santomauro","year":"2021","journal-title":"Lancet Psychiatry"},{"key":"2026070802451449000_60.14.1051.2","doi-asserted-by":"publisher","DOI":"10.2337\/diaspect.20.3.141"},{"key":"2026070802451449000_60.14.1051.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjsem-2020-000801","article-title":"Disordered eating and eating disorders in male elite athletes: a scoping review","volume":"6","author":"Karrer","year":"2020","journal-title":"BMJ Open Sport Exerc Med"},{"key":"2026070802451449000_60.14.1051.4","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association . 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