Investigating the prevalence of low energy availability, disordered eating and eating disorders in competitive and recreational female endurance runners

Eating disorders (ED), disordered eating (DE) and low energy availability (LEA) can be detrimental to health and performance. Previous studies have independently investigated the prevalence of ED, DE or LEA; however, limited studies have combined methods identifying risk within female runners. The aim of this study was to identify the prevalence of ED, DE and LEA in United Kingdom-based female runners and associations between age, competition level and running distance. The Female Athlete Screening Tool (FAST) and Low Energy Availability in Females Questionnaire (LEAF-Q) were used in a cross-sectional study design. A total of n = 524 responses eligible for analysis were received. A total of n = 248 (47.3%), n = 209 (40%) and n = 49 (9.4%) athletes were at risk of LEA, DE and ED, respectively. LEAF-Q scores differed based upon age (Age: H(3) = 23.998, p ≤ .05) and competitive level (Comp: H(1) = 7.682, p ≤ .05) whereas FAST scores differed based on age (Age: F(3,523) = 4.753, p ≤ .05). Tukey's post-hoc tests showed significantly higher FAST scores in 18-24 years compared to all other age categories (p ≤ .05). Stepwise multiple regression demonstrated age and competitive level modestly predicted LEAF-Q scores (R2adj = 0.047, F(2,523) = 13.993, p ≤ .05, VIF = 1.0) whereas age modestly predicted FAST scores (R2adj = 0.022, F(1,523) = 12.711, p ≤ .05, VIF = 1.0). These findings suggest early identification, suitable screening methods and educational intervention programmes should be aimed at all levels of female endurance runners.Highlights A total of 524 female endurance completed a self-administered, online questionnaire screening for low energy availability, disordered eating and eating disorders risk.Age and competitive level modestly predicted low energy availability and age modestly predicted disordered eating and eating disorders in female endurance runners.A higher percentage of 18- to 24-year-old female endurance runners were at greater risk of low energy availability, disordered eating and eating disorders compared to other age categories.These findings highlight the need for regular screening in order to aid early interventions to prevent potential decrements in performance and health as endurance runners mature.