Prevalence and association of low energy availability and disordered eating among female volleyball players: a cross-sectional study

Background Low energy availability and disordered eating are significant health concerns in female athletes, yet their prevalence and association in team sports, particularly volleyball, remain underexplored. This study aimed to (i) assess the prevalence of low energy availability and disordered eating risk; (ii) determine whether these risks differ by level of competition; (iii) examine their statistical co-occurrence and strength of association; and (iv) explore the relationship between disordered eating attitudes and low energy availability scores, including total and symptom-specific domains (gastrointestinal, injury, and menstrual function). Methods A total of 213 female volleyball players participated in this cross-sectional study. The sample included 43 youth-level athletes (Under17 and Under19), 110 athletes from the Turkish Women’s Second League, and 60 athletes from the First League. The participants were aged 15 years and older (M = 19.64, SD = 4.51), and all were actively competing at their respective levels during the study period. The risk of low energy availability was assessed via the Low Energy Availability in Females Questionnaire, which evaluates gastrointestinal function, injury history, and menstrual function. Disordered eating attitudes were measured via the Eating Attitudes Test-26, a validated self-report instrument commonly used to screen for eating disorder risk in athletic populations. Results Low energy availability risk was identified in 33.3% of the athletes, whereas 17.4% were classified as at risk for disordered eating. A significant association was found between the two risks (odds ratio = 3.80, 95% CI = 1.82–7.92, p  < .001), with 10.3% of participants exhibiting both conditions concurrently. Risk prevalence did not significantly differ across levels of competition. Disordered eating scores were positively correlated with total low energy availability scores ( ρ  = 0.279, p  < .001), gastrointestinal symptoms ( ρ  = 0.265, p  < .001), and injury history ( ρ  = 0.199, p  = .003) but not with menstrual dysfunction ( ρ  = 0.103, p  = .133). Conclusion A substantial proportion of female volleyball players are at risk for both low energy availability and disordered eating, with notable co-occurrence and symptom-specific associations. These findings highlight the need for early screening, targeted nutritional education, and multidisciplinary interventions across all competition levels. Future studies should employ longitudinal designs and direct energy intake/expenditure measurements to understand causality and long-term effects.