One in Ten Swedish Elite Sport Pupils Screen Positive for Eating Disorders

Almost one in ten pupils at Sweden's elite sport schools screened positive for likely eating disorders in a large new survey, with girls, regular meal-skippers and those excluding meat from their diets showing the strongest associations. The study, published in the Journal of Eating Disorders, surveyed 7,993 pupils across the Swedish upper secondary elite sport school system in spring 2023 and is among the first large-scale investigations of eating and health in this population. Of the nearly 8,000 pupils who responded to both parts of the survey, 9.5 percent screened positive, meaning they showed signs that could suggest an eating disorder.

The researchers also set out to map the pupils' everyday food lives, examining eating practices and the practical barriers they faced in managing daily meals. Half of the pupils, 49.1 percent, reported at least one such barrier, with lack of time being the most common, alongside limited cooking skills. These practical difficulties matter because they can lead to inadequate energy intake, which carries its own consequences for health and athletic performance even in the absence of a clinical eating disorder.

To identify which characteristics were linked to a positive screen, the team performed a multiple binary logistic regression, a statistical technique that estimates the odds of an outcome while accounting for the influence of several variables simultaneously. The results pointed to a consistent cluster of associated factors. Being female was the strongest, with an odds ratio of 3.50, meaning female pupils had more than three times the odds of screening positive compared with their male peers.

Regularly skipping meals was the next most strongly associated factor, with an odds ratio of 2.31. A vegetarian or vegan diet raised the odds by a factor of 1.87, while use of dietary supplements was associated with an odds ratio of 1.69. Pupils who practised an individual sport rather than a team sport had 1.40 times the odds of a positive screen.

Practical barriers themselves played a measurable role. Each increase in the number of barriers a pupil reported was associated with an odds ratio of 1.28 for screening positive, suggesting that the friction of managing food in a demanding daily schedule of training and schooling may compound vulnerability. Notably, one factor ran in the opposite direction: pupils who perceived themselves as having higher knowledge about what to eat to optimize health had lower odds of a positive screen, with an odds ratio of 0.73.

Because the survey captured a single moment in time, the associations cannot establish causation. It is unclear, for example, whether skipping meals contributes to disordered eating, whether disordered eating leads pupils to skip meals, or whether both reflect an underlying pattern. The 9.5 percent figure likewise represents the proportion screening positive on the SCOFF tool, not a confirmed clinical prevalence.

Even so, the scale of the survey lends the findings weight. Large-scale data on eating and health in the Swedish elite sport school system had been lacking, despite the system's role in developing many of the country's young athletes. The study's authors note that eating disorders can seriously affect both athletes' health and their athletic performance, and that suboptimal food practices and everyday barriers can cause inadequate energy intake with negative consequences of their own.

The findings point toward practical interventions. The researchers highlight the need for schools to prioritize initiatives that prevent eating disorder risk and to ensure that all school and sport personnel can recognize problematic eating behaviour. They also suggest practical education, such as cooking skills support, and additional school meals free of charge, alongside broader time-saving efforts, to ease the everyday food-related burdens that half of the pupils reported experiencing.

Food logistics, the study suggests, are not a peripheral concern for a school system combining academic workloads with elite training schedules. The combination of high rates of practical barriers, a meaningful screening prevalence and clearly identifiable associated factors gives schools and sports organizations a concrete starting point for supporting their pupils.

Subject of Research: Eating disorder screening and everyday food practices among Swedish elite sport school pupils

Article Title: Exploring a positive screen for eating disorders among 7,993 elite sport pupils in Sweden and its association with everyday food practices, demographics, and sports

Article References: Davidsson, I., Hörnell, A., Bengs, C., & Ferry, M. (2026). Exploring a positive screen for eating disorders among 7,993 elite sport pupils in Sweden and its association with everyday food practices, demographics, and sports. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01804-6

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01804-6

Keywords: eating disorders, SCOFF questionnaire, elite sport schools, adolescent athletes, meal skipping, vegetarian diet, dietary supplements, individual sports, cross-sectional survey, Sweden, Exploring, positive