This case study explores the transition from disordered eating (DE) to an eating disorder (ED) in a 23-year-old female orienteer. Despite her talent as an athlete, her eating habits and training practices led to significant health concerns. After following an ovo-lacto vegetarian diet for 3 years, she exhibited symptoms of DE, including low energy intake (1,200 kcal/day), low body weight (50.1 kg, BMI: 16.9), and amenorrhea. Her condition deteriorated over 2 years, resulting in a diagnosis of anorexia nervosa (AN) by February 2023. During the treatment process, the athlete utilized a multidisciplinary approach that included dietitians, psychologists, and physicians. Despite achieving some initial progress, including a slight increase in body weight and the return of menstruation in July 2022, her health declined after psychological consultations were halted, leading to a further decrease in body fat and persistent low serum iron levels. This case highlights the importance of continuous monitoring, timely intervention, and a coordinated multidisciplinary team in addressing DE and ED in athletes. It also highlights the significance of effective communication among healthcare professionals and the need for comprehensive treatment strategies that include psychological, nutritional, and medical support. This study highlights the significance of early detection, suitable intervention, and the prevention of long-term health complications, such as decreased bone density and cardiovascular issues, in athletes with DE and ED.

Background: disordered eating (DE) and eating disorders (ED) can negatively impact athletes’ health, wellbeing, and athletic performance. Objective: this cross-sectional study aims to assess DE risk, body composition, and nutrition knowledge among elite Hungarian athletes. Methods: DE risk was assessed using DESA-6H and EAT-26 scales, nutrition knowledge through the Abridged Nutrition for Sport Knowledge Questionnaire (A-NSKQ), and body composition with the OMRON BF511 device. The data were analyzed using Kendall’s tau correlations, Mann–Whitney U tests, and ROC analysis. Results: a total of 71 athletes participated (39.4% males, mean age = 24.8 years, SD = 4.8 years and 60.6% females, mean age = 24.3 years, SD = 4.3 years). At-risk scores on the DESA-6H scale were recorded for nine athletes (12.7%), while 32.4% scored in the risk zone on the EAT-26, with female athletes in aesthetic, endurance and weight-dependent sports being most affected. Low BF was observed in four males and four females. Nutrition knowledge (49.1%) was below the acceptable threshold. DESA-6H significantly correlated with EAT-26 scores, BMI, sports nutrition knowledge, and A-NSKQ total scores. A statistically significant difference by gender was found in the EAT-26 total score (p = 0.019, d = 0.65). Risk groups significantly differed in A-NSKQ scores (p = 0.026, d = 0.511) and sport nutrition knowledge, specifically (p = 0.016, d = 0.491). Using EAT-26 to identify at-risk athletes and the DESA-6H recommended cut-off, the ROC analysis showed a sensitivity of 29.1% and a specificity of 95.7%. Conclusions: insufficient nutrition knowledge plays a role in being at-risk for DE and ED. These results underscore the need for early detection, early sport nutrition education across all elite athletes, with particular attention to female athletes in aesthetic, endurance and weight-dependent sports, and for monitoring these athletes to prevent DE. Further work is warranted to optimize screening tools such as EAT-26 and DESA-6H for elite athletes.

Background: Adequate nutrient intake is an essential part of athletes’ preparation, which results in more effective training adaptation, recovery, better body composition ratios, and improved sports performance. Inadequate nutrient intake or lack of knowledge can lead to disordered eating and eating disorders, the prevalence of which is higher among athletes than in the general population. In most cases, these unwanted outcomes occur because athletes do not seek the help of a qualified dietitian. According to a 2019 report by the International Olympic Committee, disordered eating and eating disorders’ point prevalence ranges from 6% to 45% in women and 0% to 19% in men. In Hungary, no athlete sample has been tested with screening questionnaires for eating disorders, and the development of reliable measurement tools for identifying this problem is also necessary. Objective: The aim of this study is to present the Hungarian version of the DESA-6 questionnaire (DESA-6H) for screening disordered eating among athletes and to investigate its convergent validity (CV), as well as to evaluate athletes’ nutritional behaviors based on comparative study results. Methods: The DESA-6H questionnaire was tested on elite athletes (n = 131) and recreational athletes (n = 123) aged 14 and older. Kendall’s tau-b correlation was used to establish the CV between the DESA-6H and the total EAT-26 score, as well as between the DESA-6H and the three subscales of the EAT-26. The same method was used to test the potential linear relationship between eating behavior questionnaires and weekly training hours. Chi-square tests were conducted to test the relationships between nominal variables. Differences between groups based on age and sport participation levels were analyzed using Kruskal-Wallis H tests, and post-hoc analyses were conducted using Mann-Whitney U tests. Results: The CV analysis showed a significant positive correlation between the DESA-6H and the total EAT-26 score (τb = 0.49, p < 0.001), the EAT-26 Dieting subscale (τb = 0.53, p < 0.001), and the EAT-26 Bulimia subscale (τb = 0.39, p < 0.001). In the total sample, 20.4% scored above the threshold on the DESA-6H, while 40.1% scored above the threshold on the EAT-26. Among sports categories, the highest prevalence was found in aesthetic, weight-dependent, and endurance sports. A significant difference was observed in the DESA-6H scores based on gender (U = 4948.50, Z = –5.210, p < 0.001) and sports participation level (U = 6847.50, Z = –2.123, p = 0.034), with large (Cohen’s d = 0.68) and small ( Cohen’s d = 0.26) effect sizes. The Mann-Whitney U-test showed no significant difference between the 14–17-year-old and 18+ age groups in terms of DESA-6H scores (U = 6082.00, Z = –1.017, p = 0.309). No statistically significant differences were found between the two age groups on the EAT-26 scores either (U = 6490.00, Z = –0.220, p = 0.826). Overall, the statistical tests consistently supported the convergent validity of the DESA-6H when compared with the EAT-26. Conclusions: Based on the results of our research, it can be concluded that the DESA-6H questionnaire is a reliable tool for screening disordered eating among Hungarian athletes. Its application can help in the early detection and prevention of eating disorders.