Background: Eating disorders are important mental health conditions characterized by abnormal eating behaviours, disturbed attitudes toward food and body image, and potentially serious physical and psychological consequences. Medical students may be particularly vulnerable because of academic stress, demanding workloads, body-image concerns, and pressure associated with medical training. However, there is limited evidence on eating disorder risk among medical students in Rivers State, Nigeria.

Objective: This study assessed the knowledge, prevalence of eating disorder risk, and associated risk factors among medical students at Rivers State University, Port Harcourt, Nigeria.

Methods: A descriptive cross-sectional study was conducted among medical students from 100 to 600 level at Rivers State University. A total of 246 students were selected using a multistage sampling technique involving stratification by academic level, proportionate allocation, and simple random sampling but only 244 students completed the questionnaire. Data were collected using a structured self-administered questionnaire incorporating the Eating Attitudes Test-26 (EAT-26) and SCOFF (Sick, Control, One stone, Fat, Food) screening tools. Data were analysed using SPSS version 25. Descriptive statistics were presented as frequencies, percentages, means and standard deviations, while Chi-square tests, independent t-tests and other appropriate inferential procedures were used to assess associations. Statistical significance was set at p < 0.05.

Results: Of the 244 respondents, 169 (69.3%) were females and 75 (30.7%) were males, while the largest age group was 22–24 years (35.2%). Overall, 83.3% of respondents demonstrated good knowledge of eating disorders. Awareness was particularly high regarding the existence, examples, complications and treatment of eating disorders; however, knowledge was lower concerning the common age group affected and the binge-purge pattern of bulimia nervosa. Screening identified 24 (9.8%) students as being at risk of an eating disorder, while 220 (90.2%) were not classified as at risk. Following diet trends (p=0.001), comparing body image with others (p=0.021), academic stress affecting eating habits (p=0.001), and having sought counselling (p=0.001) were significantly associated with eating disorder risk. Skipping meals (p=0.650) and perceived  professional  pressure  (p=0.260)  were  not  statistically  significant. Conclusion: The study found a high level of awareness and knowledge of eating disorders among medical students at Rivers State University, but a substantial proportion (9.8%) remained at risk. The findings indicate that good knowledge alone may not translate into protective eating behaviours, as academic stress, diet trends and body-image comparison may contribute to vulnerability.

Keywords: Eating disorders, medical students, knowledge, prevalence, eating disorder risk, academic stress, body image, Rivers State University.