By Rachael Flatt
With both the Summer and Winter Olympics and Paralympics occurring in the past several months, the lights have shone brightly on athletes and athlete mental health during the Games, especially because of dramatic and tense circumstances surrounding COVID-19. However, little attention is often paid to the experiences of athletes beyond these few weeks. In the aftermath of the Games, there is typically a large pool of athletes who choose to retire after competing at the pinnacle events of their careers. A budding area of research focuses on the transition out of competitive sport and how this impacts the mental health of retired athletes.
Four studies have measured the point prevalence of eating disorders (3.1 to 27.4%; Gouttebarge et al., 2017; Gouttebarge & Kerkhoffs, 2017; Thompson et al., 2021) and lifetime prevalence (9.3 to 20%; Kerr et al., 2006; Thompson et al., 2021) of recently retired athletes. It is important to note that these studies had small sample sizes and used varied methodologies and screening tools, so future research across a wide variety of sports with larger samples will be useful to establish baseline prevalence. Although these numbers align with prevalence data for currently competing athletes (Bratland-Sanda & Sundgot-Borgen, 2013), unique circumstances around retirement warrant consideration.
One of the primary considerations around retirement from sports that may influence eating disorder risk is the substantial adjustment to no longer training at high intensities and volumes every day. The caloric and nutritional needs in retirement may vary dramatically based on sport and daily demands, and as a result, physique, muscle tone, and overall weight and shape may change. In a small qualitative study of rhythmic gymnasts, all participants reported that the distress around physical changes such as weight gain and decreased muscle mass post-retirement was one of the most important factors in their retirement experience (Stirling et al., 2012). Relatedly, dietary restrictions (e.g., no “junk food,” fad diets to eat as “cleanly” as possible) during competitive years are common. Retired athletes could swing to the other side of the pendulum upon retirement (e.g., engaging in binge eating on previously prohibited foods), potentially triggering eating disorders. Given that the first few years after retirement may be a high-risk period due to major adjustments (Thompson et al., 2021), especially for those with a history of an eating disorder, it is important for clinicians and the team around the athletes to normalize ongoing changes in dietary needs and physique as a new equilibrium is reached.
Anecdotally, high-profile athletes have shared that managing the stress around major life transitions on top of leaving a sporting career can feel completely overwhelming. Retirement from competitive sport typically occurs at a much younger age and phase of life than retirement from a career. Athletes are often seeking to finish school, begin a second career, and start families at the same time they are losing their identity as an athlete. Sustained athlete identity (the extent to which one internalizes the importance of being an athlete) into retirement may be associated with eating disorder behaviors (Buckley et al., 2019). Since eating disorder onset in non-athlete populations is known to occur around the same age of major life transitions such as entering high school, college, or the beginnings of adulthood, it is possible that among other mental health concerns (i.e., anxiety, depression), eating disorders may begin, return, or flare during this transition in terms of one’s career and identity.
So as athletes return home from Beijing and begin to transition out of elite competition, it is essential for all who surround and work with the athletes—from clinicians and coaches to friends and family—to be vigilant in looking for signs of eating disorders and mental health concerns more broadly. More than anything, it is essential to be there for support and to direct them to services that offer evidence-based resources if they need help.
Bratland-Sanda, S., & Sundgot-Borgen, J. (2013). Eating disorders in athletes: overview of prevalence, risk factors and recommendations for prevention and treatment. Eur J Sport Sci, 13(5), 499-508. https://doi.org/10.1080/17461391.2012.740504
Buckley, G. L., Hall, L. E., Lassemillante, A. M., Ackerman, K. E., & Belski, R. (2019). Retired Athletes and the Intersection of Food and Body: A Systematic Literature Review Exploring Compensatory Behaviours and Body Change. Nutrients, 11(6), 1395. https://doi.org/10.3390/nu11061395
Gouttebarge, V., Jonkers, R., Moen, M., Verhagen, E., Wylleman, P., & Kerkhoffs, G. (2017). The prevalence and risk indicators of symptoms of common mental disorders among current and former Dutch elite athletes. J Sports Sci, 35(21), 2148-2156. https://doi.org/10.1080/02640414.2016.1258485
Gouttebarge, V., & Kerkhoffs, G. (2017). A prospective cohort study on symptoms of common mental disorders among current and retired professional ice hockey players. Phys Sportsmed, 45(3), 252-258. https://doi.org/10.1080/00913847.2017.1338497
Kerr, G., Berman, E., & Souza, M. J. D. (2006). Disordered Eating in Women’s Gymnastics: Perspectives of Athletes, Coaches, Parents, and Judges. Journal of Applied Sport Psychology, 18(1), 28-43. https://doi.org/10.1080/10413200500471301
Stirling, A. E., Cruz, L. C., & Kerr, G. A. (2012). Influence of retirement on body satisfaction and weight control behaviors: Perceptions of elite rhythmic gymnasts. Journal of Applied Sport Psychology, 24(2), 129-143. https://doi.org/10.1080/10413200.2011.603718
Thompson, A., Petrie, T., Tackett, B., Balcom, K., & Watkins, C. E. (2021). Eating disorder diagnosis and the female athlete: A longitudinal analysis from college sport to retirement. Journal of science and medicine in sport, 24(6), 531–535. https://doi.org/10.1016/j.jsams.2020.12.004