Abstract
Women athletes often experience body dissatisfaction and disordered eating, contributing to a heightened risk of developing an eating disorder throughout their athletic career. Yet, the experiences of body image and disordered eating are not understood in retirement from sport. A qualitative description study with semi-structured interviews was used to describe body image and disordered eating in eight retired elite women athletes from various sports. Interviews were transcribed verbatim, analyzed inductively, and organized into three themes. The first theme “Social influences and instigators of disordered eating while competing in sport” reflects motivators of disordered eating with sub-themes: (a) coaches are uncaring and unqualified, (b) parents set the “tone,” for better or for worse, and (c) peers are not always friends, though some show support. The second theme “The pinnacle of disordered eating” depicts behaviors and feelings experienced at the peak of career with sub-themes: (a) losing weight by any means necessary and (b) the physical and emotional tolls. The third theme “Reshaping the self and compensatory behaviors” describes participants’ experiences after ceasing competition with sub-themes: (a) changes in identity and (b) compensatory eating and exercise. The results highlight diverse social-cultural factors influencing body dissatisfaction and disordered eating onset. Ultimately, results may help inform intervention strategies that will improve the overall health and well-being of women athletes both during sport and into retirement.
Introduction
Participating in sport is related to positive well-being among women athletes (Adam et al., 2021). Factors such as team camaraderie, coaching styles, sport type, and body weight and shape norms can protect against mental health difficulties yet also present risks (Thompson & Sherman, 2010). Other factors such as body-related commentary from coaches, athlete comparisons, and pressure to be thin are normalized in women’s sport and increase the risk of body weight and shape dissatisfaction (Vani et al., 2021; Willson & Kerr, 2022). While body positive movements have helped to promote the acceptance of more diverse body types in Western culture (e.g., acceptance of heavier and more curvy bodies; Cohen et al., 2021), women continue to face sociocultural pressures to maintain a thin body ideal perpetuated by society, while also encountering expectations to conform to more toned and thin sport-specific body ideals within their athletic environment. Based on the tripartite model of sociocultural influences (Thompson, 1999) and the sociocultural model of body image and eating disturbance in sport, the key factors leading to disordered eating include social agents (e.g., parents, peers, coaches, spectators/fans, and social media) who exert influence directly through commentary and regulative practices and indirectly by fostering culturally specific idealized norms on body size, shape, and weight. As such, athletes face combined pressures that heighten risks for body dissatisfaction, disordered eating, and clinically diagnosable eating disorders (de Bruin, 2017).
Disordered eating, defined as a spectrum of dysfunctional eating behaviors including laxative misuse, dieting, use of diet pills, meal skipping, compulsive eating, maladaptive movement, and vomiting, is reported among 6%–45% women elite athletes and can lead to clinical eating disorders (Mancine et al., 2020; Reardon et al., 2019). Additionally, disordered eating behaviors can fluctuate throughout a competitive season and cumulatively throughout one’s sport career leading to greater risk of injuries, negative sport performance, and lower physical health–related quality of life (Wilson et al., 2013). However, the longer-term impact of disordered eating, both within and following sport, among women athletes has not been well-elucidated. In the limited evidence of exploring the longer-term experience and impact of disordered eating, some athletes report developing an improved relationship with their body, whereas others continue experiencing a tumultuous relationship with their bodies (Papathomas et al., 2018). More research efforts are needed to describe the body image and disordered eating experiences of retired women athletes.
Buckley and colleagues (2019) developed a model of athletic body transitions which suggests that some athletes may experience more body acceptance after retiring from competition while others will struggle with their shift in identity from leaving sport which may result in maladaptive behaviors such as disordered eating. Thus, while the tripartite model (Thompson, 1999) and sociocultural model of disordered eating address challenges faced by competitive athletes active in sport (see Jankauskiene & Baceviciene, 2024; Jones & Petrie, 2023; Pallotto et al., 2022), the athletic body transition framework (Buckley et al., 2019) depicts experiences of retired athletes. However, none of these models conceptualize the unique experiences of body image and disordered eating among athletes from the time they are competing, through their transition out of sport and into retirement.
Sport retirement is an inevitable and life-altering process for elite athletes that is either an intentional choice or forced decision due to injury or other challenges (Barcza-Renner et al., 2020). Retirement from sport is typically accompanied by challenges to self-worth, identity, and lifestyle such as establishing new physical activity and eating routines (Papathomas et al., 2018; Thompson et al., 2021). Women in sport report lasting complications post-retirement due to changes to their body size, shape, and weight after ceasing athletic training (Galli et al., 2022; Papathomas et al., 2018). As such, the ongoing challenges of body image and disordered eating continue to evolve following retirement from sport. It is important to describe women athletes’ experiences of disordered eating during sport and how these behaviors shift or continue during retirement to develop effective prevention strategies. Qualitative description methodology (Sandelowski, 2000, 2010) is useful to describe and understand the nexus of body image and disordered eating for women athletes as they reflect on sport experiences and retirement transitions. Specifically, qualitative description is an appropriate strategy of inquiry for research questions focused on gaining insights and defining poorly understood phenomenon (Kim et al., 2017) such as disordered eating and body image over the course of competition through post-retirement from sport. The current study used qualitative description to describe body image and disordered eating experiences of retired elite women athletes.
Methodology
This study was designed to use qualitative description methodology. The subjectivist relativism epistemological and ontological position of the researchers is consistent with qualitative description (Sandelowski, 2010) whereby reality varies across individuals such that retired elite athletes experience and perceive their own realities, interpretations, and meanings that help to understand the phenomenon of disordered eating into retirement (Doyle et al., 2020; Sandelowski, 2000, 2010). The participants’ perspectives, experiences, and descriptions primarily directed the discussions used for data collection and analyses (Sandelowski, 2010). Furthermore, understanding how to interpret implications of body image and disordered eating from a retirement perspective required a flexible approach, which was informed by the tripartite model (Thompson, 1999), models of athletic body transitions in retirement (Buckley et al., 2019), and the sociocultural model of eating disorders in sport. Qualitative description embraces a malleable commitment to theory and guiding frameworks (Sandelowski, 2010). Finally, qualitative description has been used in healthcare research as a clear way to inform and improve practice (Doyle et al., 2020), which may be a necessary outcome of this research specific to athlete retirement interventions for prevention and treatment.
Participants
Demographic Data Collected From Participants.
Each participant contributed unique sociocultural context to enrich the research. Many women were competitive in university level sports, and many also competed in junior and senior national level competition. The sociocultural context of the research was also enriched by the diversity of sports represented (e.g., aesthetic and leanness-focused sports, team and individual sports, and outdoor and indoor environments) although disordered eating and poor body image are prevalent in elite sport regardless of sport type (Kong & Harris, 2015; Mancine et al., 2020).
Procedures
Online individual semi-structured interviews were scheduled based on the availability of both the participant and researchers. Participants were asked if they would be more comfortable with a man or woman as the researcher to conduct the interview and sent an end-to-end encrypted Zoom link. SS, who identifies as a cis-gendered woman who competed at the elite level in a team sport where she struggled with disordered eating and now studies body image among athletes from the lens of sport psychology in kinesiology, conducted six of the interviews. DB, who identifies as a cis-gender man with a competitive sports history who now studies body image experiences from the lens of sport psychology in kinesiology, conducted two interviews. Once the Zoom meeting began, the researcher obtained informed consent and administered a short demographics form to the participant prior to the start of the interview. Participants were assigned pseudonyms for anonymity. Consistent with a qualitative description strategy, the interview guide was minimally semi-structured, informed by sociocultural frameworks (e.g., Buckley et al., 2019; Thompson, 1999), and included broad questions to explore retired athletes’ experiences of body image and disordered eating. The interview began with a general discussion (e.g., What was your main sport throughout your career? How/why did you retire from this sport?) before moving to specific discussions of body image (e.g., What were your experiences with your body image across your sporting career?) and social influences (e.g., Who are the key people/sources that impacted your body image throughout your sport experiences?). Questions specific to eating behaviors included general (e.g., Describe your eating behaviors before you participated in sport, during sport training and competition, now that you have stopped competing/during retirement?) and specific (e.g., Upon retiring, how, if at all, did your eating habits and change?) experiences comparing within sport and into retirement. Participants were compensated with a $20 gift card for their time.
Data Analysis
The interviews were recorded and transcribed verbatim and Nvivo.12 software was used to organize and store the data. An inductive content analysis (Elo & Kyngäs, 2008) was used to identify codes and categories from the retired athletes and is ideal for a direct description of the data whereby codes and categories fit the data (Sandelowski, 2000, 2010). In the preparation phase of analysis, DT (a cis-gender woman who competed in high school sports and now studies body image among athletes from a sport psychology perspective situated within kinesiology) and SS read the transcripts from the interviews in depth while beginning to identify similarities in the content of the discussions. A second reading of the transcripts was used to begin to identify codes, and a third reading was used to merge similar codes into categories as the organizing step of analysis (Elo & Kyngäs, 2008). This process was iterative with repeated reading, reviewing, and refining of codes and categories aligning with a data analysis spiral (Creswell & Creswell, 2018). This spiral enabled the analysis to focus on the women’s perspectives and experiences while ensuring the researcher’s interpretations were transparent (Sandelowski, 2000). A fourth author, DQ, who identifies as a clinical psychology student studying the intersect of mental and physical wellness, provided support with DB in the analysis process by exploring and challenging the final codes and categories (i.e., critical friends; Brewer & Sparkes, 2011). CS identifies as a cis-gender woman with over 20 years of experience in body image research in sport and exercise contexts. CS reviewed preliminary and final codes and categories, offered historical expertise in concept mapping and naming, and challenged views where necessary.
The analysis process was completed for the eight retired athletes, and saturation was perceived (Guest et al., 2006; Hennink et al., 2017) based on (i) no additional information being identified in the discussions such that the codebook had stabilized (i.e., code saturation) and (ii) the first four authors agreeing they completely understood the described experiences and no further insights were identified (i.e., meaning saturation). Code and meaning saturation were identified based on comparisons across individual analyses. Study rigor was supported in several ways consistent with qualitative description (Finlay, 2006; Sandelowski, 2010). Participants were sampled purposefully to gather broad perspectives and descriptions of the phenomenon. Rapport between the interviewers and participants was established during the study inception phase (e.g., communication, information, consent, and scheduling the interviews), as well as during the introduction phase of the interviews. A trusting relationship was developed between the participants and the researchers through a willingness to exchange information, an expression of compassion and empathy during the discussions, and prolonged engagement with the discussions taking place as long as the natural dialogue occurred (Fernandez et al., 2021). Strategies of member reflections (i.e., participants reviewed their transcripts, though none provided critical feedback) and critical friends (i.e., encouraged discussion of alternative data interpretation; Brewer & Sparkes, 2011) supported data accuracy, credibility, and transparency (Burke, 2016; Tracy, 2010). Direct quotes were used to represent the data gathered from the participants themselves, and an audit trail was used to document the data collection and analysis process. Finally, a reflexivity journal was maintained by the lead interviewer (SS) throughout the research process to check internal bias and to consider how personal experiences shape the inquiry of the topic (Finlay, 2002). Discussions among the research team (i.e., DT, SS, DB, DQ, and CS) occurred throughout the analytical process, and reflections with CS also maintained study rigor.
Results
Participant interviews lasted between 45 and 75 minutes, during which time the women shared their body image and disordered eating experiences within sport and in retirement. Drawing from the personal and sociocultural perspectives discussed by each retired athlete, three researcher-driven themes were developed to describe a path of body image and disordered eating from participation to retirement: (1) social influences and instigators of disordered eating while competing in sport, (2) the pinnacle of disordered eating, and (3) reshaping the self and compensatory behaviors. These findings have been organized to represent how participants experienced body image and dysfunctional eating behaviors throughout their athletic career and into retirement. Many participant quotes are used to reflect the themes in the main summaries and a list of additional quotes is presented in the Supplemental File.
Important to all themes, the participants’ experiences of body image were personal and socioculturally influenced with diverse ages, times since retirement, sport histories, cultural backgrounds, and sexual orientations represented in the sample (see Table 1). For example, Simone highlighted the pervasiveness of body image as a woman: Body image is something that I find, unfortunately, is a big impact for everyday life … especially as a girl … and there’s social media, and everybody else around you that you’re constantly comparing yourself to … for me, body image is a negative most of the time.
May also highlighted the socially comparative nature of sport when she recalled, Everybody else on the team is … thin, they are fit, they look great, and then I look at myself, and I was not very thin back then … So that was when I was first like, “Oh, maybe if I am thinner … I am able to [perform better] with the rest of my friends.”
Social comparisons were also foundational to Isabella’s body image: I remember all my friends would say to me, they’re like, “You are the skinniest person like I’ve ever seen …” [Then] COVID happened, and I was starting to get hips and thighs … I remember that was probably the first time where I [thought], “Oh, what- what’s happening? I’m not the skinniest girl anymore, no one says that to me anymore.”
The pervasive, gendered, and socially constructed body image impacts were foundational to Simone, May, and Isabella’s trajectory of body image experiences throughout sport and into retirement.
Culture and sport-body ideals were also foundational to body image histories, as described by Audrey and Cynthia. Throughout her interview, Audrey’s cultural background layered into discussions about body image with comments such as “I am Hispanic, so I do have bigger breasts for example compared to most [sport] athletes.” Cynthia balanced competing body ideals of leanness and muscularity during her athletic career: The position I played I needed to be stronger …, a little bigger than I wanted to be … [in] my mind, “I want to be leaner …” but it’s like, “Oh if I get leaner, I’m not necessarily gonna have as much force.”
Nadia brought a broader perspective to body image by focusing on competence and de-emphasizing body ideals in sport. She shared, “we all come in different shapes and sizes and we all still play [sport], and lift weights, and are very capable.” The juxtaposing experiences of body ideals were foundational to histories of body image within and following sport competition.
In addition to the gendered, socially constructed, idealized sport bodies, physical features and body size and shape changes were prominent body image motivators for Tamara and Laura. Tamara’s post-injury physical body characteristics were explicitly compared to another athlete who had changed her body shape and size which was rewarded with lots of playing time. Tamara recalled the coaches saying “You should aim to be like her.” Similarly for Laura, comments about a changed body post-illness played into her body image perceptions: I lost a lot of weight in a really short amount of time. And when I came back, the amount of people that came to me and [said], “You look incredible! You look so good.” I [thought], “That’s really fucked up.”
While these physical changes and focused body characteristics were recalled during sport, Tamara and Laura’s experiences were impetus to the development of poor body image and disordered eating and exercise pathways through sport and into retirement.
Theme 1: Social Influences and Instigators of Disordered Eating While Competing in Sport
Social influences, including the athletes’ coaches, their parents, and peers inside and outside of sport, offered comments and comparisons of bodies. This theme is defined by three sub-themes about athletes’ experiences with individuals contributing to their engagement in disordered eating, development of eating disorders, and poor body image: (a) Coaches are uncaring and unqualified, (b) Parents set the “tone,” for better or for worse, and (c) Peers are not always friends, though some show support.
Coaches Are Uncaring and Unqualified
Many participants perceived their coaches to be unqualified to lead athletes because of commentary and opinions pertaining to body size, shape, weight, and nutrition. This lack of appropriate coach education contributed to athletes’ negative sporting experiences, doubts over performances, and precipitated retirement. Terms used to describe their coaches included “flip floppy” (Cynthia), “not qualified” (May), “unlicensed” (Tamara), and “under qualified” (Audrey). The participants recounted numerous instances of poor coaching they experienced which included pressure to return early from injury (Audrey), hypocritical decision-making (Cynthia), and harmful body-related conversations (Tamara, Simone). According to the women, coaches made frequent reference to athletes’ eating habits and shamed their food choices that led to poor body image and disordered eating. May shared, “[He] would always make comments about the things that I am eating. He would be like, ‘May, I thought you were in [kinesiology program], how can you be eating white bread?’” These conversations made May self-conscious of her body and her eating which impacted her body image as she perceived her coaches and teammates to be monitoring her and she said, “that coach was the worst for my body image.” Similarly, Audrey expressed, “… my coach really just told us to eat healthier but like he didn’t specify what that meant.” These comments were interpreted by Audrey as her coach telling her to “stop eating” and, without guidance, contributed to her persisting lack of self-control with certain foods because she “always [feels] like it’s gonna get ripped away from me.”
Athletes felt that their coaches were concerned about their food choices to control their body size and shape. Laura received comments which were intended to be positive about her weight loss resulting from a serious illness: “I lost a lot of weight, and my coaches said, ‘if we can keep you at this weight and you can bulk up’ … which is … this is not how this [body shape and weight] shit works.” Her coaches wanted to manipulate her body’s shape through building more muscle mass without adding any body weight, and these controlling comments were founded on the coaches’ perceptions that being lighter would enhance athletes’ performances in competition. For Laura, this led to body dissatisfaction and a persistent struggle with accepting her body’s shape and weight as they naturally fluctuated, even as she sought out support resources (i.e., sports medicine physicians and staff). As Isabella shared, “I’ve had a coach who said, ‘Every pound is like a millisecond, and if you gain a pound, you’re going to add a millisecond.’” Even though Isabella described having little respect for the coach, these comments still led to frustration: “It’s still probably going to bug you a little bit.” May also recalled a coach saying, “Leaner bodies do better in the heat.” May internalized this messaging and felt that her body was scrutinized for every detail which led to body dissatisfaction as her body image was going “lower, lower, lower, lower.”
Overall, athletes described that the coaches were unqualified to have conversations about body size and weight. Within these conversations and comments, there were links between size, weight, and sport performance, and a persistent impact on athletes’ body image and disordered eating. For instance, Tamara described the influence coaches have over athletes’ body image and eating behaviors. In retirement, she feels the lasting effects of her coaches’ body shaming and thinks, “[the coaches] were right … Now I look at myself and think ‘you weren’t fit enough’ … that really messes with a person.” The commentary from coaches was disruptive to the participants’ thoughts around their body and contributed to their disordered eating patterns. Despite coaches’ lack of qualification to discuss athletes’ bodies, they were effective in undermining athlete autonomy, manipulating the athletes’ behaviors, and contributed to significant detriments in body image and disordered eating that has lasted into retirement.
Parents Set the “Tone,” for Better or for Worse
Parents significantly influenced early body image development and disordered eating behaviors through comments about the athletes’ bodies and food. For example, Nadia recalled, I tore my ACL [anterior cruciate ligament] in my 4th year [of university] … My dad said, “You should probably eat less now, so you don’t get fat.” I [said], “Thanks dad. I’m half depressed because I’ve messed up my knee, and I’m in so much pain,” and your comment is, “You know what, you should probably eat less.”
Nadia felt that the comments from her dad were inappropriate and heightened a focus on her body during a time when her attention was needed for injury rehabilitation. Audrey also shared comments made by her mom related to eating and her body: “Your thighs are getting huge, you look bigger,” … “What are you eating because it doesn’t look good” … Like it was like always negative, it was always like, “You look fatter,” “It doesn’t look good” … I would just pinch my stomach, pinch my thighs.
For Audrey, the frequency of negative comments about her size and weight led to body monitoring and checking behaviors which negatively impacted her body image. Audrey described becoming self-conscious because her mother expressed concern that Audrey was “getting fat,” even though the gains were from increased muscle mass.
Despite the frequent references to parents as having a negative influence on the participants’ bodies and feelings around eating, there were instances where parents served a positive role. Tamara discussed the support she found from her parents and friends as they ensured that she was eating enough food without creating feelings of shame or guilt. She explained, Yeah, I mean, my parents were always really good. I never felt fat-shamed or anything like that from my mom or dad ... they would always just like get food and be like, “Here, eat this! Eat this, like you’ll need it for [sport].”
Through this support from her parents, Tamara was able to circumnavigate some of the negative body-related self-conscious emotions like shame and guilt which often contribute to greater body dissatisfaction and subsequent disordered eating.
Participants also described numerous instances of receiving unsolicited weight- and body-focused comments from their parents which had significant effects. These comments were influential to how athletes shaped their perceptions of their bodies through their shared discomfort in their bodies from pressures to eat (or restrict) certain foods and from changes in their shape and weight. It is noteworthy that while many of the experiences of comments from parents were negative for participants, there were also some instances of parents serving as supporting and encouraging of healthy eating behaviors to support the participants’ health and performance.
Peers Are Not Always Friends, Though Some Show Support
The athletes’ teammates often engaged in comparisons of their bodies and their eating behaviors yielding negative consequences for the participants’ body image. For example, Audrey explained, “We often compare, for example our abs. We always tried to compare to each other.” Audrey and her teammates would decide who had the “best abs” and would copy that person’s meals. Audrey went on to describe how these comparisons with her teammate’s “ripped abs” led her to engage in intense food restriction to try to cope with body dissatisfaction and satisfy the pressure of maintaining and enhancing her body’s shape. In addition to specific body parts, there were many examples of athletes comparing with teammates on general weight and body size. Cynthia explained how “in every sport, you’re going to have people that hyper fixate on their weight.” Given that athletes are inherently competitive with their bodies, the body comparisons among teammates may have been driven by the desire for an ideal body within an environment which is predisposed to competition.
Outside of sport, peers frequently negatively influenced participants’ body image and disordered eating development. While some comments may have been well-intended, references to participants’ bodies had largely negative effects on their perceptions of body image and eating as they contributed to self-consciousness about appearance. Simone described an experience of having attention repeatedly put on her body’s shape: “I’ve been tall, kind of skinny all my life and my friends always commented on that, or joked about it … ‘Oh, well why aren’t you eating, you think you’re fat?’ or, ‘You should eat something, you’re so skinny!’” For Simone, these comments contributed to self-consciousness around eating and a heightened focus on her body image. Audrey shared a similar experience of seemingly positive comments from peers leading to self-consciousness: “Girls would always tell me like ‘oh your body looks so nice’ and everything and they always commented on that and I’m like ‘Oh my god people are looking at me.’”
While peers were frequently inciting negative experiences around participants’ bodies, they were also occasionally sources of positive support. For instance, Laura shared an experience of feeling supported by her peers within sport: I’m very fortunate to be surrounded by a lot of female athletes … I’ve never in my life had so many incredible, lovely people who are my peers, my friends, my acquaintances who were either once athletes, still are [university] athletes, and just kind of get it. And they are so unbelievably supportive.
Laura appreciated the ability to openly discuss challenges around body image and eating with her teammates, during active sport competition and now in retirement, through the comfort and feeling of safety created within the group. Laura shares in a supportive system of peers who she met in sport and who continue to offer a positive lens on her challenged body image into retirement. However, this experience is uncommon as most participants described peer interactions as reflecting, and continuing to reflect, negatively on body image.
In spite of Laura’s explicit example, comments made by peers inside and outside of sport yielded primarily negative effects for the athletes’ body image and disordered eating, even if the comments were well-intended. The comments and comparisons among teammates skewed toward being related to muscles or sport-related parts of the body, while interactions with peers outside of sport were more focused around being thin. Commentary around body shape, weight, and eating habits had lasting impacts on the athletes’ perceptions of their body image and later engagement in disordered eating.
Overall, participants’ body image and eating habits were significantly shaped by comments from coaches, parents, and peers. While coaches were described as unqualified to make comments regarding athletes’ bodies, the participants share that this did not stop the coaches from making disparaging comments and comparisons. Parents and peers of the participants also frequently had a negative impact on body image and eating, though there were several instances of these individuals showing support and being sources of positivity.
Theme 2: The Pinnacle of Disordered Eating
The second theme elucidates the behaviors, thoughts, and feelings of participants at the pinnacle of their challenges with disordered eating. This is accomplished through the exploration of two sub-themes: (a) Losing weight by any means necessary and (b) the physical and emotional tolls.
Losing Weight by Any Means Necessary
The athletes described restricting food intake and overtraining as the primary methods to lose weight during their active competitive experiences. May shared her experience with food restriction, saying, I just really started to control my diet, and I would weigh the food. And then like calorie count. I would try to only eat like 1000 calories a day … I just wanted to be thin so I can do well.
May reveals her desperation for thinness in the effort for a performance boost through engagement in numerous disordered eating behaviors such as the reduction in calories and food weighing. Overtraining was another strategy undertaken by participants to lose weight or maintain a low body weight. Tamara shared, “... I would over train and not eat enough, and I think that also gave me problems with injuries and stuff, because your body doesn’t have what it needs to maintain its health …” As she began to experience the negative consequences of this dysfunctional behavior, Tamara realized her need to develop better strategies for balancing her body’s need for food and exercise.
The pressures on participants from coaches, parents, and peers contributed to engagement in disordered eating to manipulate body shape and weight. The desire for thinness, both to quell the pressure to meet body standards from coaches and parents which compounded upon their existing body dissatisfaction, led participants to heavily restrict their caloric intake through routinely skipping meals, weighing their food, and limiting the number of calories they “could” consume per day, and to overtrain.
The Physical and Emotional Tolls
Engaging in disordered eating led to harsh physical consequences for the participants that hindered performance in sport and with effects that linger into retirement. May described an experience with restricting her food intake and the negative health consequences it had on her body: And then I, obviously started to lose a lot of weight easily, because I am starving myself. But my hair started to fall out … and I also developed like a skin condition … I think it was just an immune response, right, to being starved, and always having to overtrain.
The rapid changes to her body’s weight due to self-induced starvation influenced her physical health through the development of illness and affected her ability to perform in her sport, leading to a cycle of extreme dieting to try improving performance while experiencing worsened performance. After retiring, May continues experiencing physical effects of her past restriction as her appetite is still reduced. She explained her lack of hunger after retirement saying, “After restricting for so long, I did not have much of an appetite.” Participants also shared their experiences with disordered eating in terms of the negative emotions. Laura expressed her engagement in restricting food through removing sugar from her diet: “I was like, ‘I can cut all this- I can call this crap out, it’s fine’ … for no reason other than like what would probably be to alter, modify the way that I looked.” She also shared feeling guilty for this behavior saying, “This [the restricting sugar] is really dumb, and I don’t want to be doing this to myself anymore.” For Laura, the negative emotions about her body’s appearance were clear motivators for her disordered eating though she also had to wrestle with negative emotions which stemmed from the disordered eating. In retirement, Laura continues struggles with urges to restrict her food. She shared, It [the restrictive mentality] still exists to this day. It’s there, and I know it is. The sad reality is … I don’t know if I’m able to get rid of it. It’s just learning to live with it and not let it consume me.
Guilt was also described as a resulting emotion from eating foods in which participants felt they shouldn’t be allowing themselves to indulge. Cynthia reflected on times when she was struggling with her body image and said, So, there were definitely times in my life where, I wasn’t really feeling the [best] so then I would be like, “Okay, like I’m cutting out this, I’m cutting out this,” and then feel really guilty when [I would] eat those things.
These feelings were more prevalent for Cynthia during times when her body dissatisfaction was more prominent, and she sought more of an approach of moderation to eating those same foods when she felt her body image was more positive. Some of the pressure to restrict came from her team’s support staff who instilled in her the belief that “when you have more weight, it is harder to be fast in the water,” which she said “was definitely a motivator.” However, now in retirement, Cynthia has a more relaxed approach to eating: “I just focus on eating enough to feel full and fueling my body.”
Overall, the descriptions of actions taken to lose weight and the subsequent consequences to their physical and mental health are reflective of the extensive negative body image and pressure for thinness perceived by the participants. Disordered eating and excessive exercise marked key strategies utilized to lose weight despite the effects to the participants’ health and negative emotions related to these behaviors. The outcomes of these dysfunctional behaviors had consequences for the participants’ abilities to perform to their highest potential and led to effects to physical and mental health even after retiring from sport.
Theme 3: Reshaping the Self and Compensatory Behaviors
In the third researcher-driven theme, athletes’ experiences with their bodies, food, and engagement in sport and exercise in their lives after retirement from sport are explored. Two sub-themes to guide understanding of these experiences are (a) Changes in identity and (b) Compensatory eating and exercise.
Changes in Identity
Retirement from sport marked a shift in identity for the participants. Feelings related to the body and eating were prevalent as participants worked through the struggles of no longer being an actively competitive athlete. Simone described changes she’s noticed with her body and her goals after leaving sport: “I don’t really need to be throwing around super, super heavy weights anymore. I’m not at that level … I should be doing cardio. I should just be skinny.” For Simone, the pressure to maintain a particular body shape and fitness level persisted after she retired from her sport. When she was still competing, Simone felt that she was able to, and encouraged to, engage with heavy weightlifting and to build muscle. Since retiring, her perspective shifted in terms of what kinds of physical activities were permissible. Simone felt she should avoid lifting weights that she believes would contribute to negative adaptations in her physique, whereas focusing on cardiovascular activity would potentially lead her to having her a body that aligned more with the sociocultural thin body ideal. Establishing a sense of self was difficult for Laura after retiring and the struggle has been ongoing. Laura asks herself, “‘Who do I want to become [now] that I’m no longer going to be an athlete?’ And honestly, like it’s been a year now I guess, and it’s still something that I really like struggle with.” During her time as a competitive athlete, Laura knew that being an athlete was a strong component of her identity, especially as it required intense dedication. In retirement, however, she must now renegotiate who she wants to be after sport “took up like so many hours of my life” and as she weighs the outcomes of “all the things [I] sacrificed for [sport] too, like parties, and concerts, and events, and like other social settings.”
Leaving sport appeared to be a difficult time for the participants as they needed to renegotiate and rediscover their sense of self following this significant loss of identity. The loss of sport participation was clearly a struggle for the participants, though they were able to begin carving out new activities, such as exercising in new ways, to help them with the transition. Changes in their body goals were also apparent, as some felt that they should be thinner and less muscular after leaving sport which still put pressure on their appearances despite the lack of “need” for a certain body shape to be able to compete.
Compensatory Eating and Exercise
Once participants had retired from their sports, their relationships with food and exercise changed. Some athletes described a welcomed shift in eating and exercise and a mindfulness that was discussed as liberating. May found freedom from some of the eating-related body pressures she had felt during competition once she retired: ... after I retired, I felt so free. I felt like I can do what I want, and … the feelings of dieting and stuff like that kind of disappeared. Because I no longer felt the need to restrict or be thin … I felt like the body that I saw in the mirror was okay.
For May, retirement from competitive sport means that she can enjoy eating and embrace a more positive body image, whereas when she was competing, May felt pressure to manipulate her body to be lighter and smaller. In a similar pattern with their eating behaviors, retirement marked a time when participants were able to take part in sport and exercise in a new way, without the pressures to control their bodies. Cynthia experienced a shift in her body image goals since retiring from her sport: I think now, retiring, it’s now, “Do I like the way I look? OK, do I want to change certain things? Do I want to get, I don’t know, like bigger legs? Do I wanna get abs?” … I feel like it’s more doable, I think to [achieve body image goals], because I don’t have to have this constant like thought [in] the back of my mind how this is going to impact my performance.
Compared to the pressure she felt to maximize her performance while grappling with her body image challenges, Cynthia felt a more positive shift in her body image perspective. She was able to set her own goals related to exercise and eating free from feeling constrained to only consider how her body could be used in a performance context.
While retirement marked a positive shift in eating with relation to athletes’ body image, some of the participants continued to struggle with these behaviors. Tamara also grappled with her perception of her body and eating habits: “I think now I’m a lot more conscious of what I’m eating … I’m almost more strict with what I’m eating just because I’m like, ‘Oh, I’m not burning as many calories … that means I can’t eat as much.’” It seems that even after leaving an environment which contributed to an awareness around food, Tamara’s experience post-retirement has been that of heightened fixation on calories and restricting her intake. Isabella also experienced conflict with eating after retiring. She compared her time in sport with her feelings toward food after retiring and said, I definitely think [accepting my body changing] was one of the hardest parts. Because like … you’re eating so much food and then all of a sudden you stop swimming. And then it’s like, your body is still like, “Oh, I’m hungry, I’m hungry, I’m hungry,” but it’s like, “No, you don’t need that much food.”
For Isabella, trying to set limits on her food intake while still feeling hungry was associated with having negative emotions toward food and eating in general. She said, “I don’t enjoy food as much as I used to, I find. And that’s like super weird, ‘cause I love food. But I feel like sometimes I just don’t enjoy it, and I don’t want to eat it.” The negative feelings around eating did not seem to be so pronounced while she was still competing as compared to now since Isabella retired, especially as she explained that food doesn’t bring her the same happiness as it previously would have.
In addition to continuing challenges with eating, the shift to retirement did not always lead to positive associations with exercise. Laura shared her experience of feeling the ups and downs related to exercise after retirement. In her words, I think [retirement] is very similar to when I was in my career, it’s like ebbs and flows of being like, “I didn’t work out yesterday, and I didn’t work out the day before that. I wanted to work out like 5, or 6 times this week, and I only worked out 3. That’s not good.”
While in sport, she was under a regimented schedule of exercising and the freedom from the pressure to continue with that schedule led to feelings of guilt for Laura. She explained trying to justify her new feelings toward exercising in comparison to her time being competitive. Laura shared, It’s like a split-brain situation I have that side saying one thing, and the other side being like, “That’s OK. Like that’s fine, that’s normal … now that you’re like not on a training schedule you’re not going to get in the gym 7 bajillion times in a week, X amount of times in a month and that’s OK.”
Striking a new balance between being accountable to her desire to regularly exercise with recognizing that she was no longer being pressured to meet a certain target of workouts during retirement posed challenges for Laura.
Overall, leaving sport marked a shift in participants’ identities which led to new priorities related to exercise and body image. For some participants, retirement from competition allowed the women greater freedom with eating and exercise, while others still felt burdened by the pressures for thinness and the negative body image lingering from their time spent in sport.
Discussion
There are well-documented challenges of body image and disordered eating among women involved in elite sport; yet, while some athletes experience better body image after retirement, many experience continuity of these challenges into retirement. This qualitative description study aimed to describe and understand the nexus of body image and disordered eating for women athletes as they reflect on their sport experiences and retirement transitions. Drawing from the personal and sociocultural perspectives discussed by each retired athlete, three main themes were used to describe the social influences of disordered eating while competing in sport, the main experiences of disordered eating, and body image changes and compensatory behaviors during retirement.
The retired athletes in the current study described many social influences that impacted their body image and disordered eating engagement. Explicit comments and judgments from coaches, teammates, and family members play a role in the maintenance or facilitation of poor body-related attitudes and behaviors (Baceviciene et al., 2023; Willson & Kerr, 2022). Specifically, many participants experienced direct and indirect communication connecting their weight to performance from coaches, parents, and peers, resulting in the internalized belief that being lighter and thinner would lead to better performance. Conversely, the cognitive restraint (e.g., thoughts about food restriction; Solomon-Krakus et al., 2022) and behavioral restriction (e.g., engaging in restrictive eating behaviors) commonly utilized by athletes to lose weight with the intent to improve their performance are often detrimental (Burke et al., 2021). The retired athletes in the current study corroborated the negative mental and physical health and well-being consequences of efforts to lose weight and the lasting effects of body size and weight comparisons that were perpetuated by social influences in sport and into retirement. Interestingly, while the athletes identified several instances of peers and parents as positively influencing their body image and eating, there was no discussion of coaches having a positive influence on their body image. To ameliorate the issue of coaches being under-qualified to discuss body image with athletes, it may be useful for body image resources designed for coaches to provide education about the impact of disordered eating on performance and delineate appropriate language when discussing athlete’s bodies. Together these may be effective in increasing their knowledge of body image concepts and related coaching strategies (Schneider et al., 2024).
Most participants were at an age (e.g., older adolescence and emerging adulthood) when concerns about weight and body shape often emerge for women, making them inherently at risk of developing pathological eating behaviors (Volpe et al., 2016). Unlike the general population, women athletes navigate an environment with additional risk factors for eating pathology (Thompson & Sherman, 2010). Concepts such as “anorexia athletica” and “seasonal eating disorders” have been introduced to describe eating behaviors uniquely tied to athletic contexts (Sudi et al., 2004; Thompson et al., 2017). Despite being retired, participants’ age may have heightened their susceptibility to internalizing thin ideals and an overidentification with weight and shape ideals compared to older individuals (Paterna et al., 2021). Moreover, narratives around weight and shape perpetuated by parents can amplify the risk of eating pathology regardless of athletic status (Field et al., 2008). The women in the current study described consistent parental influences on their body image and eating behaviors, though those influences may be different for athletes who retire at an older age. Indeed, women who had diversified their interests and cultivated a positive and functional body image that aligned with their evolving identities described generally adaptive relationships with their bodies.
The second theme identified in the study was a description of the pinnacle of disordered eating. Despite the known negative health outcomes from restricting food intake and engaging in maladaptive exercise, the participants’ motivation to achieve or maintain a particular body outweighed the consequences. Women’s engagement in food restriction and maladaptive movement reflects specific disordered eating behaviors, driven and reinforced by body dissatisfaction and negative emotions about the body and eating. There were many examples of cognitive restraint and behavioral restriction (Solomon-Krakus et al., 2022). Women experienced negative body-related emotions, including guilt when both engaging in disordered eating behaviors and when eating to nourish themselves. Evidently, disordered eating behaviors coincide with complex emotional landscapes (Gillbanks et al., 2022). Women also recognized the serious health and performance consequences of disordered eating consistent with relative energy deficiency in sport (RED-S). Specifically, RED-S stems from the body lacking available energy to sustain itself beyond survival and is associated with consequences to health and performance (Mountjoy et al., 2023). Athletes with RED-S are at a greater risk for menstrual dysfunction, injury, anxiety and depression, and decreased performance (Mountjoy et al., 2023; Stellingwerff et al., 2023). The consequences of RED-S are not only experienced during sport competition but appear to linger into retirement. In fact, many women in the sample retired from sport due to decreased performance related to body image and disordered eating.
It was clear that disordered eating behaviors were fostered by coach comments and inherent to sport environments. To mitigate the negative impact of coaches on disordered eating trajectories and emotional well-being, educational interventions that drive real-world change are needed. Although coaches have expressed a clear desire for education on topics related to eating, body shape, and weight, workshops and training on these subjects are available but rarely endorsed by larger organizations (Hamer et al., 2021; Haslam et al., 2021). Furthermore, these topics are not yet incorporated into accreditation training (Hamer et al., 2021). Enhancing the standard of coaching education on these issues would benefit from both top-down and bottom-up approaches, ultimately improving the well-being of women athletes.
Aligned with well-documented and consistent research (Cash, 2024; Jewett et al., 2019), retiring from sport marked a shift in the participants’ identities, lending to a need to rediscover sense of self after leaving sport. Participants expressed changes in their body image goals and attitudes toward eating, feeling free from the restrictive standards they experienced while they were competing. While some participants appreciated a shift in focus to their bodies’ functionality or strength, others still struggled with accepting their body appearance. Similarly, while some participants experienced positive changes to their approaches to eating and exercise, others felt more burdened by pressures to be thin and needing to “earn” their food. The athlete paradox describes the struggle between a desire to meet thin body ideals and the reality of having a muscular body that aligns with their sporting demands (Papathomas et al., 2018). In the current study, participants embodied this paradox through the expression of guilt around food and immense pressure to maintain an ideal body. The lack of guidance for athletes transitioning from competition into retirement (Fuller, 2014) may leave them vulnerable to disordered eating and maladaptive movement as they struggle to adapt to life post-retirement. While some programs for athletes transitioning to retirement have become available, these programs are not globally accessible and likely do not provide education or support for body-related concerns (Hong & Minikin, 2023). Alternatively, providing athletes transitioning to retirement with guidance on adaptive eating and exercise behaviors, along with social support, represents a promising approach to bolstering their health (Brown et al., 2018). Future research could explore how trends in the uptake of these interventions impact athlete outcomes, which may inform the development of comprehensive and accessible programs for retiring athletes.
Strengths and Limitations
A limitation of the present study is that participants were interviewed at a single time point. Researchers should longitudinally explore body image and eating processes throughout the athletic career and into retirement in real-time. A recruitment bias may have led to women who experienced particularly negative experiences with body image in sport volunteering for the study, thus limiting descriptions of positive body image. The similarity of the participants’ ages, sexual orientation, racial/ethnic background, and time since retirement may limit the description of athletes’ experiences. Notwithstanding these limitations, the study design offered an in-depth examination of the perspective of retired athletes on the progression of their body image throughout their athletic careers and into retirement. The retired women athletes offered diverse sport histories and multiple perspectives to be considered when examining the experiences of body image and disordered eating. The findings extend theory and conceptualizations of body image and disordered eating to highlight the retirement transition. The findings also extend well-documented evidence that adolescent girls report negative comments and body talk from social influences such as coaches and teammates that influence their body image (Lucibello et al., 2021; Sabiston et al., 2020). Body image concerns are not exclusive to women in elite sport and these findings reflecting body image and disordered eating have transferrable implications for sport contexts beyond the elite level of competition and across age groups of girls and women.
Conclusion
Body image in sport is complex and women and girls are being driven away from sports largely due to the influence of sporting environments on their body image (Canadian Women & Sport, 2024). The study used qualitative description approach to better understand the experiences of body image and disordered eating in retired elite women athletes to inform efforts to help women athletes engage and excel in sports. The impacts of coaches, parents, and peers toward body image and disordered eating were profound and were reflected through dysfunctional eating and exercise behaviors often manifesting in challenges to body image and eating persisting after the athletes retired. Knowledge translation efforts based on the lived experiences of these athletes will discourage coaches from engaging in body commentary, empower athletes to embrace their athletic bodies, and hopefully mitigate engagement in disordered eating. For current athletes, emphasizing strength and the body’s athletic capabilities may be helpful in assuaging the impacts of body commentary from others. Among retired athletes, these results emphasize the need to recalibrate physical activity and sport goals to de-emphasize appearance, focusing instead on finding enjoyable activities which promote positive body image and eating behaviors. The findings may also be used to inform coaches, parents, and athletes’ peers of the implications of their words and to teach them that sports performance is not determined by the shape and size of one’s body. Rather, promoting positive body image attitudes and healthy relationships with food will help to continue engaging women athletes in their sports and contribute to fewer body-related challenges after retirement.
Supplemental Material
Supplemental Material - Coaches Say Lighter Is Better, But at What Cost? A Qualitative Exploration of the Lingering Impact of Body Image on Disordered Eating in Retired Elite Women Athletes
Supplemental Material for Coaches Say Lighter Is Better, But at What Cost? A Qualitative Exploration of the Lingering Impact of Body Image on Disordered Eating in Retired Elite Women Athletes by Delaney E. Thibodeau, Sara Sutherland, David M. Brown, Danika A. Quesnel, and Catherine M. Sabiston in Qualitative Health Research
Footnotes
Author Contributions
Co-first authors provided primary collection and analysis of interview data, the third, fourth, and fifth authors served as critical friends to the findings and organization of themes, and all authors contributed to the editing and final approval of the manuscript.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was funded by the Canada Research Chairs Program awarded to the corresponding author.
Ethical Statement
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References
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