Disordered eating & body image of current and former athletes in a pandemic; a convergent mixed methods study - What can we learn from COVID-19 to support athletes through transitions?

Abstract

Background The COVID-19 pandemic has seen worsened mental health as a result of lockdowns, isolation and changes to sociocultural functioning. The postponement of the Tokyo 2020 Olympics is representative of global cancellations of sporting events, reduced facility access and support restrictions that have affected both current and former athlete’s psychological wellbeing. This study aimed to determine whether current (n = 93) and former (n = 111) athletes experienced worsened body image, relationship with food or eating disorder symptomatology during acute COVID-19 transitions. Methods The study was a Convergent Mixed Methods design whereby qualitative content analysis was collected and analysed simultaneously with quantitative cross-sectional data using the EAT-26 and self-report COVID-19 questions. Data were collected from April until May 2020 to capture data pertaining to transitions related to the pandemic and included individuals across 41 different individual and team sports from club to international competition levels. Results There was a surge in disordered eating in current and former athletes as a result of the early COVID-19 response. Eating disorders were suggested to occur in 21.1% of participants (18% current athletes n = 17, 25% former athletes (n = 26). There was a significant difference between males and females (p = 0.018, r = 0.17), but interestingly no differences between groups from individual vs team sports, type of sporting category (endurance, antigravitational, ball sport, power, technical and aesthetic) or level of competition (club, state, national or international). 34.8% (n = 69) self-reported worsened body image and 32.8% (n = 65) self-reported a worsened food relationship directly from COVID-19. Qualitative analysis indicated that disordered eating occurred predominantly in the form of body preoccupation, inhibitory food control, fear of body composition changes and binge eating. Conclusions This study indicates that transitions in COVID-19 have worsened food-body relationships in current and former athletes and must be treated as an at-risk time for eating disorder development. We suggest that resources are allocated appropriately to assist athletes to foster psychologically positive food and body relationships through COVID-19 transitions. This study makes practice suggestions in supporting athletes to manage control, seek support, adapt and accept change and promote connection and variety through athletic transitions.

Just Do It: High Intensity Physical Activity Preserves Mental and Physical Health in Elite and Non-elite Athletes During COVID-19

“…Furthermore, female athletes reported higher levels of psychological distress, body dissatisfaction, and worse mental health compared to males. These findings support Hypothesis 2a and agree with literature studies highlighting that female athletes report more depressive and anxiety symptoms than males ( Mascret, 2020 ; Mon-López et al, 2020a , b ; Pillay et al, 2020 ; Buckley et al, 2021 ). Contrary to our expectations, team players also seemed to experience greater body dissatisfaction than individual ones.…”

“…Hypothesis 2a . Female athletes would report higher intrinsic motivation toward PA, lower mental health, higher psychological distress, higher intolerance of uncertainty, and higher body dissatisfaction compared to males, as previously shown in both non-pandemic ( Reardon et al, 2019 ) and pandemic situations ( Mascret, 2020 ; Mon-López et al, 2020a , b ; Pillay et al, 2020 ; Buckley et al, 2021 ).…”

“…Other factors contributing to understanding athletes’ quality of life under a stressful and uncertain situation such as a pandemic may include general distress, intolerance of uncertainty, and body dissatisfaction ( Buckley et al, 2021 ; Li et al, 2021 ).…”

“…Body dissatisfaction describes all the concerns with one’s body size and shape and has been indicated as the strongest predictor of eating disorders in athletes ( Reardon et al, 2019 ). Only one study has examined its role in athletes during the pandemic and found higher concerns in female current and former athletes compared to males ( Buckley et al, 2021 ).…”

A systematic scoping review of research on COVID‐19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field

“…The first theme identified was the prevalence of possible eating disorder cases among non‐clinical samples during the pandemic. Eleven studies (participant n s = 120–5,378) investigated this theme by estimating the proportion of participants scoring above an established clinical cut‐off on a self‐report assessment (Alessi et al, 2020 ; Buckley et al, 2021 ; Cecchetto et al, 2021 ; Chan & Chiu, 2021 ; Christensen et al, 2021 ; Flaudias et al, 2020 ; Kohls et al, 2021 ; Racine et al, 2021 ; Thompson & Bardone‐Cone, 2021 ; Troncone et al, 2020 ; Trott et al, 2021 ). None of the samples was representative of the wider population, nor were sampling weights applied in any study in attempts to generalize to the wider population.…”