Retired Athletes and the Intersection of Food and Body: A Systematic Literature Review Exploring Compensatory Behaviours and Body Change
Abstract
:1. Introduction
2. Methods
2.1. Search Strategy
2.2. Data Synthesis and Analysis
3. Results
3.1. Eligible Studies and Thematic Development
3.2. Body Dissatisfaction and Grief
3.3. Disordered Eating and Compensation
3.4. Long Term Influence of Sporting Culture
4. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Samuel, R.D.; Tenenbaum, G. The Role of Change in Athletes’ Careers: A Scheme of Change for Sport Psychology Practice. Sport Psychol. 2011, 25, 233–252. [Google Scholar] [CrossRef]
- Liu, T.C.; Liu, Y.Y.; Lee, S.D.; Huang, C.Y.; Chien, K.Y.; Cheng, I.S.; Lin, C.Y.; Kuo, C.H. Effects of short-term detraining on measures of obesity and glucose tolerance in elite athletes. J. Sports Sci. 2008, 26, 919–925. [Google Scholar] [CrossRef] [PubMed]
- Knights, S.; Sherry, E.; Ruddock-Hudson, M. Investigating Elite End-of-Athletic-Career Transition: A Systematic Review. J. Appl. Sport Psychol. 2016, 28, 291–308. [Google Scholar] [CrossRef]
- Taylor, J.; Ogilvie, B.C. A conceptual model of adaptation to retirement among athletes. J. Appl. Sport Psychol. 1994, 6, 1–20. [Google Scholar] [CrossRef]
- Erpič, S.; Wylleman, P.; Zupančič, M. The effect of athletic and non-athletic factors on the sports career termination process. Psychol. Sport Exerc. 2004, 5, 45–59. [Google Scholar] [CrossRef]
- Park, S.; Lavallee, D.; Tod, D. Athletes’ career transition out of sport: A systematic review. Int. Rev. Sport Exerc. Psychol. 2013, 6, 22–53. [Google Scholar] [CrossRef]
- Pearson, R.E.; Petitpas, A.J. Transitions of athletes: Developmental and preventive perspectives. J. Couns. Dev. 1990, 69, 7–10. [Google Scholar] [CrossRef]
- Webb, W.M.; Nasco, S.A.; Riley, S.; Headrick, B. Athlete identity and reactions to retirement from sports. J. Sport Behav. 1998, 21, 338–362. [Google Scholar]
- Martin, L.A.; Fogarty, G.J.; Albion, M.J. Changes in Athletic Identity and Life Satisfaction of Elite Athletes as a Function of Retirement Status. J. Appl. Sport Psychol. 2014, 26, 96–110. [Google Scholar] [CrossRef]
- Cosh, S.; Crabb, S.; Lecouteur, A. Elite athletes and retirement: Identity, choice, and agency. Aust. J. Psychol. 2013, 65, 89–97. [Google Scholar] [CrossRef]
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®); American Psychiatric Pub: Arlington, VA, USA, 2013. [Google Scholar]
- Chapman, J.; Woodman, T. Disordered eating in male athletes: A meta-analysis. J. Sports Sci. 2015, 34, 101–109. [Google Scholar] [CrossRef] [PubMed]
- Dunn, T.M.; Bratman, S. On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eat. Behav. 2016, 21, 11–17. [Google Scholar] [CrossRef] [PubMed]
- Murray, S.B.; Rieger, E.; Touyz, S.W.; De la Garza García, L. Yolanda, Muscle dysmorphia and the DSM-V conundrum: Where does it belong? A review paper. Int. J. Eat. Disord. 2010, 43, 483–491. [Google Scholar] [CrossRef] [PubMed]
- Lichtenstein, M.B.; Hinze, C.J.; Emborg, B.; Thomsen, F.; Hemmingsen, S.D. Compulsive exercise: Links, risks and challenges faced. Psychol. Res. Behav. Manag. 2017, 10, 85–95. [Google Scholar] [CrossRef] [PubMed]
- Moher, D.; Liberati, A.; Tetzlaff, J.; Altman, D.G. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 2009, 6, e1000097. [Google Scholar] [CrossRef] [PubMed]
- Pluye, P.; Gagnon, M.P.; Griffiths, F.; Johnson-Lafleur, J. A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in Mixed Studies Reviews. Int. J. Nurs. Stud. 2009, 46, 529–546. [Google Scholar] [CrossRef] [PubMed]
- Gouttebarge, V.; Aoki, H.; Kerkhoffs, G.M. Prevalence and determinants of symptoms related to mental disorders in retired male professional footballers. J. Sports Med. Phys. Fit. 2016, 56, 648–654. [Google Scholar]
- Gouttebarge, V.; Jonkers, R.; Moen, M.; Verhagen, E.; Wylleman, P.; Kerkhoffs, G. The prevalence and risk indicators of symptoms of common mental disorders among current and former Dutch elite athletes. J. Sports Sci. 2017, 35, 2148–2156. [Google Scholar] [CrossRef]
- Gouttebarge, V.; Frings-Dresen, M.H.W.; Sluiter, J.K. Mental and psychosocial health among current and former professional footballers. Occup. Med. Oxf. 2015, 65, 190–196. [Google Scholar] [CrossRef] [Green Version]
- Gouttebarge, V.; Kerkhoffs, G.; Lambert, M. Prevalence and determinants of symptoms of common mental disorders in retired professional Rugby Union players. Eur. J. Sport Sci. 2016, 16, 595–602. [Google Scholar] [CrossRef]
- Kerr, Z.Y.; DeFreese, J.D.; Marshall, S.W. Current Physical and Mental Health of Former Collegiate Athletes. Orthop. J. Sports Med. 2014, 2, 2325967114544107. [Google Scholar] [CrossRef] [PubMed]
- Marquet, L.A.; Brown, M.; Tafflet, M.; Nassif, H.; Mouraby, R.; Bourhaleb, S.; Toussaint, J.F.; Desgorces, F.D. No effect of weight cycling on the post-career BMI of weight class elite athletes. BMC Public Health 2013, 13, 510. [Google Scholar] [CrossRef] [PubMed]
- O’Connor, P.J.; Lewis, R.D.; Kirchner, E.M.; Cook, D.B. Eating disorder symptoms in former female college gymnasts: Relations with body composition. Am. J. Clin. Nutr. 1996, 64, 840–843. [Google Scholar] [CrossRef] [PubMed]
- Stephan, Y.; Torregrosa, M.; Sanchez, X. The body matters: Psychophysical impact of retiring from elite sport. Psychol. Sport Exerc. 2007, 8, 73–83. [Google Scholar] [CrossRef]
- Greenleaf, C. Athletic body image: Exploratory interviews with former competitive female athlete. Women Sport Phys. Act. J. 2002, 11, 63–88. [Google Scholar] [CrossRef]
- Papathomas, A.; Petrie, T.A.; Plateau, C.R. Changes in body image perceptions upon leaving elite sport: The retired female athlete paradox. Sport Exerc. Perform. Psychol. 2018, 7, 30–45. [Google Scholar] [CrossRef]
- Plateau, C.R.; Petrie, T.A.; Papathomas, A. Exercise attitudes and behaviours among retired female collegiate athletes. Psychol. Sport Exerc. 2017, 29, 111–115. [Google Scholar] [CrossRef] [Green Version]
- Stephan, Y.; Bilard, J. Repercussions of transition out of elite sport on body image. Percept. Motor Skills 2003, 96, 95–104. [Google Scholar] [CrossRef]
- Cooper, H.; Winter, S. Exploring the Conceptualization and Persistence of Disordered Eating in Retired Swimmers. J. Clin. Sport Psychol. 2017, 11, 222–239. [Google Scholar] [CrossRef]
- Kerr, G.; Dacyshyn, A. The retirement experiences of elite, female gymnasts. J. Appl. Sport Psychol. 2000, 12, 115–133. [Google Scholar] [CrossRef]
- Plateau, C.R.; Petrie, T.A.; Papathomas, A. Learning to eat again: Intuitive eating practices among retired female collegiate athletes. Eat. Disord. 2017, 25, 92–98. [Google Scholar] [CrossRef] [PubMed]
- Stirling, A.E.; Cruz, L.C.; Kerr, G.A. Influence of Retirement on Body Satisfaction and Weight Control Behaviors: Perceptions of Elite Rhythmic Gymnasts. J. Appl. Sport Psychol. 2012, 24, 129–143. [Google Scholar] [CrossRef]
- Lavallee, D.; Gordon, S.; Grove, J.R. Retirement from sport and the loss of athletic identity. J. Pers. Interpers. Loss 1997, 2, 129–147. [Google Scholar] [CrossRef] [Green Version]
- Karazsia, B.T.; van Dulmen, M.H.; Wong, K.; Crowther, J.H. Thinking meta-theoretically about the role of internalization in the development of body dissatisfaction and body change behaviors. Body Image 2013, 10, 433–441. [Google Scholar] [CrossRef] [PubMed]
- Mountjoy, M.; Sundgot-Borgen, J.; Burke, L.; Carter, S.; Constantini, N.; Lebrun, C.; Meyer, N.; Sherman, R.; Steffen, K.; Budgett, R.; et al. The IOC consensus statement: Beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). Br. J. Sports Med. 2014, 48, 491. [Google Scholar] [CrossRef]
- Mountjoy, M.; Sundgot-Borgen, J.K.; Burke, L.M.; Ackerman, K.E.; Blauwet, C.; Constantini, N.; Lebrun, C.; Lundy, B.; Melin, A.K.; Meyer, N.L.; et al. IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. Br. J. Sports Med. 2018, 52, 687–697. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sundgot-Borgen, J.; Torstveit, M.K. Prevalence of eating disorders in elite athletes is higher than in the general population. Clin. J. Sport Med. 2004, 14, 25–32. [Google Scholar] [CrossRef]
- Dorian, L.; Garfinkel, P. Culture and Body Image in Western Society. Eating Weight Disorders 2002, 7, 1–19. [Google Scholar]
- Atkinson, M. Male Athletes and the Cult(ure) of Thinness in Sport. Deviant Behav. 2011, 32, 224–256. [Google Scholar] [CrossRef]
- Cosh, S.; Crabb, S.; Kettler, L.; LeCouteur, A.; Tully, P.J. The normalisation of body regulation and monitoring practices in elite sport: A discursive analysis of news delivery sequences during skinfold testing. Qual. Res. Sport Exerc. Health 2015, 7, 338–360. [Google Scholar] [CrossRef]
- Fairburn, C.G.; Cooper, Z.; Shafran, R. Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behav. Res. Ther. 2003, 41, 509–528. [Google Scholar] [CrossRef]
Population | Retired Athletes |
---|---|
Intervention/exposure of interest | Relationship with food and/or body |
Comparators | NA |
Outcome | Primary outcome: disordered eating, eating disorders, maladaptive food behaviours, restriction, rigid food control Secondary outcome: body image issues, weight control, body control, compensatory exercise, negative self-image, and dysmorphia |
Study design | All qualitative, quantitative and mixed-methodology studies |
Author, Year | Country | Participant Characteristics, Sport | Years Since Retirement | Validated Tool Used | Key Finding | Study Limitations | Study Quality [17] |
---|---|---|---|---|---|---|---|
Gouttebarge, Aoki and Kerkhoffs (2016) [18] Cross-sectional analysis | Belgium, Chile, Finland, France, Japan, Norway, Paraguay, Peru, Spain, Sweden, Switzerland | Male; n = 219 Age: 35.0 ± 6.9 Soccer (Football) | 4.4 ± 3.6 | 4 x adverse nutrition statements (validated) | 65% had adverse nutrition behaviour. More likely to occur with life events occurring in the last 6 months. | Lack of clear validation process or statistics | 66% |
Gouttebarge et al. (2017) [19] Cohort study | Netherlands | Male; n = 138 Female; n = 143 Age: 50.7 ± 15.1 Non-specified Olympic sports | 20.2 ± 15.4 | 4 x adverse nutrition statements (validated) | More likely to have ED symptoms when had athletic injury, career dissatisfaction, inadequate social support, significant life events or surgery | Lack of clear validation process or statistics, insignificant statistical power | 66% |
Gouttebarge, Frings-Dresen, and Sluiter (2015) [20] Observational study | Australia, Ireland, Netherlands, New Zealand, Scotland, USA | Male; n = 104 Age: 36.0 ± 5 Soccer (Football) | 5 ± 3 | 4 x adverse nutrition statements (validated) | 42% had adverse nutrition behaviour compared to 26% of current players. | Lack of clear validation process or statistics | 33% |
Gouttebarge, Kerkhoffs, and Lambert (2016) [21] Cross-sectional analysis | France, Ireland, South Africa | Male; n = 295 Age: 38 ± 6 Rugby Union | 8 ± 5 Range: 1–25 | 4 x adverse nutrition statements (validated) | 61.9% had adverse nutrition behaviour, made more likely with significant life events and career dissatisfaction | Lack of clear validation process or statistics | 66% |
Kerr, DeFreese and Marshall (2014) [22] Cross-sectional study | USA | Male; n = 376 Female; n = 421 Age: 22–51 Various NCAA Division 1 Sports | Unknown | No | 5.8% (n = 46) had uncontrolled eating, higher than the USA general population | Un-validated tool with no confounding factors | 0% |
Marquet, et al. (2013) [23] Longitudinal | France | Female; n = 20 Male; n = 84 Age: unspecified Rowing, Wrestling, Boxing, Judo | Unspecified | Eating Attitudes Test (EAT-26) | Those who engaged in diets in their athletic career were likely to have high ‘dietary restraint’ into retirement | Sampling rationale limited | 66% |
O’Connor, Lewis, Kirchner and Cook (1996) [24] Cross-sectional | USA | Female; n = 22 Age: 36.6 ± 3.8 Gymnastics | ~15 years | Eating Disorder Inventory 2 (EDI-2) | Retired athletes were less likely to have body dissatisfaction compared to controls | Sampling rationale limited | 66% |
Stephan, Torregrosa and Sanchez (2007) [25] Cross-sectional | France | Males; n = 46 Females; n = 23 Age: 34.88 ± 4.82 Various Sports | 5.15 ± 3.28 | No | Those who experienced difficulties related to the body changes were negatively related to self-esteem, physical self-worth, physical condition, sports competence and attractiveness. | Lack of validated tool and no mention of sampling rationale | 33% |
Author, Year, Methodology, Methods | Country | Participant Characteristics | Years Since Retirement | Validated Tool Used | Key Quantitative Finding | Key Themes | Study Quality [17] |
---|---|---|---|---|---|---|---|
Greenleaf (2002) [26] Cross-sectional, thematic analysis | USA | Female; n = 6 Age: 23–31 (M = 26) Various Sports | 1–5 years | Figure Rating Scale (FRS) | Nil significant findings (The FRS served as an additional source of complementary information) | (1) Factors influencing body image: uniforms, teammates, appearance, fitness and coaches, (2) comparison to previous body, (3) social body ideal vs. athletic ideal | 33% |
Papathomas, Petrie and Plateau (2018) [27] Cross-sectional, interpretivist analysis, multimethod | USA | Female; n = 218 Age: 25.72 ± 1.19 Gymnastics, Swimming | 2–6 years | No | Years since retirement was unrelated to weight status, satisfaction and control. 55% dissatisfied with weight, 59.6% trying to lose weight. | (1) Move toward the feminine ideal, (2) feeling fat, flabby and ashamed, (3) a continued commitment to a former self, 4) conflicting ideals: the retired female athlete paradox | 66% |
Plateau, Petrie, and Papathomas (2017) [28] Cross-sectional, inductive analysis, multimethod | USA | Female; n = 218 Age: 25.72 ± 1.19 Gymnastics, Swimming | 2–6 years | No | Athletes expressed concern on changing body shape and weight with reduced exercise. | (1) Finding new meanings in exercise (2) Negotiating exercise independence (3) Repositioning exercise in a broader life context | 66% |
Stephan and Bilard (2003) [29] Longitudinal, thematic analysis, multimethod | France | Female; n = 8 Male; n = 8 Age: 30.6 ± 3.7 Various Sports | 1.5 months and 4.5months | Body Image Questionnaire (BIQ) | Decrease in body satisfaction between 1.5–5 months after retirement. | (1) Weight gain and uncertainty about physical capacities, (2) awareness of physical deterioration, (3) unpleasant somatic symptoms, (4) decrease in social recognition | 66% |
Author, Year, Methodology, Methods | Country | Participant Characteristics, Sport | Years Since Retirement | Objective or Research Question | Key Theme | Study Quality [17] |
---|---|---|---|---|---|---|
Cooper and Winter (2017) [30] Interpretative phenomenological analysis | USA | Male; n = 2 Female; n = 4 Age: 26.4 ± 6.3 Swimming | 4.8 ± 6.1 | How have DE patterns developed in relation to their competitive performance and how have these patterns changed or persisted with the influence of sport retirement? | (1) Pressures unique to swimming, (2) transition to eating pattern awareness, (3) maintaining ideal eating patterns in retirement | 100% |
Kerr and Dacyshyn (2000) [31] Inductive analysis | Canada | Female; n = 7 Age: 16–22 Gymnastics | 0.5–5 years | To enhance understanding of the retirement experiences of elite female gymnasts | (1) Retirement phases; nowhere land, new beginnings, transition process | 66% |
Plateau, Petrie and Papathomas (2017) [32] Inductive and deductive thematic analysis | USA | Female; n = 218 Age: 25.72 ± 1.19 Swimming, Diving, Gymnastics | 2–6 years | To explore retired female collegiate athletes’ eating practices in the context of the intuitive eating framework | (1) Permission to eat, (2) recognising internal hunger and satiety cues, (3) eating to meet physical and nutritional needs | 17% |
Stirling, Cruz, and Kerr (2012) [33] Thematic analysis | USA | Female; n = 8 Age: 19.88 ± 2.64 Rhythmic Gymnastics | 2.75 ± 1.58 | To examine retired rhythmic gymnasts’ perceptions of the influence of retirement on their body satisfaction and weight control behaviours | (1) Increased body dissatisfaction, (2) guilt around weight gain, loss of muscle mass and eating habits | 33% |
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Buckley, G.L.; Hall, L.E.; Lassemillante, A.-C.M.; Ackerman, K.E.; Belski, R. Retired Athletes and the Intersection of Food and Body: A Systematic Literature Review Exploring Compensatory Behaviours and Body Change. Nutrients 2019, 11, 1395. https://doi.org/10.3390/nu11061395
Buckley GL, Hall LE, Lassemillante A-CM, Ackerman KE, Belski R. Retired Athletes and the Intersection of Food and Body: A Systematic Literature Review Exploring Compensatory Behaviours and Body Change. Nutrients. 2019; 11(6):1395. https://doi.org/10.3390/nu11061395
Chicago/Turabian StyleBuckley, Georgina L., Linden E. Hall, Annie-Claude M. Lassemillante, Kathryn E. Ackerman, and Regina Belski. 2019. "Retired Athletes and the Intersection of Food and Body: A Systematic Literature Review Exploring Compensatory Behaviours and Body Change" Nutrients 11, no. 6: 1395. https://doi.org/10.3390/nu11061395