Weight charts, 'fat clubs' and disordered eating: the hidden health crisis in women's football

The physical and mental health of footballers is being put at risk by an alarming trend of disordered eating and fat-shaming within the Women’s Super League, a Daily Telegraph investigation has revealed.

Current and former players, and experts, highlighted concerns that the sport could be in danger of a health crisis, centring on restrictive eating and players feeling forced to maintain a certain body aesthetic.

The investigation revealed:

• Players fear being consigned to a “fat club” if they do not achieve weight targets set by coaches.

• Obsession around weight and body image is “the worst it’s been in years”, according to one player.

• The WSL has a “clinical knowledge gap” surrounding diet and nutrition, according to one expert.

The corrosive relationship between players and their food intake was highlighted in September last year when Dr Alex Culvin, a former WSL footballer and now senior lecturer in sports business at University of Salford, published damning research into how the professionalisation of the women’s top flight in 2018 had impacted players’ physical and mental well-being.

Testimonies from players painted a picture of fat-shaming and disordered eating, which is defined as unhealthy behaviours such as restrictive eating, being obsessive around food and weight and feeling guilty about eating too much or too often. Eating disorders are extreme cases of this trend.

One senior international told Culvin that her “whole team won’t have carbs after an intense session cause [sic] carbs are the ‘devil’ ” and that players in her squad “have to be a certain body fat or you’re in fat club and you have to train by yourself”.

A youth international said the results of her body-fat test were sent to the club’s board “to see if the investment is worth it ... The coach had to write an email saying why I had put on x amount of fat”.

These concerns are echoed by players who spoke to The Telegraph. One recently retired WSL player said that the issues raised by Culvin’s research were “definitely happening now across the league”. Disordered eating and obsessions around body weight were “probably the worst I’ve seen in years”.

Last season, players at her club were colour coded according to body fat, with those in the “red” asked to train more. “I’ve spoken to players at other WSL clubs who’ve been in fat clubs and they’ve had to do extra sessions to lose weight,” the player  said. “They don’t realise what that does to a player.

“Players will banter and joke about it in the dressing room, but those same players go home and they don’t eat. Over the past couple of years, I’ve seen it get really bad among some of my closest friends.”

The monitoring of body weight, which she was asked to upload onto an app each day, became so invasive that it started to interfere with her eating pattern ahead of competition.

“Me being in the red on the Friday meant I wouldn’t eat any carbs, any pasta on the Saturday for the game on the Sunday,” she said.

“It got that severe. My partner had to watch everything I was eating, making sure I was putting carbs on my plate. Most nights, I wouldn’t eat carbs.”

A current player said: “We had a couple of players who had to record and take pictures of what they were eating and send it to the nutritionist. It was one way to keep those players accountable. It is controlling.”

Clubs are becoming more sensitive to players’ issues around weight and food intake. Renee McGregor, a sports and eating disorder specialist dietitian who has spent 20 years working with Olympic and Paralympic athletes with dysfunctional relationships with food, said she had been asked by two WSL clubs to “review” some of their players.

“The players didn’t necessarily have eating disorders, but they were struggling with some clinical-type conditions,” McGregor said.

“I’ve only worked with two of the players so far and I’ve had feedback that the club would like me to do a session with everybody and create much more of a partnership.”

One WSL player who has struggled with disordered eating said that she had been seeking help from the psychologist of the men’s club, as the women’s club did not have one.

“It’s symptomatic of how mental health is such a massively undertreated problem in women’s football,” she said. “We see our own physios when we’re injured, so why don’t we have our own psychologist to help us with mental health?”

McGregor believes there is a “clinical knowledge gap” in the elite women’s game, meaning those who develop chronic disordered eating habits can go unnoticed. She also questioned some of the weight-management practices in use.

“Weighing somebody every day is very archaic,” she said. “What does that do? It doesn’t tell you anything about a person or their body composition. It goes back to that old belief system that being lighter makes you faster. There’s no proof for that.

“I can imagine the conversations that go on – girls wanting to be a bit leaner and thinking that having more protein than carbohydrates is better. That’s the worst thing you can possibly do as a female athlete.”

Dietary expertise at women’s clubs is not good enough

By Renee McGregor, Sports and eating disorder specialist dietitian

As a sports dietitian who specialises in eating disorders and athlete health, I’ve spent the last 10 years helping athletes who develop complicated relationships with food and training.

In the past year, I’ve been approached by two Women’s Super League clubs who asked me to assess some of their players for clinical type eating behaviours. I've also started to see more female players individually in my clinic.

I’m a firm believer that the clinical nutritional knowledge at women’s clubs is lacking. Clubs are good at performance nutrition, but they might not be equipped to use a style of questioning, or have the knowledge to read blood tests that can give clues to suggest that a player is struggling with their food.

I recently worked with one player from Ireland. A lot of her problems started due to the pressure she felt about having to be lean.

While her sports nutritionist appreciated that a problem was going on, due to the lack of their clinical knowledge, they continued to provide a very standard approach to performance nutrition which the player struggled to follow.

The player's fears were further heightened as skin folds, a technique used in sport to measure body composition, were being done frequently and gave her a number to fixate over.

It took a good year, but we came out the other side nursing a much better relationship with food and exercise. She even ended her season as player of the season.

These players are in pressurised environments and the increased profile of the women's game has brought greater scrutiny.

Those who lack self-worth or those that have a perfectionist mindset, both traits which have been linked to an increase in prevalence of eating issues look to find some area of their life they can control, food and training become this medium.

Chronic under-fueling - and specifically when their carbohydrate requirements are not being met - can result in a number of consequences, including a higher risk of injury and poor bone health.

Reproductive hormones may also become down regulated and a player’s period may stop, but it can be really hard to detect hormonal changes if a player is on contraception.

We’ve had so many athletes on contraception who say, ‘Oh I still have a period.’ But that’s not a period, it’s just a withdrawal bleed every month.

It feels as if women’s football has reached this tipping point, perhaps because the sport has finally got some funding and the recognition that the game didn’t have a few years ago.

That’s why I think it’s important those WSL clubs have reached out. It’s really good when a club medic says, ‘I think I might be missing something, I want to check.”