2026 ECNP Congress

EP01-1041

Literature review of suicide risk in athletes and individuals with eating disorders

Petranka Chumpalova — V. Valtchev, E. Dimitrova, L. Tumbev, G. Yanchev, I. Veleva · Medical University, Psychiatry and Medical psychology, Pleven, Bulgaria

2026 ECNP Congress

This literature review aims to examine the critical link between extreme levels of psychological stress and suicidal behavior, focusing on two specific groups: athletes experiencing professional failures and individuals with eating disorders. The common denominator between these conditions is often an identity crisis and destructive perfectionism. Once suicidal thoughts have occurred, they may be more likely to occur in the presence of: impulsivity as a personality trait; hopelessness or pessimism; imitation of behavior. Based on publications available in the literature, we analyzed the relationship between suicidal behavior, sports failures, and eating disorders. Statistics show that elite athletes are exposed to up to a 20% higher risk of depressive states in the event of a sudden career end or severe setback, and their risk of suicidal thoughts is enhanced by the public nature of the failure [1] [2]. In sports failures, the loss of social status and physical pain can lead to a sudden loss of meaning. In parallel, eating disorders remain among the mental illnesses with the highest mortality. Research suggests that people with anorexia nervosa are up to 18 times more likely to commit suicide than the general population, and approximately 25-30% of people with bulimia make at least one suicide attempt [3], [4]. Eating disorders—particularly anorexia and bulimia—have some of the highest suicide mortality rates due to the combination of emotional exhaustion, cognitive changes due to malnutrition, and high impulsivity. Eating disorders among elite athletes are a serious, often underestimated problem that carries a high risk of mortality, including suicide. The pressure to achieve a certain weight or appearance, combined with extreme physical exertion, makes athletes particularly vulnerable. Male athletes are at higher risk of developing an eating disorder. Up to 19% of male athletes experience disordered eating and/or an eating disorder. Those at higher risk include those who play sports that require a specific physique, such as gymnasts, swimmers, jockeys, weightlifters, wrestlers, and bodybuilders. Research suggests that over a third of people with eating disorders are men. Unfortunately, many men with eating disorders remain undiagnosed due to their own reluctance to seek help, due to stigma, lack of awareness in the community, due to lack of understanding on the part of health professionals. Conclusion: Elite athletes with eating disorders are a risk group for committing suicide. Therefore, we need to increase our efforts towards early diagnosis of the problem, psychological support for elite athletes before and after sports competitions, as well as to make additional efforts to prepare sports physicians how to respond to athletes with eating disorders. It is important to note that early initiation of treatment in elite athletes with eating disorders such as psychotherapy, nutritional counseling and support groups is effective in both men and women and the prospect of recovery is equally possible.

References

  1. Rice, S. M., et al. (2016). “The Mental Health of Elite Athletes: A Narrative Systematic Review.”
  2. Gouttebarge, V., et al. (2019). “Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis.”
  3. Arcelus, J., et al. (2011). “Mortality rates in patients with eating disorders: a meta-analysis of 36 studies.”
  4. Udo, T., Bitley, S., & Grilo, C. M. (2019). “Suicide attempts in US adults with lifetime DSM-5 eating disorders.”