“We were weighed every day and sent to fat club. You got on the scales daily and someone would just say you needed to go and do more sessions or not.” – Claire Rafferty on how football fuelled her disordered eating.
When you break your leg, you seek help, you rehab, you recover, you go again. It’s a visible ailment that prevents you from being active. You put a cast on, people happily sign it and, in conjunction with physios and doctors, you do the work to get back out there in a relatively set period of time. No-one questions the ‘severity’ of your condition because it is a tangible condition that they can see and therefore comprehend.
Mental health just doesn’t work like that.
You can’t see it, you can’t touch it, you can’t put a cast on it, and you certainly can’t put a time frame on recovering from something that is affecting your mental health. At the same time, while physical injuries have a general continuity throughout them and therefore a more standardised treatment plan, mental health is a many faceted, ever-changing beast that is unique to the individual.
What if you don’t have a choice?
In the deepest darkest depths of my own eating disorder, I wanted to disappear. I just wanted to be so small that I didn’t take up that space on the Earth. I wanted no contact from others, I used baggy clothing to swamp myself and I was engulfed by numbers, shapes, Instagram pages and ‘thinspo.’ My choice was to hide and that was what nearly killed me but ultimately led to my starting in the direction of recovery.
But what about when you haven’t got a choice? You can’t run and you can’t hide. You’re a professional footballer with a duty to your club and the fans and you’re expected to go out there and put your body and brain on the line for the badge on your shirt. What’s more is that the sport you love and the training you dedicate your life to are ultimately contributing to your own internal struggle. You feel it’s a show of weakness if you share your strife and seeking help is ‘not the done thing.’ You’re there on that stage and you’re expected to perform. Your internal monologue remains just that – internal. You can be at a low mentally but still show up on the pitch thus masking those underlying feelings for that 90 minutes. But we know that masking and repressing feelings and emotions is not a healthy coping mechanism and, while huge strides have been taken in regard to mental health in sport, it is becoming evident that more needs to be done in terms of eating disorders and elite performance.
Recent research from Perry et al at the University of Central Lancashire found that 36% of leading female football players in England displayed eating disorder symptoms. This was the first of its kind research and that feat alone showed just how little the topic is discussed within the sport. Indeed weight, and in particular controlling it, proved a recurring theme. “Our findings reported that 35% of footballers were currently trying to lose weight and 45% reported attempting to lose weight in the previous four weeks,” said Perry.
She remains particularly concerned that eating disorders have become normalised in this professional context adding: “Highly disordered eating scores were not associated with currently needing psychological support. We believe this finding warrants further investigation as this could indicate that disordered eating symptoms are not self-recognised. Instead, it’s possible they are normalised in the footballers’ sporting environment.”
In conversation with Claire Rafferty
For former Chelsea, West Ham and England star Claire Rafferty, whose career was full of highs such as winning the FAWSL, the FA Cup and a World Cup Bronze, these findings resonate on a personal level. When she joined the England player development centre in her teens, she was weighed daily, sent to ‘fat club’ if the scales had gone the wrong way, and led to believe that this number was a fundamental influencer for her place in the side. While this behaviour was not prevalent at Chelsea, it continued when she was at England camps at least two weeks of every month. This association had a hugely negative impact on her own mental health and forced her to turn to disordered eating to control her emotions and navigate the world. Even when you search Claire on Wikipedia, one of the first points that comes up is her weight and that itself speaks volumes about the emphasis placed on it.
In a brave and open interview with me, the former international opened up about her struggles with bulimia and binge eating as well as her diagnosis of ADHD and the impact these all had on her career and her life.
“I was in a really controlled environment from a young age. Even in my teens we were weighed every day at the England development camps and sent to ‘fat club’. You got on the scale daily and someone would just say you needed to go and do more sessions or not and that became a marker that you were constantly reminded of. You had no choice to opt in or out, you just did what you were told” says Rafferty. “My eating disorder was the only thing I had control over. Well, I thought I had control anyway. I battled bulimia for a time before the binge eating and excessive exercise took over. I felt that if I’d eaten a lot, I needed to train more and over-exercised to try and compensate. I knew exactly what I’d weighed the day before and I was incredibly conscious of what my body looked like and how it felt. I still am and I guess I always will be. That’s the lasting scarring it’s left.
“You go into that elite set-up knowing you’re going to be scrutinised for certain things because that’s the nature of elite sport, but to quite that level wasn’t explained. We were constantly weighed and compared to others, and it made weight seem like this enormous factor that came between you and a place in the side. I still don’t know what weight they were expecting us to be and why that was a factor or how they expected us to lose it by jumping on a bike at ‘fat club.’
“I’ve never discussed it with the other girls because it’s not a normal thing and it’s still quite raw. We did what we were told but you could see the pain in people’s faces at weighing or during sessions. We tried to make light of it because it wasn’t something you talked about. I think those at the top didn’t have the long vision of the impact it would have and none of us questioned it because it was just what we did. But we were so young and it embedded the perceived importance of weight early. It took hold of me and became an obsession and even to this day I can’t have scales in my house because of the scarring. I haven’t stepped on the scales since I stopped playing. It’s not healthy.”
Being in control
It became about what she could control in such a regimented environment. This was her food intake and compensatory exercise.
“For me, it became a case of what I could eat that day. How much? When? What sessions was I doing? What would I have to wear? How much exercise would I be able to do around my eating? It was obsessive. I also never wanted to eat on match days because it made me feel lighter and I’d convinced myself I would perform better that way. That’s not a healthy way to play. You need energy but I was focused on how I felt and what I would look like.”
It wasn’t just the internal feelings of control but what it was like to be on a public stage in shorts while also competing for positions that began to take over her eating habits.
“You’re exposed,” she adds. “You’re there in shorts with your legs out so it became as much about what we looked like as players as our performance as the audience got bigger. You didn’t just have to play well, you also had to look good. Football is always about opinion, and I was comparing my shape and size to those competing for the same position. What did she look like? What can I do to my body to look better than her on the pitch? Do I need to look more athletic? Will this change people’s opinions of me? Is that how I succeed?”
There’s no denying that there is a certain mindset associated with the elite athlete. That motivation, determination and that drive for perfection is something we are familiar with in all sports. But the internalisation of how she was feeling about food and weight changed the motivations of the defender.
“I internalised everything and it was what I did to survive. I was living in that bubble and it was what I turned to so I could keep going. I never realised how much it was taking over my day-to-day thinking because it was my norm. The binge eating and exercise gave me that control that I didn’t have over other aspects of my life and it was that which motivated me rather than other factors. Of course, I still wanted to play and perform at my best, but this felt like a controllable. It affected how I could train and it took over everything. I was motivated to compensate food. If I’d eaten more, I trained harder no matter the football.”
There were other factors affecting Claire’s mindset that she was not aware of, but professional diagnosis has since helped her come to terms with her thoughts.
“I’ve since been diagnosed with ADHD. It’s all about that lack of dopamine and the need for control. There’s a correlation between ADHD and binge eating because both look to find that reward. ADHD is another one that isn’t talked about much in professional sport and I’m not sure whether it’s seen as a weakness or just not the done thing to talk. I never knew about it when I was playing although I know I’ve always been a fidgeter. Perhaps the clues were there and now I know it, I can see it. It’s another area where coaches and support staff need further education and we need to increase those conversations to help players navigate their mental state. I was always seeking that high, that hit, and that validation and it was exaggerated by ADHD and my eating disorder.”
In 2015, Claire was voted 43rd on a list of ZOO Magazine’s 101 sexiest women. She laughs at the recollection but it’s another stark reminder of the focus on appearance in women’s sport. Does being “sexy” really have any relation to being good at football?…
“It was again that external validation I needed and it fuelled the binge eating needs and those ADHD tendencies. I looked a certain way and made that list. It made me think what I was doing was good and getting me noticed. It was an ego boost and it helped my self-esteem and gave me a purpose. But once again it was a focus on appearance and not performance and that’s something that you can’t shy away from in elite women’s sport. I’ve had it with people shouting that they can see my pants or ‘nice legs love’ or ‘you could make those shorts shorter and more people would watch’ while I’m playing. I still don’t get why people feel that they have a right to comment on women’s bodies like that and it takes the focus away from performance.”
As with any sports professional, there have been some dark times for Claire. Some of the hardest of these were during times when she suffered injuries and when she stopped playing professionally and was left to her own internal conversations.
Injuries impact physical and mental health
“When I had my ACL injuries I turned to binge eating as a sort of coping mechanism. Again, it was that control thing. I couldn’t exercise and there were occasions when I felt really low and turned to my eating disorder. I was unable to do what I wanted and the binge eating still didn’t give me that high so it became this horrible cycle and I beat myself up a lot. I knew I was gaining weight and I was hyper critical of myself. I’ve never really looked back on it like this before and I’m at a stage now where I can look back and reflect while also feeling sad that I couldn’t have found that help and support at the time.
“When I stopped playing football I was in a dark place because I didn’t have that outlet. I was left to my own thoughts and again I turned to food for that comfort and dopamine rush. I was binge eating more because I was searching for external pleasure so as a consequence, I was doing secret training to compensate. It all added to the secretive side of everything and was a lot to bottle up. I didn’t know what to do or who to turn to. I’ve never felt so alone and I didn’t know how to live my life without it planned for me. I’ve only acknowledged it recently and thanks to the support of the PFA and finding a therapist to talk to, I’ve learned how to have control in my life again.
“It took me around two years after I retired to reach out. I’d thought I would be judged because I didn’t look like your standard idea of someone with an eating disorder who is just skin and bone. I’d never mentioned it to anyone and I was terrified of having to convince someone or be criticised. It’s not like my ACL injuries that can be diagnosed and seen, but I went along to a group session and being surrounded by people with similar experiences made the whole thing easier to face. I realised I’d been self-medicating with disordered behaviours and that there are healthier ways of coping.”
The growth of women’s football
There’s no denying that the popularity and publicity around the sport has increased beyond recognition in recent years, but there is still such a lack of research into the association between elite sport and eating disorders, anxiety and depression. There is also that fine line between positive coverage and criticism over appearance for sponsorship and interest.
“Women’s football has gained a lot more interest in recent years,” says Rafferty. “That’s a great thing but there’s always going to be negative aspects when it comes to comparison. In our society, there’s this emphasis on looking a certain way to attract sponsors and media attention. It validated my position in the public eye and made me feel I was doing the right thing in my career and regarding how I was portrayed to the world. My appearance came hand in hand with my success. It didn’t matter what was happening internally because I had that external visual appreciation. Even saying it now makes me realise how unhealthy that sounds.”
That kind of validation and appreciation is hard to come by in any other setting and is something Claire struggled with once she stepped off the field for the last time.
“Without football I felt I had no identity. You can’t replicate those highs and I couldn’t get the dopamine hits I’d been hunting in football. Again, I turned to those disordered behaviours and it spiralled while I struggled to discover my purpose. There have been some extremely hard times and there were days I felt there was no point going on anymore because I had no place. Saying that out loud is hard, but I am no longer in that place and I have grown as a person internally since. I hit some extreme lows, but I have my coping kit bag now that I go to. I’m learning and growing all the time and use these healthy coping mechanisms instead of turning to that eating disorder and what I thought it was bringing me. I focus on the now and I appreciate meditation and daily mantras. Every morning I set out my intentions and focus myself on the present. It keeps me grounded and has become a real calming aspect for my life now that I am in another phase of it.”
Speaking out can be a daunting step for anyone suffering with an eating disorder. They are secretive illnesses that thrive on isolation but simply by sharing her story, Claire is taking a huge step in her own recovery and to help others in her sport. Her advice to coaches and professionals? “Treat us as humans first and athletes second, focus on the person and what their needs are, educate and inform and stop with the weighing. There is nothing healthy about daily weigh-ins. There’s also a huge step to be taken in normalising conversations but we are starting to make steps. If my story helps just one person, then that is a positive. It’s 2022 and we shouldn’t ever feel ashamed of our feelings and our struggles. I am in a better place now and I’ve been able to emerge from my own isolation and start to embrace the world again.
On Friday I went to that historic Lionesses game at Wembley. It was more than just a game for me – I was nervous before about how I looked and what people would say but to get there and see the incredible game, my former teammates, and to make that lap around Wembley proved to me that I have taken huge steps in the right direction. I now keep fighting, live in the here and now, and embrace what the day has to offer. That is more important than any number on a scale.”
In terms of what can be done to support players, Claire now hopes more can be done by the FA and the PFA to support and educate players and coaches. This isn’t just at the elite level but right through from grassroots and isn’t just limited to female players – male footballers are subject to the same criticisms and eating disorders do not discriminate. She’s now calling for workshops, education, interacting with players, social media call-outs and continual normalisation of talking about mental health. “Together it can be done and we can break down these stigmas,” she concludes.
Talking to Claire was a real privilege for me and, in the short time we had together, it was evident what an impact all these behaviours have had on her life and mental health. Just one footballer speaking so openly is a huge step for the game and hopefully from here, more players will share their stories and there can be greater positive steps made to support footballers of all ages and genders.
Support is available
If anything in this article has triggered you or affected you, please know there are plenty of support groups and places you can go to for help: https://www.beateatingdisorders.org.uk/
A final piece of advice from Claire to her younger self fretting over daily weigh-ins:
“You are good enough. That number means nothing. You are strong and beautiful and you are talented and loved. Everyone is unique, including you and that is your superpower. You can achieve whatever you want and no number can ever change that. You are enough.”
Click here to get in touch with Georgie Heath at email@example.com and Claire Rafferty at firstname.lastname@example.org.