A recent scientific review, published in the journal Sports Medicine, has found that a substantial number of ultra runners struggle with mental health challenges and eating disorders.
The study, which was published earlier this month, looked into the mental, behavioural, and physical demands that ultrarunners – those who run events longer than the traditional marathon distance of 26.2 miles – face during both their training and races.
‘Among ultra-endurance runners, the mental, behavioural, and physical demands of training/competition can result in maladaptive outcomes,’ the researchers wrote. ‘Mental health issues are common in athletes and can impact psychology, physical health, and performance.’
While the benefits of physical activity on mental health have been widely documented - a 2023 study from the British Journal of Sports Medicine concluded that exercise is efficacious in treating depression and depressive symptoms and should be offered as an evidence-based treatment option - another study demonstrates that the relationship between physical activity and mental health follows a U-shaped curve with higher levels (or excessive amounts) of exercise actually doing the opposite and having damaging effects on mental health.
The researchers of this latest study reviewed and analysed 282 other studies in total. After excluding the duplicates, screening titles and abstracts, 42 of those studies were deemed relevant for full-text assessment and eleven studies, published between 2013 and 2022, fulfilled the researchers' criteria and were included in this extensive cross-study review.
Pooling together data from 3,670 ultrarunners, both male and female, the review focused on mental health concerns among both elite athletes and nonprofessional ultramarathon runners.
The findings painted a worrisome picture. Among ultrarunners, the prevalence of eating disorders ranged between 32 and 62.5 per cent while exercise addiction also affected a substantial portion of ultrarunners, with rates varying from 11.5 to 18.2 per cent.
Notably, the study indicated that exercise addiction wasn’t merely tied to training volume or race distance, but rather to the individual’s relationship with exercise, underscoring the complex interplay between physical activity and mental well-being.
Eating disorders among athletes are a recurring topic – according to a 2021 study in the International Journal of Mental Health and Addiction, athletes report frequently adopting extreme weight-control practices, including overexercising, for instance prior to competition, during resting periods, or after injury.
The researchers in the systematic review suggested that ‘the higher interest in eating disorders among ultramarathon runners could be related to the evidence that running emphasises leanness or low body weight as a performance-related factor’, and that when comparing eating disorders between elite athletes and the general population, there was a ‘higher prevalence of eating disorders among the elite group’ and among the female athletes.
In addition to these findings, depressive symptoms were found to affect 18.6 per cent of ultrarunners, highlighting that while running is usually associated with positive mental health benefits, there’s a need for a more comprehensive understanding of the psychological effects, the pressure and the high demands linked to ultrarunning.
Sleep disturbances, which affect both our mental and physical health, were also investigated and reported by 24.5 per cent of ultrarunners.
Of course, while these findings cast light upon the prevalence of mental health issues among ultramarathoners’, the comparative study acknowledges the need for further research. The researchers emphasise the importance of investigating differences in mental health concerns between elite and non-elite ultrarunners, and the long-term effects of these endurance events and challenges.
‘Future comparative studies are needed to better understand sex differences and positive outcomes associated with participation in ultra-endurance running among nonprofessional athletes. It is important to continue investigating mental health issues among ultrarunners to better understand the risk factors and develop interventions to promote the well-being of these athletes,’ they write.
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