Psychological health in gymnastics: a systematic review of disordered eating, body image, mental well-being, and psychological resources

  • Anisa Sholiha Mia 
    Universitas Negeri Padang
    Indonesia
  • Ifdil Ifdil
    Center for Educational Neuroscience, Trauma, and Human Behavior, Universitas Negeri Padang.
    Indonesia

Abstract

Competitive and developmental gymnastics involve intensive training, performance evaluation, and, in several disciplines, explicit body-shape and weight expectations. These conditions may create psychological risks, but evidence is dispersed across disordered eating, body image, mental health, and psychological-skills research. This systematic review synthesised empirical evidence on psychological health in gymnasts across competitive, recreational, developmental, and post-competitive contexts published between 2021 and 2026. The review followed PRISMA 2020 and used Scopus, PubMed, and ScienceDirect. Eligible studies were peer-reviewed empirical investigations involving gymnasts and reporting at least one psychological or mental-health outcome. From 398 records identified, 11 duplicates were removed; 387 records were screened, 47 full texts were assessed, and 20 studies were included. Methodological quality was appraised using the MMAT 2018, with domain-level ratings retained for transparency and no study excluded solely because of quality. The synthesis identified three analytical themes: (1) disordered eating, body image, and weight pressure; (2) mental health and psychological consequences; and (3) psychological skills and regulatory resources. The evidence indicates that disordered eating and body-image concerns are concentrated in higher-pressure contexts, whereas adaptive self-talk, task-involving motivational climates, supportive coach relationships, and regulated perfectionism are potential protective resources. Because most studies were cross-sectional and heterogeneous, the findings should not be interpreted causally and no meta-analysis was conducted. Prospective longitudinal, intervention, and multi-method studies are needed, particularly in under-represented disciplines and among male gymnasts.

Keywords
  • Gymnastics, Disordered eating, Body image, Mental health, Sport psychology
Lisensing Information
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

References
  1. Amato, A., Proia, P., Caldara, G. F., Alongi, A., Ferrantelli, V., & Baldassano, S. (2021). Analysis of body perception, preworkout meal habits and bone resorption in child gymnasts. International Journal of Environmental Research and Public Health, 18(4), 2184. https://doi.org/10.3390/ijerph18042184
  2. Besson, L., & Edouard, P. (2024). Long-term consequences of practicing high-level women’s artistic gymnastics: A retrospective study of 27 former high-level gymnasts. Journal de Traumatologie du Sport. https://doi.org/10.1016/j.jts.2024.08.006
  3. Bouzid, M. S., Melki, H., Ben Romdhane, M., Hammoudi, S., Khalfallah, W., Rezgani, Y., Racil, G., & Padulo, J. (2025). The impact of video feedback on motor skill and motivation in acrobatic gymnastics through the use of digital tools in physical education. Journal of Human Sport and Exercise, 20(4), 1277 1292. https://doi.org/10.55860/pbyv8s24
  4. Buzzi, P. C., Nishida, F. S., de Oliveira, L. P., Felipe, D. F., & Verardi, C. E. L. (2025). Quality of life and level of perfectionism of rhythmic gymnastics athletes. Motriz, 31, e10220147. https://doi.org/10.5016/s1980-6574e10220147
  5. Donti, O., Donti, A., Gaspari, V., Pleksida, P., & Psychountaki, M. (2021). Are they too perfect to eat healthy? Association between eating disorder symptoms and perfectionism in adolescent rhythmic gymnasts. Eating Behaviors, 41, 101514. https://doi.org/10.1016/j.eatbeh.2021.101514
  6. Donti, A., Maraki, M. I., Psychountaki, M., & Donti, O. (2025). Eating Disorder Symptoms and Energy Deficiency Awareness in Adolescent Artistic Gymnasts: Evidence of a Knowledge Gap. Nutrients, 17(10), 1699. https://doi.org/10.3390/nu17101699
  7. Edlund, K., Forsberg, N., Källberg, H., & Melin, A. (2024). Assessment of eating disorder symptoms, compulsive exercise, body dissatisfaction and depression in Swedish national team gymnasts, with a one-year follow-up. Eating and Weight Disorders, 29, 46. https://doi.org/10.1007/s40519-024-01667-3
  8. Feng, B., & Yuan, Y. (2021). Research on burnout level of juvenile trampolinists and relevant affecting factors. Revista Brasileira de Medicina do Esporte, 27(3), 299 302. https://doi.org/10.1590/1517-8692202127032021_0162
  9. Gómez-Landero, L. A., Santos-Rosa, F. J., Reguera-López-de-la-Osa, X., & Cervelló, E. (2026). Do Different Interdependencies within a Sport Affect the Perceived Motivational Climate, Use of Spontaneous Self-Talk, Positivity or Precompetitive Anxiety? Journal of Human Kinetics, 102, 227 240. https://doi.org/10.5114/jhk/204776
  10. Hong, Q. N., Pluye, P., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.-P., Griffiths, F., Nicolau, B., O’Cathain, A., Rousseau, M.-C., & Vedel, I. (2018). Mixed Methods Appraisal Tool (MMAT), version 2018.
  11. Kontele, I., Vassilakou, T., & Donti, O. (2022). Weight pressures and eating disorder symptoms among adolescent female gymnasts of different performance levels in Greece. Children, 9(2), 254. https://doi.org/10.3390/children9020254
  12. Laureys, F., Collins, D., Deconinck, F. J. A., Vansteenkiste, P., & Lenoir, M. (2023). A one-year follow-up of the cognitive and psycho-behavioural skills in artistic gymnastics. Psychology of Sport and Exercise, 66, 102375. https://doi.org/10.1016/j.psychsport.2022.102375
  13. Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions. PLoS Medicine, 6(7), e1000100. https://doi.org/10.1371/journal.pmed.1000100
  14. Montero, A., Drummond, M., Baranoff, J., & Adams, R. (2026). The impact of sport retirement on mental health and sleep: A qualitative study with female ex-gymnasts. Psychology of Sport and Exercise, 84, 103085. https://doi.org/10.1016/j.psychsport.2026.103085
  15. Nuñez, B. P., Sanchez-Lastra, M. A., Diz, J. C., & Pérez, C. A. (2024). Body dissatisfaction among young girls in recreational rhythmic gymnastics. Children, 11(6), 696. https://doi.org/10.3390/children11060696
  16. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., Thomas, J., Tricco, A. C., Welch, V. A., Whiting, P., & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
  17. Polak, E., Gardzińska, A., & Zadarko-Domaradzka, M. (2022). Anorexic readiness syndrome in elite female acrobatic gymnasts—International study. International Journal of Environmental Research and Public Health, 19(20), 13181. https://doi.org/10.3390/ijerph192013181
  18. Portas-Núñez, B., Blanco-Martínez, N., Sánchez-Lastra, M. A., Diz-Gómez, J. C., & Ayán-Pérez, C. (2026). Prevalence of eating disorder, body image dissatisfaction and musculoskeletal complaints among former Spanish rhythmic gymnasts: A retrospective study. The Physician and Sportsmedicine, 54(2), 140 146. https://doi.org/10.1080/00913847.2025.2597180
  19. Remmel, L., Jürimäe, J., Tamm, A.-L., Purge, P., & Tillmann, V. (2021). The associations of body image perception with serum resistin levels in highly trained adolescent Estonian rhythmic gymnasts. Nutrients, 13(9), 3147. https://doi.org/10.3390/nu13093147
  20. Remmel, L., Jürimäe, J., Tamm, A.-L., Purge, P., & Tillmann, V. (2024). High serum irisin concentration is associated with more disturbed behavioural eating pattern in adolescent rhythmic gymnasts. Children, 11(11), 1384. https://doi.org/10.3390/children11111384
  21. Santos-Rosa, F. J., Montero-Carretero, C., Gómez-Landero, L. A., Torregrossa, M., & Cervelló, E. (2022). Positive and negative spontaneous self-talk and performance in gymnastics: The role of contextual, personal and situational factors. PLoS ONE, 17(3), e0265809. https://doi.org/10.1371/journal.pone.0265809
  22. Sriwahyuniati, C. F., Tomoliyus, Wicaksono, D., Andareza, A., Virdania, E., Ningsih, G. R., Sari, S. I., Ventiano, G. S., Gafar, M. A., & Susila, R. F. (2025). Achievement motivation in gymnastics athletes based on the Achievement Motivations Scale for Sports Environments: A study of gender differences. Fizjoterapia Polska. https://doi.org/10.56984/8ZG007DG9B
  23. Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8, 45. https://doi.org/10.1186/1471-2288-8-45
  24. Tranfield, D., Denyer, D., & Smart, P. (2003). Towards a methodology for developing evidence-informed management knowledge by means of systematic review. British Journal of Management, 14(3), 207 222. https://doi.org/10.1111/1467-8551.00375
  25. Yoshitani-Kuwabara, K., Yumen, Y., Takayama, Y., Kitayama, N., & Nagai, N. (2025). High proportions of low body mass index and menstrual dysfunction among rhythmic gymnasts: Association with body image distortion and eating behaviors and attitudes. Journal of Nutritional Science and Vitaminology, 71, 519 526. https://doi.org/10.3177/jnsv.71.519

Downloads

PDF

Statistic

Abstract Views
: 5 times
PDF
: 2 times