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Weight Gain During NFL Career Linked to Post-Retirement Health Problems

Key findings

  • Former professional football players report substantial weight gain, beginning in young adulthood and continuing through professional football participation and into retirement (average weight gain 40 pounds)
  • Most of this weight gain occurred during, not after, football participation
  • Among the former professional football players, the current prevalence of self-reported health problems ranged from 28% for chronic pain to 9% for established cardiovascular disease
  • Weight gain during active football participation was strongly and independently associated with later-life chronic disease, even after adjustment for length of football participation, post-career weight gain and numerous post-football lifestyle variables

Over the past several decades, the average size of elite football players has increased markedly, such that many players' body mass index (BMI) meets the accepted definitions of obesity. A recent study detected significant associations between post-career BMI changes and coronary disease, diabetes and hypertension, but little research has examined the impact of weight gain during football participation.

To investigate, Timothy W. Churchill, MD, and Aaron L. Baggish, MD, of Massachusetts General Hospital, and colleagues surveyed former players from the National Football League (NFL) who played as early as 1960. The results, reported in the American Journal of Medicine, demonstrate strong associations between intra-career weight gain and later-life chronic health problems, independent of post-career weight gain and other potential risk factors.

Altogether, 3,506 of 12,357 former players contacted (28.4%) completed a 76-question survey. The average age was 53 years and 36% identified as Black/African-American. Most respondents started playing competitive football in their preteen years (average age 11.7 years). While playing in the NFL, approximately one-third of respondents were linemen. Along with questions about lifestyle and health history, they were asked to report their weight at the end of their high school football participation, weight during their collegiate participation, their weight during their professional career, their maximum post-retirement weight and their current weight.

The responses indicated statistically significant weight gain during each of the three time intervals studied

  • High school to college (mean gain of 23 pounds)
  • College to professional career (11 pounds)
  • Professional career to current weight (6 pounds)

Weight gain patterns were similar for both linemen and non-linemen.

Close to a third of the cohort (28%) reported that they currently have chronic pain, followed by cardiometabolic disease (25%), sleep apnea (22%), neurocognitive impairment (17%) and cardiovascular disease (9%). Early-adulthood weight gain during periods of football participation was independently associated with many of these problems.

The associations between weight gain and poorer health were particularly strong for weight gained in the transition from college to professional participation. The associations persisted even after adjustment for demographic factors, football exposure, post-career lifestyle variables and weight gain.

The authors caution against generalizing the findings to non-athletes and athletes from other sports because football players are at high risk of frequent head trauma and musculoskeletal injuries. In addition, the weight gain in football players tends to be characterized by a high percentage of lean muscle mass. Another caution is that because the weight and health history were assessed at a single point in time, no causal relationships can be inferred between weight gain and chronic diseases. It is also unknown whether targeted post-career weight loss might compensate for the adverse effects of weight gain during football participation. Therefore, the researchers draw no conclusion about whether deliberate football-associated weight gain should be discouraged.

They do, however, recommend providing football players and aspiring players with the full complement of information about the potential health effects of deliberate weight gain.

of former professional football players reported chronic pain

of former professional football players reported established cardiovascular disease

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