Top executives are thinking more deliberately about their physical and mental health 
In 2019, Jennifer Tejada, chief executive of software company PagerDuty, was deep in the throes of preparing for its stock market debut. Her life had become a whirlwind of travel and meetings and her health was deteriorating.
A former competitive golfer, Tejada had long been managing a back injury through exercise. But as the IPO neared, the pain became unmanageable and surgery could no longer be delayed.
“The doctor said, ‘Do you celebrate Christmas or Hanukkah? Well, you’re going to be celebrating with me’,” she recalls. Recovery meant long periods lying on the floor — hardly the pace she was used to. But it was, she says, “a great wake-up call”.
Tejada is now one of a growing number of top executives thinking far more deliberately about their physical and mental health, and how entwined this is with professional success.
This greater focus on wellness comes as two-thirds of chief executives admit to feeling burnt out more regularly, with nearly a quarter experiencing it frequently or nearly every day, according to Vistage, an executive coaching organisation for small and medium-sized businesses.
Some are going as far as to say the modern chief executive needs to operate more like a professional athlete.
“We can to a great extent invest in strength, endurance, mental wellness, nutrition and sleep in order to optimise our performance,” Tejada says. She now avoids early meetings, exercises daily and schedules quiet time for reflection. “I am much more intentional. I work with my team to protect my workouts. I set goals and measure my nutrition and protein intake. I’m more disciplined in how I plan my time and how I spend it.”
Today’s demands on a chief executive may not be comparable to the height of the 2008 financial crisis or the Covid pandemic but the pressure is still constant. Publicly listed company bosses have normalised being “on the job 24/7,” wrote Bob Sternfels, chief executive of consultancy McKinsey, in a recent report. He describes CEOs as responsible for “an ever-shifting array of problems and threats”, often under intense scrutiny.
The challenges are reflected in the rapidly rising pay packages awarded to the top executives. But despite the perks, tenures are becoming shorter and more CEOs are choosing to do the job once and step away. “Since the pandemic, it’s been one crisis after another,” says Christina Harvey, who coaches business leaders at headhunter Korn Ferry. “Burnout has become a common theme. People talk about it more openly.”
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One of the earliest high-profile acknowledgments of executive burnout came in 2011, when António Horta-Osório, then chief executive of Lloyds Banking Group, took a leave of absence for exhaustion.
At the time, he was trying to rescue the bank from near collapse. “I started sleeping less and less. Nights became endless,” he tells the Financial Times, 14 years on from the episode. After several days without sleep, he checked into a London clinic. Despite building a career “doing stressful jobs . . . it was a massive shock,” he says.
On his return, Horta-Osório changed how he worked. Meetings were never back-to-back. His diary included empty space for emergencies. Email was off-limits between 8pm and 7am. For urgent matters he told his team to phone him. “At Lloyds, I had made it my mission to save the bank,” he says. “I wouldn’t have lunch, no intervals between meetings, just 16-hour working days. I thought I could be an oak tree resisting the storm. But I should have been more like a palm that bends with the wind and rain.”
Like Tejada, Horta-Osório, who currently holds board and advisory roles, now sees performance peaks as something to prepare for — and recover from. “You need a lot of them and you have to prepare for them. But you also need to plan for recovery. You can’t be at the peak forever.”
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Some executives are borrowing from the world of elite sport, engaging sports psychologists and performance coaches to help them manage their working lives.
Josephine Perry, a psychologist who usually works with professional athletes, says she is now helping more CEOs. Many rituals of corporate life are at odds with peak performance, she notes. “Drinking the night before a board meeting is just about the worst thing you can do . . . These [CEO] roles are not designed for wellbeing.”
Where elite sports prioritise recovery, corporate culture often treats rest as weakness despite it helping with mental clarity, stamina and resilience. “The best athletes spend more time recovering than competing or training,” says Perry. “In the corporate world, it’s about how much more we can squeeze into the day and how much more we can be doing.”
Clients arrive at her door with persistent stomach aches, shoulder pain, back issues — symptoms often tied to high stress levels. “I’ve seen people suffer seizures from stress. Often they think they can power through with Diet Coke, coffee and try to combat stress with exercise but it is often something [high intensity] like ironman or Hyrox. This doesn’t help you recover.”
Those who seek her help often want support preparing for high pressure moments: board presentations, investment rounds or earnings calls. “They want to make better decisions under stress.”
Perry helps clients get into the right mindset and build strategies to cope. They may be thinking “I’m in charge, what if I mess it up, what if I’m not good enough,” she says. “They’re worried about outcomes and what those outcomes say about them as a person. What do poor earnings results say about me?”
Sabine Donnai, founder of Viavi, a London-based preventive health clinic, has also seen a steady stream of CEOs seeking help with issues such as brain fog, fatigue and burnout. Her team screens for inflammation and mitochondrial function among other factors that determine energy levels. Increasingly, they are also investigating something else: the so-called “CEO brain”.
Donnai says data collected over 15 years shows a striking feature among many senior business people. A genetic variation that affects the reabsorption of dopamine — widely known as the “feel-good hormone” — is present in 23 per cent of the clinic’s clients. But among CEOs, hedge fund owners, lawyers and bankers, it is at 81 per cent. “You have these high dopamine levels, but that also means you don’t have that off switch,” says Donnai.
She adds that this could mean CEOs are more vulnerable to burnout as they do not stop. “The danger is that they could push too far.”
“Cortisol goes up and up and up . . . until your adrenals get exhausted. This is what we try to anticipate,” adds Donnai. Recovery can then take months.
Wearable tech, sleep-tracking apps and other ways to monitor nutrition and biometric data are becoming more popular as tools to manage executive life.
Harvey at Korn Ferry says many of today’s chief executives are realising the importance of reducing their workload altogether and delegating to their inner circle. “Those who thrive aren’t trying to do it all. They see their role as enabling others.”
But this brings its own consequences. Pushing work on to others can mean the pressure just shifts down the organisation. “CEOs now tell me: ‘The layer below is operating at our level.’ The pressure’s just cascading,” says Donnai.
She adds: “One client had five phones. If they didn’t answer email, they’d get a WhatsApp, then a call. Everyone is on edge. We used to switch off. Now it’s nonstop.”
Not all executives buy into the idea of curating the ideal work-life balance.
“You can’t lead a company like a process, according to a schedule,” says Håkan Samuelsson at Volvo Cars, who has returned to the post of chief executive for a second time. “As a leader you need to enjoy it but most importantly, you must have a firm belief in what you want to achieve and be passionate about improving your company.”
Tejada, who has had to manage a falling share price since PagerDuty’s IPO, finds it helps to regularly speak with other CEOs. “[There] are things you can’t talk to your team or spouse about. It’s helpful to hear others’ perspectives.”
Then at home, she priorities “activities that recharge me, inspire me, connect me to my family. It’s not perfect — but I feel better than I ever have.”
This story has been updated to correct a quote from António Horta-Osório.
