“It's hard to find balance when you're broken”: Exploring female endurance athletes’ psychological experience of recovery from relative energy deficiency in sport (RED-S)

Langbein, Rachel K.; Martín, Daniel; Allen‐Collinson, Jacquelyn; Jackman, Patricia C.

doi:10.1016/j.peh.2021.100214

Cited by 8 publications

(13 citation statements)

References 42 publications

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“…Reductions in athletic performance, often through downstream outcomes of dysfunction in physiological processes, may be more impactful for encouraging behavioral change in athletes with RED-S. Some athletes may be unable or unwilling to acknowledge the negative health consequences of LEA until their performance is negatively affected ( 27 ). Thus, understanding the impact of LEA on the maladaptive physiological and psychological processes of sports performance is imperative for sports practitioners.…”

Section: Performance and Injury Implicationsmentioning

confidence: 99%

“…The psychological impact of RED-S can be both an outcome as well as an antecedent, providing a unique relationship of reciprocity between the cause and effect of LEA. With an increased prevalence of eating disorders in female endurance athletes, research on this population demonstrates the pervasiveness of negative psychological outcomes for athletes with RED-S. For some athletes, restrictive EI and excessive EEE behaviors manifest following adverse childhood or young adult experiences ( 27 ). The experience of this group when being asked to change eating and exercise habits to improve RED-S can induce severe anxiety, depression, and for some, suicidality thoughts ( 27 ).…”

Section: Performance and Injury Implicationsmentioning

confidence: 99%

“…With an increased prevalence of eating disorders in female endurance athletes, research on this population demonstrates the pervasiveness of negative psychological outcomes for athletes with RED-S. For some athletes, restrictive EI and excessive EEE behaviors manifest following adverse childhood or young adult experiences ( 27 ). The experience of this group when being asked to change eating and exercise habits to improve RED-S can induce severe anxiety, depression, and for some, suicidality thoughts ( 27 ). These results align with those found by Ackerman et al ( 1 ), noting a 2.4 times increased likelihood of psychological disorders in athletes with LEA compared to those with adequate EA.…”

Section: Performance and Injury Implicationsmentioning

confidence: 99%

“…Some athletes may experience an acute increase in performance as a result of initial body weight loss at the onset of LEA (e.g., increased relative maximal oxygen uptake) ( 63 ). Although the elevated level of performance is ultimately unsustainable, some athletes attribute the acute increase in performance to excessive exercise and restrictive eating behaviors, causing a desire to pursue more rigid behaviors leading to long-term LEA ( 27 ). If psychopathologies are not considered and treated even after being classified as physiologically recovered from RED-S, the potential for an athlete to return to LEA-inducing behaviors is much greater ( 37 , 38 ).…”

Section: Performance and Injury Implicationsmentioning

confidence: 99%

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Relative energy deficiency in sport (RED-S): scientific, clinical, andpractical implications for the female athlete

Cabre¹,

Moore²,

Smith‐Ryan³

et al. 2022

Dtsch Z Sportmed

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Problem: If athletes develop low energy availability (LEA), it can lead to a Relative Energy Deficiency in Sport (RED-S) syndrome which has severe health consequences if not treated. Methodology: A narrative review of the most recent and pertinent literature on the topic, with special emphasis on women. Results: In assessing the current literature, we have synthesized: i) the scientific implications of LEA and RED-S, ii) the clinical manifestations of the conditions currently available for detection, as well as iii) the practical implications for healthcare and support for female athletes and teams in planning intervention or prevention strategies (maintaining EA >45 kcal/kg FFM/day). Discussion: The ‘Female Athlete Triad” emerged in the 1990s as researchers understood more of the etiological adaptation of female athlete health to sports training. In the last 10 years, the scientific community has recognized that the ‘Triad’ approach was too narrow in focus, and the broader concept of RED-S emerged. Both the Triad and RED-S are consequences of a frequently prevalent LEA in athletes (<30 kcal/kg FFM/day). Developing LEA and RED-S compromises training adaptation, performance capacity, and health in athletes. For these reasons, it is critical that an athlete’s support team recognize the behaviors that may indicate RED-S evolution. In this way, we can assist female athletes in reaching their full potential in sports while protecting their health. Key Words: Energy Availability, Stress, Performance, Hormones, Menstrual Health

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Section: Performance and Injury Implicationsmentioning

confidence: 99%

Section: Performance and Injury Implicationsmentioning

confidence: 99%

Section: Performance and Injury Implicationsmentioning

confidence: 99%

Section: Performance and Injury Implicationsmentioning

confidence: 99%

See 2 more Smart Citations

Relative energy deficiency in sport (RED-S): scientific, clinical, andpractical implications for the female athlete

Cabre¹,

Moore²,

Smith‐Ryan³

et al. 2022

Dtsch Z Sportmed

View full text Add to dashboard Cite

show abstract

“…regular body monitoring/weigh-ins, body shaming). 22,23,37,[61][62][63][64][65] Currently, limited guidance exists for how physique management and/or weight related discussions should be conducted within the context of specific sports. Hence, it is apparent that coaches require greater support and structures around them, which orient their behaviours towards optimal performance without compromising athlete health.…”

Section: Physique and Weight Managementmentioning

confidence: 99%

A review exploring coach knowledge, attitudes/beliefs and behaviours towards low energy availability in athletes

Hamer

Desbrow

Irwin

2022

International Journal of Sports Science & Coaching

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Coaches are important figures of influence with potential to create environments that influence athlete health and performance outcomes. Ideally, coaches provide supportive environments that lead to performance optimisation and long-term health. Coaches who employ language and behaviours that overemphasise body composition and/or provide misinformed nutrition advice may predispose athletes to low energy availability (LEA) and the associated health consequences. Having a clear understanding of current knowledge, attitudes and beliefs of coaches with regard to LEA is required to guide future coach education/support initiatives to optimise athlete health and performance. Thus, the aim of this investigation was to systematically review published literature regarding coach knowledge, attitudes/beliefs and behaviours of LEA. Data from 20 eligible studies was extracted into predetermined categories according to coach ‘knowledge‘; ‘attitudes/ beliefs’; and ‘behaviours’ regarding LEA/Relative Energy Deficiency in Sport/Female Athlete Triad and/or eating disorders and/or disordered eating. Any single study could provide outcomes to inform one or multiple of these categories. The majority of results were drawn from studies conducted prior to LEA being defined as a concern for athlete health, which limited our understanding of the contemporary knowledge, attitudes/eliefs and behaviours of coaches on this important issue. That said, indications of gaps in coach knowledge and the employment of inappropriate attitudes/beliefs and behaviours regarding issues associated with LEA were evident. An opportunity exists for key stakeholders to develop comprehensive coach education frameworks, which equip coaches with the adequate capability, opportunity and motivation to support athlete health and avoid the consequences of LEA.

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Assessment of eating disorder symptoms, compulsive exercise, body dissatisfaction and depression in Swedish national team gymnasts, with a one-year follow-up

Edlund,

Forsberg,

Källberg

et al. 2024

Eat Weight Disord

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Purpose The purpose of this study was to explore changes in symptoms of eating disorders, compulsive exercise, and depression, between two assessments 12 months apart, among elite gymnasts. Method Factors related to the development of mental health symptoms in male and female Swedish national team gymnasts were investigated using baseline and 1-year follow-up scores in two subscales of the Eating Disorders Inventory 3; drive for thinness and body dissatisfaction, two subscales of the Compulsive Exercise Test; avoidance and rule-driven behavior and exercise for weight control, and the Montgomery-Åsberg Depression Rating Scale-Self report (MADRS-S). Linear mixed models were used to investigate the influence of drive for thinness, exercise for weight control, avoidance and rule-driven behavior, and MADRS-S on body dissatisfaction. Results Body dissatisfaction increased from baseline to the follow-up assessment, while drive for thinness and depression remained stable. Symptoms of eating disorders and depression were generally low in this group of elite gymnasts at both assessments. Drive for thinness, exercise for weight control, and symptoms of depression were associated with body dissatisfaction. Discussion Our findings indicate that there were no significant changes over time in eating disorders and depression symptoms but significant associations with body dissatisfaction. Furthermore, we found independent effects of drive for thinness, exercise for weight control and symptoms of depression for body dissatisfaction.

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“It's hard to find balance when you're broken”: Exploring female endurance athletes’ psychological experience of recovery from relative energy deficiency in sport (RED-S)

Cited by 8 publications

References 42 publications

Relative energy deficiency in sport (RED-S): scientific, clinical, andpractical implications for the female athlete

Relative energy deficiency in sport (RED-S): scientific, clinical, andpractical implications for the female athlete

A review exploring coach knowledge, attitudes/beliefs and behaviours towards low energy availability in athletes

Assessment of eating disorder symptoms, compulsive exercise, body dissatisfaction and depression in Swedish national team gymnasts, with a one-year follow-up

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