“I’d got self-destruction down to a fine art”: a qualitative exploration of relative energy deficiency in sport (RED-S) in endurance athletes

Being in a state of relative energy deficiency can predispose athletes to developing anxiety, depression, or other mental illnesses even without a history of psychological problems.

“Even in those without a history of psychological problems, being in a state of relative energy deficiency can predispose athletes to developing anxiety, depression, or other mental illnesses [17,18].”

Athletes are driven by strong internal and external pressure to achieve optimal performance.

“Athletes are driven by strong internal and external pressure to achieve optimal performance.”

Recent qualitative studies involving mainly subelite endurance athletes report that LEA from intentional or unintentional origins can be associated with short-term positive results such as performance improvements or social approval.

“Recent qualitative studies 1 67 involving mainly subelite endurance athletes provide support for this premise, reporting that LEA from intentional (eg, weight regulation) or unintentional (eg, failing to consciously increase EI with increased EEE) origins can be associated with short-term positive results such as performance improvements or social approval from the coach and the sports culture. 1”

A prior history of DE behaviours or an ED might perpetuate continued under-fuelling of energy and must be considered an important risk factor for developing REDs.

“A prior history of DE behaviours or an ED might perpetuate a continued under-fuelling of energy 1 and must therefore be considered an important risk factor for developing REDs.”