Lightweight rowers’ perspectives of living with Relative Energy Deficiency in Sport (RED-S)
Open accessAbstract
Objective: To compete in lightweight rowing, strict limits are placed on the maximum body weight of each individual. As a result, lightweight rowers commonly restrict calorie intake despite high energy expenditure. This can result in Relative Energy Deficiency in Sport (RED-S). The aim of this study is to investigate the physical and psychosocial impact of RED-S, from the perspective of lightweight rowers. Design: Semi-structured individual qualitative interviews. Participants: Adults living in the United Kingdom who are current or former lightweight rowing participants and experienced ≥1 symptom of RED-S. Method: Audio-recorded semi-structured individual telephone interviews were performed. Data was analysed using an inductive thematic approach, coding was iterative and data-driven, facilitated by NVivo software. Results: Twelve current or former lightweight rowers (intermediate to international standard, 67% female, aged 19–32 years) participated. Participants restricted calories and increased energy expenditure to elicit weight-loss in order to meet weight requirements. This resulted in psychosocial implications (reduced social interaction, difficulty maintaining relationships, poor emotional regulation, low mood, poor concentration, disordered eating, guilt and anxiety around food, and a negative body image). Some psychosocial implications persisted after retirement from lightweight rowing. Participants described a range of physical implications, including disrupted sleep, decreased performance and recovery, bowel disruption, menstrual dysfunction, fatigue, musculoskeletal pain, injury and weakened immune systems. Conclusions: This study describes short and long-term physical and psychosocial impacts of RED-S from the perspective of lightweight rowers. Findings highlight the importance of effective RED-S prevention and management strategies for lightweight rowers. These findings may be used to educate health-care professionals, coaches and athletes on the personal impacts and serious health consequences of RED-S.
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Gillbanks et al. found 83.3% of twelve lightweight rowers with REDs reported disrupted sleep and fatigue, and 100% had objectively decreased performance and impaired recovery.
“In Gillbanks et al.'s study of twelve lightweight rowers with REDs, 83.3% reported disrupted sleep and fatigue, and 100% had objectively decreased performance and impaired recovery [83].”
From Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis (2025) · cites this paper as [83]
The Results (Physical implications; page not provided) say ten of twelve participants believed dieting disrupted their sleep and caused fatigue, and all reported decreased performance and impaired recovery. The study reports participants’ experiences; it does not say performance was objectively measured, so “objectively decreased” is unsupported. (LLM, conf=0.91)
Experimental — accuracy not yet measuredAthletes may experience internal and/or external pressure to attain an 'athletic look' (aesthetic), potentially leading to body dissatisfaction and LEA, and then to symptoms of REDs, DE behaviours or EDs.
“Athletes may experience internal and/or external pressure to attain an 'athletic look' (aesthetic), potentially leading to body dissatisfaction and LEA, and then to symptoms of REDs, DE behaviours or EDs.76 131”
From 2023 international olympic committee's (IOC) consensus statement on relative energy deficiency in sport (REDs) (2023) · cites this paper as [76]
The Results sections report societal pressure to have a masculine physique, negative body image, restricted intake, excessive exercise, disordered eating, and RED-S implications among lightweight rowers (pages not provided). They do not establish the claimed pathway from pressure to attain an ‘athletic look’ through body dissatisfaction to low energy availability and RED-S; the reported weight-loss practices were primarily tied to making competition weight. (LLM, conf=0.85)
Experimental — accuracy not yet measuredGillbanks et al. found 91.7% of 12 lightweight rowers with REDs reported a history of musculoskeletal pain and injuries, and 83.3% had a history of recurrent injuries, including rib stress fractures, intervertebral disc extrusions, joint pain, and wrist/ankle injuries.
“Finally, in Gillbanks et al.'s descriptive study of 12 lightweight rowers with REDs, 91.7% reported a history of musculoskeletal pain and injuries, and 83.3% had a history of recurrent injuries, including rib stress fractures, intervertebral disc extrusions, joint pain, and wrist/ankle injuries [83].”
From Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis (2025) · cites this paper as [83]
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Research works printed but not linked: 19
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- Authors
- Gillbanks, L., Mountjoy, M., & Filbay, S. R.
- Affiliations
- University of Oxford (GB)
- International Olympic Committee (CH)
- The University of Melbourne (AU)
- Corresponding author
- Filbay, Stephanie R.
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2022-03-17
- Volume
- 17
- Issue
- 3
- Pages
- e0265268
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC8929546
- OpenAlex
- W4221096041
- Cited by
- 30
- References
- 22
- Citations by year
- 2026: 9 · 2025: 7 · 2024: 8 · 2023: 5 · 2022: 1
- FWCI
- 4.80
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Funders
- National Health and Medical Research Council (1194428)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Keywords
- relative energy deficiency in sport, lightweight rowing, rowers, caloric restriction, weight loss, disordered eating, menstrual disorders, sleep disruption, fatigue, musculoskeletal pain, immune function, body image, psychosocial impact, elite athletes
- MeSH terms
- Water Sports, Relative Energy Deficiency in Sport, Adult, Female, Humans, Male, Sports, Weight Loss, Athletes
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