Twelve lightweight rowers describe living with RED-S: calorie restriction to make weight brought disrupted sleep, poorer performance and recovery, menstrual dysfunction, injury and lasting psychosocial harm
Weight-making culture needs prevention, not reaction
Participants
n=12 current or former UK lightweight rowers (intermediate to international standard, 67% female, aged 19–32) who had experienced at least one RED-S symptom.
Protocol
Qualitative design: audio-recorded semi-structured individual telephone interviews (from the abstract)
Eligible: adults in the United Kingdom, current or former lightweight rowers who had experienced ≥1 symptom of RED-S
Analysis: inductive thematic approach, iterative data-driven coding facilitated by NVivo software
Key Findings
To make weight, participants cut calories and raised energy expenditure; the psychosocial harm that followed included low mood, poor concentration, less social interaction, trouble keeping relationships going, difficulty regulating emotions, a negative body image, disordered eating, and guilt and anxiety around food — part of it lasting beyond retirement from lightweight rowing.
Physical implications described: fatigue, disturbed sleep, weakened immune function, musculoskeletal pain, injury, menstrual dysfunction, bowel disruption, and decreased performance and recovery.
Authors' conclusion: the short- and long-term impacts underline the need for effective RED-S prevention and management strategies for lightweight rowers, and the accounts can educate health professionals, coaches and athletes.
Practical Application
Twelve lightweight rowers with RED-S described sleep disruption, worse performance and recovery, menstrual dysfunction, injury, and low mood and disordered eating that could outlast their careers, all tied to weight-making. Treat weight-making as the hazard: de-emphasise extreme cuts and plan the weight-management approach with a dietitian rather than leaving it to the athlete.
Not from this paper; the base's own practice: screen energy availability proactively in lightweights (weight-making history, menstrual status, sleep and recovery, bone-stress flags) instead of waiting for breakdown — the study calls for prevention strategies but does not test a screening protocol (REF-341 for the REDs consensus).
Route any suspected low energy availability or RED-S to a sports physician and dietitian; coaching adjusts load and weight-making pressure.
Limitations
Small qualitative sample (n=12; experiential, not causal); self-selected participants who had experienced RED-S; themes may not generalise across squads, sexes or non-lightweight rowers; "bone stress" is not among the abstract's reported symptoms (injury and musculoskeletal pain are).
How this entry was checked and changed
Content correction 2026-09-27
"Bone stress" in the title and findings -> the abstract reports injury and musculoskeletal pain, not bone stress; replaced.
"Argue for proactive energy-availability screening" -> the abstract calls for prevention and management strategies; screening relabelled as the base's own practice.
Added n=12, 67% female, ages 19–32, standard, the full psychosocial list and its persistence after retirement; Tier set from the abstract (intermediate to international).
2026-09-28: added Protocol from the abstract (Europe PMC/PubMed PMID 35298499).
2026-09-28: PMID 35298511 belonged to an unrelated paper; replaced with 35298499, the PubMed record for this entry's own DOI.