November 9, 2025 • 22 mins
Have you ever taken on a 10km run, or a half marathon - maybe pushed yourself just a little too much, without properly researching what you should be eating, to fuel your efforts?
Many have. And it’s no wonder endurance activities are an increasingly popular coping mechanism for those of us struggling to deal with the mental load of everyday life.
But experts across the globe say they have been seeing athletes - and regular people - who have been under-eating and suffering from a little-known syndrome called REDs, or relative energy deficiency in sport.
Today, Good Weekend senior writer Katrina Strickland, on this contentious syndrome, which some experts say can be allied to eating disorders, and has led some sufferers to have “bones like dust” and - in one case - a woman in her late 20s to have, as her gynaecologist put it, the “uterus of a 60 year old”.
Subscribe to The Age & SMH: https://subscribe.smh.com.au/
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
S1 (00:01):
From the newsrooms of the Sydney Morning Herald and The Age.
This is the morning edition. I'm Samantha Seelinger Morris. It's Monday,
November 10th. Have you ever taken on a ten kilometer
run or a half marathon? Maybe pushed yourself just a
little too much without properly researching what you should be
(00:22):
eating to fuel your efforts? I know I have, and
it's no wonder endurance activities are an increasingly popular coping
mechanism for those of us struggling to deal with the
mental load of everyday life. But experts across the globe
have been seeing athletes and regular people who have been
under-eating and suffering from a little known syndrome called redds,
(00:45):
or relative energy deficiency, in sport today. Good weekend, senior
writer Katrina Strickland on this syndrome, which can be allied
to eating disorders and has led some sufferers to have
bones like dust and in one case, a woman in
her late 20s to have, as her gynecologist put it,
the uterus of a 60 year old. So, Katrina, I
(01:12):
am so excited to have you on today because you
have just written a cracking feature about what some experts
have called the hot button topic du jour. But I
think it's fair to say that few of us actually
know about this particular condition that is leading a lot
of people, athletes, regular people, to suffer quite a lot.
Now this condition is called reds. So what is it?
S2 (01:33):
Yes. Well, I must say, Sam, I hadn't heard of
it before I started this feature. It's relative energy deficiency
in sport. And what it is, is when you're an
athlete and you can be an elite athlete, but you
can also be an amateur. And what you're taking in,
in terms of energy, you are expending more than that
in both the exercise you're doing and in your bodily functions,
(01:58):
and over an extended period of time, that low energy
availability becomes a problem because less is coming in than
is going out, and it causes all sorts of problems.
The obvious signs for a woman are if they're still
menstruating age, their period stops for no more than three months.
They might suffer a lot of stress fractures. So they've
(02:20):
got very low bone density. And they come into the
doctors with, you know, three stress fractures within six months
or something. If it's men, because it is it used
to be thought of as just a female thing, but
it's it's now recognised that it can be in male
athletes as well. They might have low libido or just, um,
lack of morning erections. So it's all to do with
(02:41):
the endocrine system and hormones really. And you've kind of
strained your body to such an extent that your endocrine
system is completely out of whack, and it starts showing up,
not just in blood tests and in the things I've
just said, but also your performance starts tanking. So whereas
you might have been really performing well even though you
didn't have your period, your performance starts suffering.
S1 (03:03):
And what do we know about how widespread reds is?
Because it became very clear in your piece that, you know,
it's not just cyclists, it's not just other endurance athletes,
but it's actually quite widespread in terms of who can
suffer from this, right?
S2 (03:17):
Yeah. I mean, one of the problems is that we
don't know how many people have it. It was first
talked about in a statement to the International Olympic Committee
in 2014. They updated that statement in 2023 when there
was a bit more understanding of it. And they said,
say for women athletes, it was something between 23% and
close to 80%. I mean, that's almost everyone. That's kind
(03:40):
of as what, you know, you could drive a bus
through those stats and the people who put that statement in,
they also agreed that's problematic. So we're very early in
the evolution that some of the studies are not that rigorous.
The definition is not that clear cut. But, you know,
one that I spoke to who's a sports physician in Melbourne.
She said she'd get five people a week coming in
with something that might be signs of reds. And it's
(04:03):
a clinical diagnosis of exclusion and it's multi-factorial. So that's
again where the kind of nuance comes in. It's the
person who will come to that sports medico, and they'll
rule out all the really bad things as to why
your periods stopped or why you keep getting fractures. And
then often, if there's no other explanation, once they've looked
(04:24):
at your blood tests, looked at a whole lot of things,
they'll conclude that you've got reds. So it's not like
there's a blood test that says you've got reds. It's
much more kind of nuanced than that.
S1 (04:35):
And I was really struck by one of the experts
you spoke to. This is Alice McNamara. I believe she's
a medico. And you said that she's among a number
of medicos who now report seeing 20 and 30 somethings
with hip fractures or bones like dust, two things that
absolutely should not be present at that age. So are
those people that they're seeing among those who've now got
(04:55):
bones like dust? Are they just like regular people who
are taking on endurance stuff, or is it just those
really elite athletes who are seeing that really horrific?
S2 (05:02):
I mean, that's the thing they were saying. And Renee McGregor,
an American dietitian who's really big in this area, she
said to me, like, when you think about it, your
grandmother or your mother, they weren't doing marathons or half
marathons whilst working full time and looking after their parents,
as well as three young kids. Like the life load,
(05:23):
they talk about the life load, which I think is
a great term, is really high on people. And often
we're doing you think about it yourself. I've done half marathons.
I'm not going to do another one. But, you know,
like the city to surf, you know, we all love
now it's a very big thing if I say in
the story, if you're not, if you're middle aged and
not doing a marathon, are you really middle aged? You know,
(05:44):
like it's it's kind of become a thing. And yet
do all of us know really how to fuel properly
for that, how to recover properly for that. And then
you add into that the intermittent fasting fads that have
kind of swept the world. You know, don't eat until,
you know, 1:00 pm from 7:00 the night before that
kind of thing. Like if you're doing all of this
(06:05):
ad hoc without really properly researching it, without really knowing
what your body requires, you can get yourself into trouble
and not not even really know it until you get
to that point where things are not right.
S1 (06:19):
Well that's right. I mean, you and I, I'll just
share with the listeners. We were laughing a little bit
before we started recording that. It's so timely that we're
speaking now because I think you've got Tennis Elbow. I
believe at the moment I've got a massive bandage on
my arm from absolutely stacking it during a trail run
that I was not equipped to do. Certainly for me.
I won't speak for you, Katrina, but I know that
for me, this is like what I do in order
to cope with the insanity. Like the mental load of
(06:42):
everyday life.
S2 (06:44):
Exactly. And I mean, my tennis elbow is not from,
you know, nice little game of tennis. It's from boxing.
You know.
S1 (06:50):
Like.
S2 (06:52):
We're all we all kind of want to do more. Um,
tough stuff. And the period thing is really interesting, I thought,
because it's still very much thought about in a lot
of sports, that if you are female and you don't
get your period, that shows that you're training hard enough.
And what that's really saying is you're more like a man.
(07:13):
You know, women didn't used to box at the numbers
they do now. I love boxing, I'm not saying we
shouldn't box, but you know, we're all aware of building
up bone density in those kind of things. But also
we're all pushing ourselves. And that's one of the messages
I think is like, just know a bit more about
the signs. If you're pushing yourself too far and you're
(07:34):
not eating right, your body will show you.
S1 (07:38):
And I think for some who suffer, it's really quite
a long journey of suffering, I guess of various sorts,
before they actually realise this is what they have. Maybe
to illustrate this, you can take us through what one
of the athletes you've spoken to went through this is
cyclist Georgie Howe. And really her experience is pretty harrowing.
So tell us about her.
S2 (07:57):
It is. I really, really felt for Georgie the more
I spoke to her, and it's such a nuanced thing.
That's the other thing. It's not a black and white thing,
and that's what makes it difficult to diagnose. So Georgie
was an elite rower. She went to a Melbourne Girls Grammar.
Then she got a scholarship in rowing. She rowed at
the top level at Melbourne Girls Grammar, got a scholarship
(08:18):
to Princeton, was a very top, was the co-captain, I think,
one of the few non American co-captains of the rowing
team that won multiple, you know, Ivy League seasons in
a row, came back to Australia. She represented Australia not
at the Olympics but at representative level. During Covid she
just started riding her bike. This is a kind of
athletic kind of person. She is did so well at
(08:41):
that that someone noticed her, who's a trainer and said,
you should try out for one of these teams in Europe.
Got got to ride with a professional team. She was
working at E, the big kind of accounting conglomerate quit
that went in a kind of late 20s, went to
live in Europe, was kind of living the dream of
being a professional cyclist. And then at the end of 2023,
(09:03):
the team hadn't done as well as the coach had wanted.
And so they had a conversation with her about how
she needed to lose weight. And she was like one
of those. She always said she was built like a
brick shithouse, which I love. That quote.
S1 (09:17):
Oh, we love that.
S2 (09:19):
And so her whole body type was strength, and she
was this position in and I didn't really know anything
about cycling teams, but she was a position in the
team called a domestique, which is they ride out in
front of the stars, they break the wind. It's all
very strategic. They're kind of part of the, you know,
looking after the stars, who then will race at the
(09:39):
end and a time triallist as well, which means that,
you know, being fast and strong was her thing. So
her body type suited the role she had on the team,
but the team wanted everyone to lose some weight going
into the next year. So she went on this extreme diet. She,
you know, she talked about how she'd go on a
multi hour road side training ride and she'd have a
(10:02):
smoothie at the end where she might have had, you know,
eggs on toast before. And so she really, really restricted
her food in a way she never had and kept
on training and in quite a tight time frame as well.
It's not known what effect that has. But, you know,
some people say that might have some something to do
(10:24):
with it. She lost some weight to begin with, and
then her body just stopped losing weight. So no matter
how much she didn't eat and she even put some
weight on, and she got a whole lot of blood
tests that showed that something was out of whack. Like
her cholesterol was really high, her thyroid was really low,
her hormones were really low, her irons were low. And
she showed these results to a doctor and she hadn't
(10:46):
had her period for best part of a year. She
showed this to a physician in Melbourne who said, yeah,
your endocrine system is completely out of whack. What you
really need to do is get off the bike for
a while. But in those kind of teams and in
that kind of environment, you can't really get off the bike.
S3 (11:04):
And tell me, I guess.
S1 (11:05):
About what sort of physical and even psychological anguish she
was experiencing, because I was quite stunned when I read
your feature. I believe one of the people that was
examining her said that she had the uterus of a
60 year old. That's how much, you know, what she
was doing was affecting her system. I mean, that is
gobsmacking because she was probably, what, in her late 20s
at that point.
S2 (11:24):
That's right. She was not even 30. A couple of
the medicos, one said to me, it's like you've turned
the thermostat down. And not about her specifically, but this
is what the condition is. Another one said, it's like
your phone going on low battery mode. So your whole
body is just kind of like it's doing what it
(11:45):
needs to do to just keep going. And it's robbing
from everything else that you can do just to keep
the basics going. And then it becomes a psychological component.
Or maybe it always did have where you're obsessed with food,
you're obsessed with trying to do this thing that your
body is not doing for you. And then you have
all that grief attached with, you know, you're an elite athlete.
(12:06):
You're used to being able to push through barriers that
other people would stop at, because that's always got you
to the top. And that's not working for you anymore.
So your whole kind of way of being in the
world has to change, and you kind of have to
step back and have a lot of psychological help, as
(12:26):
well as physiological help to really get out of this
quite bad situation.
S1 (12:36):
We'll be right back. Now, Katrina, I'd love to turn
to what I don't know might be the broader cultural
implications of this particular condition. Because I was wondering, when
I was reading your piece, if there is some suggestion
that the coaches are perhaps negligently putting undue pressure on
their athletes to lose a lot of weight, and in
particular women. I mean, you mentioned that anecdote before about
(12:58):
it being something of a truism within the athletic community
or the professional athletic community that if women are training
and they don't have their period, that's a sign of
job well done, which certainly makes me very worried because
obviously it's a sign your body is not functioning. So, yeah,
our coaches are partly to blame here.
S2 (13:18):
I think in some cases, I mean, it's very hard
to generalise in that, you know, I'm sure there's great
coaches and other coaches who aren't so great, but what
a lot of them who I spoke to, the endocrinologist
would say is that the understanding that it should be
performance led and what happens to the diet and the
(13:40):
exercise should be a result of the performance, not a
skinfold test or an arbitrary weight loss goal, and that
if you focus on performance, the rest will follow. And
that's what they're saying. Sometimes the old school thinking in
in coaching can be about these kind of set things
(14:01):
that you must. And it's the same in dance. It's
also an issue in, in any kind of sport or
athletic endeavor where a you have to look really good
and that's almost all female athletes when you think about it,
because there's not as much money in female sport. And
therefore to get sponsorships you it's just the hard truth,
you know, sponsors would deny it. But it's pretty much
(14:23):
true that if you look good, you're going to be
more likely to get a sponsor who wants to put
you in their shorts in their ad than if you don't.
So yeah, I do think that there's a spectrum. And
a lot of them said there's an education job to
be done really across a whole lot of sports, all
countries to really make people understand more about women's physiology
(14:44):
and that it's different to men's. And of course, this
happens in male physiology as well, male athletes as well,
but that women are not small men. Women have different needs.
And the more education that gets done and the more
research that gets done, if more research gets done, then
we'll understand a bit more how and why the women's
body changes or reacts to certain things and not to others.
S3 (15:08):
Well, this leads me.
S1 (15:09):
Very nicely to my next question, which is the fact
that there are some experts who are critical of the
Reds diagnosis. Tell us about this.
S2 (15:19):
Yeah, that was really interesting. There's had been a nice
little scientific brawl around Reds, which I didn't know about
before I started. So this group of physicians, dieticians, kind
of experts in the field put in these statements to
the International Olympic Committee about Reds. Then another group did
a study for the Sports Medicine Journal, which had this
(15:40):
very provocative title Does Reds Exist? And I spoke to
one of them, Jose Arrieta, who's an Argentinian born, England
based scientist. I spoke to him and he said, look,
we're not saying that these symptoms are not problematic for
the athletes, but we don't think causality is established. We
don't think that it's automatically because of low energy availability
(16:03):
and the other things that are in this kind of
multifactorial reds diagnosis. These symptoms might be because of a
whole lot of other things, other stresses in the athlete's life,
other things to do with their body that you don't
know about, that don't come into the reds tool of diagnosis.
And so he and his colleagues were saying there's just
no causality. You're acting as if causality is automatic and
(16:27):
it's not established. So I think what they all concluded
was we need more research. We need to understand this more.
No one's saying that there's not issues. No one's saying
that they're made up. I mean, it's interesting. It's nothing
like chronic fatigue or carpal tunnel or ADHD or anything.
But it reminded me a bit of those debates around
(16:47):
those conditions because it's something that, you know, you can
see very easily how if it takes off as an idea,
every second person will say they have it. And what
Hosain and his other colleagues were saying was, hang on,
let's just get a bit more careful about what it
is and what it isn't and what causes it. Before
we make every second athlete who's got something happen, say
(17:12):
that they've got Reds. So it was really interesting actually,
to see that back and forth. And I think in
a funny way, they're not as far apart as they sound.
It's just kind of the crux of it is this
causality thing.
S1 (17:24):
And I was really struck by something that Georgie Howe said,
and we should be clear, this has ended her career.
She is no longer a professional cyclist, but she said
that not only did she lose her intuition around her appetite,
but also everything fatigue, illness, emotions, she said. You're very
disconnected from your own body and it takes a long
time to get it back. And then we have to
(17:46):
talk about what's the last sentence in your piece, but
I'm going to get you to, to walk us through,
really the penny drop moment that she had really some
psychological anguish that came out from all of this.
S2 (17:57):
Yeah, I'll paraphrase it because I don't have it in
front of me. But she she basically has been working
with a psychiatrist, um, which I think is pretty natural
in this kind of environment, you know, psychologists, psychiatrists, lots
of different experts. And she said, she said to him
that what she realized is that sometimes in sport, being
(18:18):
the athlete is the worst job because you get to
the other end and, you know, you leave the sport
and you realize that you really were just a commodity
and no one really cared about you. And her psychiatrist
said to her, validated that feeling. The psychiatrist said, you know,
that's not a crazy thing to think. And that really
(18:40):
that really set her back. Really. And her parents said
some interesting things to her father said, look, you know,
everyone goes and he sees they live in Melbourne. He
sees former AFL athletes hobbling around their suburb with, you know,
hips and even the one we all know about concussion,
he said. You don't expect when you go into athletics
(19:02):
or any kind of sport to have permanent things, and
so many do. And her mother, Sally, who is a
former nurse, former health administrator, former board member of Swimming Australia,
she said, look, you know, the the prism you should
put any decision through in sport or anything else is health. Like,
(19:23):
is this going to harm someone's health? Do no harm.
That should be. That should be front and center. Everything
should go through that prism and it just doesn't. So
she was she was also saying, you know, I'll I'll
think that things are really changing when endocrinologists are a
regular part of a sports medical team.
S1 (19:42):
Wow, that's really interesting. And Katrina, just to wrap up,
I mean, what tips do you have, if any? Because,
you know, I'll tell the listeners you worked on this
for more than a month. You've spoken to heaps of
experts that didn't even make it into the piece, as
is always the case with a great, good weekend feature.
So I guess, what tips do you have for listeners?
You know, those of us who perhaps you know, don't
do the right things when we go do trail runs
(20:03):
or box or whatever it is? Yeah. What tips do
you have, I guess, for how to avoid this?
S2 (20:08):
I mean, I would say I'm no expert, but what
I took from the experts is all the basic things
that we've been told forever that we've probably ignored. Right?
Like eat three meals a day, eat a mixture of
carbohydrates and protein. Don't think that if you're training a
lot that you're just going to cut out all your carbs.
Make sure that you eat you know something before you
(20:31):
go training and something after so that it's not robbing
from your bones. It's all those things that we knew anyway.
I mean, that's what I thought. Like, they're all things
I've heard and ignored for my whole life, you know?
S1 (20:45):
Yeah. I hate it there. The messages, the kind of
messages that we get from, like, our mothers that, you know,
we know they're right. But it's so irritating to listen
to because it's like we don't want to have to
listen to them.
S2 (20:56):
And we all and, you know, as women, we've all
wanted to be thinner. You know, it's authentic, but it's
just true. Not everyone probably, but no.
S1 (21:04):
But 100%, 100% brainwash a lot of us. Fully brainwashed.
S2 (21:08):
And so we've kind of thought, oh, look, if I
don't have a banana before I go boxing, then I'll lose.
I won't, you know, lose weight. Well, no, that actually
might just be wrecking your bones or, you know, like
so all those things that they've said, what a surprise.
They were right. They had logic behind them.
S1 (21:27):
Oh, man, I hate that. But, Katrina, I'm so delighted
to have spoken to you about this. So thank you
so much for your time.
S2 (21:34):
Thank you so much, Sam.
S1 (21:45):
Today's episode of The Morning Edition was produced by myself
and Josh towers. Our executive producer is Tammy Mills. Tom
Mackendrick is our head of audio. To listen to our
episodes as soon as they drop. Follow the Morning Edition
on Apple, Spotify, or wherever you listen to podcasts. Our
newsrooms are powered by subscriptions, so to support independent journalism,
(22:07):
visit the page or smh.com.au. To subscribe and to stay
up to date, sign up to our Morning Edition newsletter
to receive a summary of the day's most important news
in your inbox every morning. Links are in the show. Notes.
I'm Samantha Selinger. Morris, thanks for listening.
From the newsrooms of the Sydney Morning Herald and The Age.
This is the morning edition. I'm Samantha Seelinger Morris. It's Monday,
November 10th. Have you ever taken on a ten kilometer
run or a half marathon? Maybe pushed yourself just a
little too much without properly researching what you should be
(00:22):
eating to fuel your efforts? I know I have, and
it's no wonder endurance activities are an increasingly popular coping
mechanism for those of us struggling to deal with the
mental load of everyday life. But experts across the globe
have been seeing athletes and regular people who have been
under-eating and suffering from a little known syndrome called redds,
(00:45):
or relative energy deficiency, in sport today. Good weekend, senior
writer Katrina Strickland on this syndrome, which can be allied
to eating disorders and has led some sufferers to have
bones like dust and in one case, a woman in
her late 20s to have, as her gynecologist put it,
the uterus of a 60 year old. So, Katrina, I
(01:12):
am so excited to have you on today because you
have just written a cracking feature about what some experts
have called the hot button topic du jour. But I
think it's fair to say that few of us actually
know about this particular condition that is leading a lot
of people, athletes, regular people, to suffer quite a lot.
Now this condition is called reds. So what is it?
S2 (01:33):
Yes. Well, I must say, Sam, I hadn't heard of
it before I started this feature. It's relative energy deficiency
in sport. And what it is, is when you're an
athlete and you can be an elite athlete, but you
can also be an amateur. And what you're taking in,
in terms of energy, you are expending more than that
in both the exercise you're doing and in your bodily functions,
(01:58):
and over an extended period of time, that low energy
availability becomes a problem because less is coming in than
is going out, and it causes all sorts of problems.
The obvious signs for a woman are if they're still
menstruating age, their period stops for no more than three months.
They might suffer a lot of stress fractures. So they've
(02:20):
got very low bone density. And they come into the
doctors with, you know, three stress fractures within six months
or something. If it's men, because it is it used
to be thought of as just a female thing, but
it's it's now recognised that it can be in male
athletes as well. They might have low libido or just, um,
lack of morning erections. So it's all to do with
(02:41):
the endocrine system and hormones really. And you've kind of
strained your body to such an extent that your endocrine
system is completely out of whack, and it starts showing up,
not just in blood tests and in the things I've
just said, but also your performance starts tanking. So whereas
you might have been really performing well even though you
didn't have your period, your performance starts suffering.
S1 (03:03):
And what do we know about how widespread reds is?
Because it became very clear in your piece that, you know,
it's not just cyclists, it's not just other endurance athletes,
but it's actually quite widespread in terms of who can
suffer from this, right?
S2 (03:17):
Yeah. I mean, one of the problems is that we
don't know how many people have it. It was first
talked about in a statement to the International Olympic Committee
in 2014. They updated that statement in 2023 when there
was a bit more understanding of it. And they said,
say for women athletes, it was something between 23% and
close to 80%. I mean, that's almost everyone. That's kind
(03:40):
of as what, you know, you could drive a bus
through those stats and the people who put that statement in,
they also agreed that's problematic. So we're very early in
the evolution that some of the studies are not that rigorous.
The definition is not that clear cut. But, you know,
one that I spoke to who's a sports physician in Melbourne.
She said she'd get five people a week coming in
with something that might be signs of reds. And it's
(04:03):
a clinical diagnosis of exclusion and it's multi-factorial. So that's
again where the kind of nuance comes in. It's the
person who will come to that sports medico, and they'll
rule out all the really bad things as to why
your periods stopped or why you keep getting fractures. And
then often, if there's no other explanation, once they've looked
(04:24):
at your blood tests, looked at a whole lot of things,
they'll conclude that you've got reds. So it's not like
there's a blood test that says you've got reds. It's
much more kind of nuanced than that.
S1 (04:35):
And I was really struck by one of the experts
you spoke to. This is Alice McNamara. I believe she's
a medico. And you said that she's among a number
of medicos who now report seeing 20 and 30 somethings
with hip fractures or bones like dust, two things that
absolutely should not be present at that age. So are
those people that they're seeing among those who've now got
(04:55):
bones like dust? Are they just like regular people who
are taking on endurance stuff, or is it just those
really elite athletes who are seeing that really horrific?
S2 (05:02):
I mean, that's the thing they were saying. And Renee McGregor,
an American dietitian who's really big in this area, she
said to me, like, when you think about it, your
grandmother or your mother, they weren't doing marathons or half
marathons whilst working full time and looking after their parents,
as well as three young kids. Like the life load,
(05:23):
they talk about the life load, which I think is
a great term, is really high on people. And often
we're doing you think about it yourself. I've done half marathons.
I'm not going to do another one. But, you know,
like the city to surf, you know, we all love
now it's a very big thing if I say in
the story, if you're not, if you're middle aged and
not doing a marathon, are you really middle aged? You know,
(05:44):
like it's it's kind of become a thing. And yet
do all of us know really how to fuel properly
for that, how to recover properly for that. And then
you add into that the intermittent fasting fads that have
kind of swept the world. You know, don't eat until,
you know, 1:00 pm from 7:00 the night before that
kind of thing. Like if you're doing all of this
(06:05):
ad hoc without really properly researching it, without really knowing
what your body requires, you can get yourself into trouble
and not not even really know it until you get
to that point where things are not right.
S1 (06:19):
Well that's right. I mean, you and I, I'll just
share with the listeners. We were laughing a little bit
before we started recording that. It's so timely that we're
speaking now because I think you've got Tennis Elbow. I
believe at the moment I've got a massive bandage on
my arm from absolutely stacking it during a trail run
that I was not equipped to do. Certainly for me.
I won't speak for you, Katrina, but I know that
for me, this is like what I do in order
to cope with the insanity. Like the mental load of
(06:42):
everyday life.
S2 (06:44):
Exactly. And I mean, my tennis elbow is not from,
you know, nice little game of tennis. It's from boxing.
You know.
S1 (06:50):
Like.
S2 (06:52):
We're all we all kind of want to do more. Um,
tough stuff. And the period thing is really interesting, I thought,
because it's still very much thought about in a lot
of sports, that if you are female and you don't
get your period, that shows that you're training hard enough.
And what that's really saying is you're more like a man.
(07:13):
You know, women didn't used to box at the numbers
they do now. I love boxing, I'm not saying we
shouldn't box, but you know, we're all aware of building
up bone density in those kind of things. But also
we're all pushing ourselves. And that's one of the messages
I think is like, just know a bit more about
the signs. If you're pushing yourself too far and you're
(07:34):
not eating right, your body will show you.
S1 (07:38):
And I think for some who suffer, it's really quite
a long journey of suffering, I guess of various sorts,
before they actually realise this is what they have. Maybe
to illustrate this, you can take us through what one
of the athletes you've spoken to went through this is
cyclist Georgie Howe. And really her experience is pretty harrowing.
So tell us about her.
S2 (07:57):
It is. I really, really felt for Georgie the more
I spoke to her, and it's such a nuanced thing.
That's the other thing. It's not a black and white thing,
and that's what makes it difficult to diagnose. So Georgie
was an elite rower. She went to a Melbourne Girls Grammar.
Then she got a scholarship in rowing. She rowed at
the top level at Melbourne Girls Grammar, got a scholarship
(08:18):
to Princeton, was a very top, was the co-captain, I think,
one of the few non American co-captains of the rowing
team that won multiple, you know, Ivy League seasons in
a row, came back to Australia. She represented Australia not
at the Olympics but at representative level. During Covid she
just started riding her bike. This is a kind of
athletic kind of person. She is did so well at
(08:41):
that that someone noticed her, who's a trainer and said,
you should try out for one of these teams in Europe.
Got got to ride with a professional team. She was
working at E, the big kind of accounting conglomerate quit
that went in a kind of late 20s, went to
live in Europe, was kind of living the dream of
being a professional cyclist. And then at the end of 2023,
(09:03):
the team hadn't done as well as the coach had wanted.
And so they had a conversation with her about how
she needed to lose weight. And she was like one
of those. She always said she was built like a
brick shithouse, which I love. That quote.
S1 (09:17):
Oh, we love that.
S2 (09:19):
And so her whole body type was strength, and she
was this position in and I didn't really know anything
about cycling teams, but she was a position in the
team called a domestique, which is they ride out in
front of the stars, they break the wind. It's all
very strategic. They're kind of part of the, you know,
looking after the stars, who then will race at the
(09:39):
end and a time triallist as well, which means that,
you know, being fast and strong was her thing. So
her body type suited the role she had on the team,
but the team wanted everyone to lose some weight going
into the next year. So she went on this extreme diet. She,
you know, she talked about how she'd go on a
multi hour road side training ride and she'd have a
(10:02):
smoothie at the end where she might have had, you know,
eggs on toast before. And so she really, really restricted
her food in a way she never had and kept
on training and in quite a tight time frame as well.
It's not known what effect that has. But, you know,
some people say that might have some something to do
(10:24):
with it. She lost some weight to begin with, and
then her body just stopped losing weight. So no matter
how much she didn't eat and she even put some
weight on, and she got a whole lot of blood
tests that showed that something was out of whack. Like
her cholesterol was really high, her thyroid was really low,
her hormones were really low, her irons were low. And
she showed these results to a doctor and she hadn't
(10:46):
had her period for best part of a year. She
showed this to a physician in Melbourne who said, yeah,
your endocrine system is completely out of whack. What you
really need to do is get off the bike for
a while. But in those kind of teams and in
that kind of environment, you can't really get off the bike.
S3 (11:04):
And tell me, I guess.
S1 (11:05):
About what sort of physical and even psychological anguish she
was experiencing, because I was quite stunned when I read
your feature. I believe one of the people that was
examining her said that she had the uterus of a
60 year old. That's how much, you know, what she
was doing was affecting her system. I mean, that is
gobsmacking because she was probably, what, in her late 20s
at that point.
S2 (11:24):
That's right. She was not even 30. A couple of
the medicos, one said to me, it's like you've turned
the thermostat down. And not about her specifically, but this
is what the condition is. Another one said, it's like
your phone going on low battery mode. So your whole
body is just kind of like it's doing what it
(11:45):
needs to do to just keep going. And it's robbing
from everything else that you can do just to keep
the basics going. And then it becomes a psychological component.
Or maybe it always did have where you're obsessed with food,
you're obsessed with trying to do this thing that your
body is not doing for you. And then you have
all that grief attached with, you know, you're an elite athlete.
(12:06):
You're used to being able to push through barriers that
other people would stop at, because that's always got you
to the top. And that's not working for you anymore.
So your whole kind of way of being in the
world has to change, and you kind of have to
step back and have a lot of psychological help, as
(12:26):
well as physiological help to really get out of this
quite bad situation.
S1 (12:36):
We'll be right back. Now, Katrina, I'd love to turn
to what I don't know might be the broader cultural
implications of this particular condition. Because I was wondering, when
I was reading your piece, if there is some suggestion
that the coaches are perhaps negligently putting undue pressure on
their athletes to lose a lot of weight, and in
particular women. I mean, you mentioned that anecdote before about
(12:58):
it being something of a truism within the athletic community
or the professional athletic community that if women are training
and they don't have their period, that's a sign of
job well done, which certainly makes me very worried because
obviously it's a sign your body is not functioning. So, yeah,
our coaches are partly to blame here.
S2 (13:18):
I think in some cases, I mean, it's very hard
to generalise in that, you know, I'm sure there's great
coaches and other coaches who aren't so great, but what
a lot of them who I spoke to, the endocrinologist
would say is that the understanding that it should be
performance led and what happens to the diet and the
(13:40):
exercise should be a result of the performance, not a
skinfold test or an arbitrary weight loss goal, and that
if you focus on performance, the rest will follow. And
that's what they're saying. Sometimes the old school thinking in
in coaching can be about these kind of set things
(14:01):
that you must. And it's the same in dance. It's
also an issue in, in any kind of sport or
athletic endeavor where a you have to look really good
and that's almost all female athletes when you think about it,
because there's not as much money in female sport. And
therefore to get sponsorships you it's just the hard truth,
you know, sponsors would deny it. But it's pretty much
(14:23):
true that if you look good, you're going to be
more likely to get a sponsor who wants to put
you in their shorts in their ad than if you don't.
So yeah, I do think that there's a spectrum. And
a lot of them said there's an education job to
be done really across a whole lot of sports, all
countries to really make people understand more about women's physiology
(14:44):
and that it's different to men's. And of course, this
happens in male physiology as well, male athletes as well,
but that women are not small men. Women have different needs.
And the more education that gets done and the more
research that gets done, if more research gets done, then
we'll understand a bit more how and why the women's
body changes or reacts to certain things and not to others.
S3 (15:08):
Well, this leads me.
S1 (15:09):
Very nicely to my next question, which is the fact
that there are some experts who are critical of the
Reds diagnosis. Tell us about this.
S2 (15:19):
Yeah, that was really interesting. There's had been a nice
little scientific brawl around Reds, which I didn't know about
before I started. So this group of physicians, dieticians, kind
of experts in the field put in these statements to
the International Olympic Committee about Reds. Then another group did
a study for the Sports Medicine Journal, which had this
(15:40):
very provocative title Does Reds Exist? And I spoke to
one of them, Jose Arrieta, who's an Argentinian born, England
based scientist. I spoke to him and he said, look,
we're not saying that these symptoms are not problematic for
the athletes, but we don't think causality is established. We
don't think that it's automatically because of low energy availability
(16:03):
and the other things that are in this kind of
multifactorial reds diagnosis. These symptoms might be because of a
whole lot of other things, other stresses in the athlete's life,
other things to do with their body that you don't
know about, that don't come into the reds tool of diagnosis.
And so he and his colleagues were saying there's just
no causality. You're acting as if causality is automatic and
(16:27):
it's not established. So I think what they all concluded
was we need more research. We need to understand this more.
No one's saying that there's not issues. No one's saying
that they're made up. I mean, it's interesting. It's nothing
like chronic fatigue or carpal tunnel or ADHD or anything.
But it reminded me a bit of those debates around
(16:47):
those conditions because it's something that, you know, you can
see very easily how if it takes off as an idea,
every second person will say they have it. And what
Hosain and his other colleagues were saying was, hang on,
let's just get a bit more careful about what it
is and what it isn't and what causes it. Before
we make every second athlete who's got something happen, say
(17:12):
that they've got Reds. So it was really interesting actually,
to see that back and forth. And I think in
a funny way, they're not as far apart as they sound.
It's just kind of the crux of it is this
causality thing.
S1 (17:24):
And I was really struck by something that Georgie Howe said,
and we should be clear, this has ended her career.
She is no longer a professional cyclist, but she said
that not only did she lose her intuition around her appetite,
but also everything fatigue, illness, emotions, she said. You're very
disconnected from your own body and it takes a long
time to get it back. And then we have to
(17:46):
talk about what's the last sentence in your piece, but
I'm going to get you to, to walk us through,
really the penny drop moment that she had really some
psychological anguish that came out from all of this.
S2 (17:57):
Yeah, I'll paraphrase it because I don't have it in
front of me. But she she basically has been working
with a psychiatrist, um, which I think is pretty natural
in this kind of environment, you know, psychologists, psychiatrists, lots
of different experts. And she said, she said to him
that what she realized is that sometimes in sport, being
(18:18):
the athlete is the worst job because you get to
the other end and, you know, you leave the sport
and you realize that you really were just a commodity
and no one really cared about you. And her psychiatrist
said to her, validated that feeling. The psychiatrist said, you know,
that's not a crazy thing to think. And that really
(18:40):
that really set her back. Really. And her parents said
some interesting things to her father said, look, you know,
everyone goes and he sees they live in Melbourne. He
sees former AFL athletes hobbling around their suburb with, you know,
hips and even the one we all know about concussion,
he said. You don't expect when you go into athletics
(19:02):
or any kind of sport to have permanent things, and
so many do. And her mother, Sally, who is a
former nurse, former health administrator, former board member of Swimming Australia,
she said, look, you know, the the prism you should
put any decision through in sport or anything else is health. Like,
(19:23):
is this going to harm someone's health? Do no harm.
That should be. That should be front and center. Everything
should go through that prism and it just doesn't. So
she was she was also saying, you know, I'll I'll
think that things are really changing when endocrinologists are a
regular part of a sports medical team.
S1 (19:42):
Wow, that's really interesting. And Katrina, just to wrap up,
I mean, what tips do you have, if any? Because,
you know, I'll tell the listeners you worked on this
for more than a month. You've spoken to heaps of
experts that didn't even make it into the piece, as
is always the case with a great, good weekend feature.
So I guess, what tips do you have for listeners?
You know, those of us who perhaps you know, don't
do the right things when we go do trail runs
(20:03):
or box or whatever it is? Yeah. What tips do
you have, I guess, for how to avoid this?
S2 (20:08):
I mean, I would say I'm no expert, but what
I took from the experts is all the basic things
that we've been told forever that we've probably ignored. Right?
Like eat three meals a day, eat a mixture of
carbohydrates and protein. Don't think that if you're training a
lot that you're just going to cut out all your carbs.
Make sure that you eat you know something before you
(20:31):
go training and something after so that it's not robbing
from your bones. It's all those things that we knew anyway.
I mean, that's what I thought. Like, they're all things
I've heard and ignored for my whole life, you know?
S1 (20:45):
Yeah. I hate it there. The messages, the kind of
messages that we get from, like, our mothers that, you know,
we know they're right. But it's so irritating to listen
to because it's like we don't want to have to
listen to them.
S2 (20:56):
And we all and, you know, as women, we've all
wanted to be thinner. You know, it's authentic, but it's
just true. Not everyone probably, but no.
S1 (21:04):
But 100%, 100% brainwash a lot of us. Fully brainwashed.
S2 (21:08):
And so we've kind of thought, oh, look, if I
don't have a banana before I go boxing, then I'll lose.
I won't, you know, lose weight. Well, no, that actually
might just be wrecking your bones or, you know, like
so all those things that they've said, what a surprise.
They were right. They had logic behind them.
S1 (21:27):
Oh, man, I hate that. But, Katrina, I'm so delighted
to have spoken to you about this. So thank you
so much for your time.
S2 (21:34):
Thank you so much, Sam.
S1 (21:45):
Today's episode of The Morning Edition was produced by myself
and Josh towers. Our executive producer is Tammy Mills. Tom
Mackendrick is our head of audio. To listen to our
episodes as soon as they drop. Follow the Morning Edition
on Apple, Spotify, or wherever you listen to podcasts. Our
newsrooms are powered by subscriptions, so to support independent journalism,
(22:07):
visit the page or smh.com.au. To subscribe and to stay
up to date, sign up to our Morning Edition newsletter
to receive a summary of the day's most important news
in your inbox every morning. Links are in the show. Notes.
I'm Samantha Selinger. Morris, thanks for listening.
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Are You A Charlotte?
In 1997, actress Kristin Davis’ life was forever changed when she took on the role of Charlotte York in Sex and the City. As we watched Carrie, Samantha, Miranda and Charlotte navigate relationships in NYC, the show helped push once unacceptable conversation topics out of the shadows and altered the narrative around women and sex. We all saw ourselves in them as they searched for fulfillment in life, sex and friendships. Now, Kristin Davis wants to connect with you, the fans, and share untold stories and all the behind the scenes. Together, with Kristin and special guests, what will begin with Sex and the City will evolve into talks about themes that are still so relevant today. "Are you a Charlotte?" is much more than just rewatching this beloved show, it brings the past and the present together as we talk with heart, humor and of course some optimism.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.