Relative energy deficiency in sport

Date Published: 
Wednesday, January 12, 2022

Dr Megan Ogilvie discusses how to screen for Relative Energy Deficiency in Sport (RED-S), a clinical syndrome comprising low energy availability (LEA) as a result of over-training and a negative calorific balance. She talks about how to investigate and manage these patients that are often overlooked in our community.



  • 00:00 Intro
  • 01:00 The term RED-s
  • 03:59 What is the underlying mechanism underpinning RED-s?
  • 08:07 Does RED-S only affect female athletes?
  • 10:15 Patient screening
  • 16:30 Common clinical features
  • 18:55 physical examination and history
  • 21:33 investigations, what should we order?
  • 30:32 What is the diagnostic criteria?
  • 33:17 The multidisciplinary team
  • 37:49 What is the outcome for these athletes?
  • 40:27 prevention messages in our communities
  • 42:42 Junior athletes
  • 44:47 Para athletes
  • 45:36 Transgender athletes
  • 46:31 Take home messsages


Take-home messages

  • Energy deficiency is an extremely common and often missed diagnosis – don’t exclude just because BMI is normal
  • These patients need ongoing preferably multidisciplinary support for recovery
  • Aims – liberalising food groups and nutrition, enough nutrition, don’t overdo the exercise and manage the stress and anxiety
  • The medical lead must continue to follow and support as well as co-ordinating care from the others in the multidisciplinary team





Dr Megan Ogilvie

Megan is a general and reproductive endocrinologist with particular interests in energy deficiency in the athlete, menopause, polycystic ovarian syndrome and gonadal dysgenesis.  She works at Fertility Associates and the Auckland District Health Board.  Megan has been part of WHISPA , a High Performance Sport NZ medial advisory board since 2017.  

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This presentation is intended for qualified health practitioners professional development and should not be relied upon for any other purpose. Any opinions offered are those of the presenter or other speaker and do not necessarily represent the views of Goodfellow Unit.