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#Time2Act: Harassment and abuse in elite youth sport culture
  1. Margo Mountjoy1,2
  1. 1 Family Medicine, McMaster University Michael G DeGroote School of Medicine, Waterloo, Ontario, Canada
  2. 2 International Olympic Committee Working Group on the Prevention of Harassment and Abuse in Sport, Lausanne, Switzerland
  1. Correspondence to Dr Margo Mountjoy, Family Medicine, McMaster University Michael G DeGroote School of Medicine, Waterloo, ON N2G 1C5, Canada; mountjm{at}

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“After months of dieting and frustration, Cain found herself choosing between training with the best team in the world, or potentially developing osteoporosis or even infertility. She lost her period for 3 years and broke five bones. She went from being a once-in-a-generation Olympic hopeful to having suicidal thoughts.” 1 (Lindsay Crouse on Mary Cain) “And so trying to shame somebody into losing weight is just such, I mean, an emotionally, psychologically and mentally traumatising way to coach somebody.” (Mary Cain)

At the age of 17, Mary Cain was a running phenomenon in the USA when she joined Nike’s Oregon Project. In November 2019 Mary Cain went public in the New York Times with allegations of psychological and physical abuse by her coach, Alberto Salazar,1 who has subsequently apologized.2 As a result of the public weighing practices, being told she needed to become “thinner, thinner and thinner” to improve her performance and public body shaming, Cain developed the syndrome of Relative Energy Deficiency in Sport (RED-S). Cain’s disturbing disclosure caused a flurry of media attention exposing the dark underbelly of elite youth sport culture.

Mary Cain’s story is a ‘call to action’ for sport. Do youth sport programmes meet the International Olympic Committee (IOC)’s standards of a ‘safe sport’ culture?3 In the recent publication on Safeguarding at the Youth Olympic Games (YOG2018), 1254 athletes were asked to define their understanding of the term ‘safe sport’. The results were sobering. …

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  • Twitter @margo.mountjoy

  • Contributors MM: substantial contributions to the conception and design of the editorial, drafting, writing and revising of the manuscript and final approval of the version to be published.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.