• female
• energy deficiency
• relative energy deficiency

Changing a sport system requires the appointment of new leaders or a grass roots cultural revolution. ‘I got caught in a system designed by and for men, which destroys the bodies of young girls,’ said Mary Cain as she cast light on her toxic coach/athlete relationship and exposed unhealthy coaching and nutrition practices. Her candour has inspired a social media movement calling for changes to women’s sport.1 In the following days, major news publications followed up with similar reports of athletic women being body shamed.2–4

It is time for a drastic paradigm change in women’s sport, coupled with education at all levels to improve the long-term health and athletic achievement of female athletes. The shift needs to include:

1. Raising awareness of the negative effects of chronic low energy availability (LEA) (calorie restriction) so athletes can make wise choices for their own long-term health.

2. Updating and developing best-practice protocols and safe standards for monitoring body composition/weight.

3. Eliminating toxic training environments featuring abusive body shaming.

Overexercising or underfueling, occurring consciously or subconsciously, can cause Relative …