Roles and expectations related to relative energy deficiency in sport (REDs) – A survey assessing the perceptions of REDs between athletes, coaches, and support staff

Since the introduction of relative energy deficiency in sport (REDs) in 2014, research has primarily focused on athletes’ experiences of REDs symptomatology and consequences, limiting understanding beyond athletes’ perspective. This study assessed the relationship between athletes’ expectations of coaching and support staff in relation to REDs, and staff members’ perceptions of athletes’ REDs experiences. Two interrelated questionnaires were implemented in a mixed-methods cross-sectional study: the Athlete- and Coach-Centric Questionnaires. 101 respondents participated, comprising 56 athletes and 45 coaching and support staff. Awareness of REDs was reported by 31 (55%) athletes and 33 (73%) coaching and support staff. Among athletes, 31 (55%) expected coaches to be aware of REDs symptoms, while 35 (62%) expected awareness of REDs consequences. Only 8 (18%) staff members reported the presence of a REDs assessment, and 10 (22%) a REDs treatment responsibility in their sporting organisation. Qualitative analysis highlighted the importance of the coach-athlete relationship in delivering individualised REDs care. Athletes reported negative coaching practices, and expected to receive limited support, while coaching and support staff highlighted that REDs symptoms were often unreported by athletes. Staff also felt that REDs was under-supported by national governing bodies (NGBs), limiting their potential to positively influence REDs experiences. Further exploration of REDs-specific education for coaching and support staff, athletes, and NGBs is warranted.