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Therapy for Relative Energy Deficiency in Sport (RED-S) Athletes

Virtual therapy for athletes experiencing low energy availability, performance decline, and the psychological impact of underfueling

I provide sport-informed, virtual therapy for athletes with RED-S across PA, NJ, DE, FL, VT, and OR. Therapy focuses on both health and performance, addressing the mental and emotional factors that often maintain RED-S over time.

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Relative Energy Deficiency in Sport (RED-S) is a condition that occurs when an athlete’s energy intake does not meet the demands of training, recovery, and daily life. This state of low energy availability can affect nearly every system in the body, including hormonal, bone, immune, metabolic, cardiovascular, and psychological functioning, and it often leads to declines in athletic performance. Unlike the older concept of the Female Athlete Triad, RED-S affects athletes of all genders and involves far more than weight or menstrual function.

RED-S is common in sport cultures that emphasize discipline, leanness, or high training volume - and it often goes unnoticed because many symptoms are normalized as “part of training.”

What is RED-S?

    • Recurrent injuries like stress fractures

    • Fatigue

    • GI distress

    • Hormonal disruption like missed periods or low testosterone

    • Plateau or decline

    • Poor recovery

    • Weakened immune system

    • Loss of power or endurance

    • Loss of joy in sport

    • Anxiety around fueling or rest, and guilt when training regimen is disrupted

    • Fear of weight gain

    • Rigid food rules

    • Perfectionism or overcontrol

Common Signs and Symptoms of RED-S

I want you to know that developing RED-S is not your fault. Athletes can appear healthy, and even perform well, while internal systems are suffering. Some symptoms, such as fatigue and poor recovery, can be interpreted as normal impacts of training rather than signs of under-fueling. Low energy availability in athletes might even be normalized or praised in some sport cultures. While you might not see yourself as “having a problem” or “sick enough”, let’s prioritize your body’s needs without judgement.

RED-S often goes unrecognized.

How Therapy Helps with RED-S

Therapy for RED-S focuses on addressing the psychological drivers that contribute to ongoing low energy availability, while supporting sustainable recovery and performance.

In therapy, we may work on:

  • Reducing fear around adequate fueling and body changes

  • Addressing compulsive exercise or difficulty resting

  • Challenging all-or-nothing and performance-based thinking

  • Managing anxiety, perfectionism, and control patterns

  • Supporting identity beyond performance alone

I take a collaborative, sport-informed approach and regularly work alongside dietitians, physicians, and sports medicine providers when appropriate.

Some athletes with RED-S meet criteria for an eating disorder. Others do not.

RED-S can occur with or without a diagnosable eating disorder, and therapy can be helpful regardless of diagnosis. Early psychological support can reduce the risk of RED-S progressing into more entrenched disordered eating patterns.

If you’re unsure where you fall, therapy can help you clarify what’s happening and determine appropriate next steps.

RED-S vs. Eating Disorders

  • Competitive and recreational athletes

  • High school, collegiate and elite-level athletes

  • Athletes in endurance, aesthetic, weight-class, and team sports

  • Athletes questioning if they’re fueling enough

  • Athletes in endurance, aesthetic, weight-class, and team sports

    All therapy is provided virtually, making it accessible around training, school, and competition schedules.

Who I work with:

Get in touch

Change is possible.

Click this link to choose a day and time for a free, confidential consultation. We’ll talk through your symptoms to see if therapy for RED-S is a good fit.

FAQs

Frequently asked questions

  • No. Therapy can be helpful for RED-S even without a formal eating disorder diagnosis.

  • RED-S can impact people of any gender identity.

  • I take a multidisciplinary approach to therapy, meaning I collaborate with other providers when I can. Having a support team ensures that you are receiving well-rounded, high-quality care.

  • Yes - athletes of all body sizes can be impacted by RED-S.

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