Low Energy Availability (LEA) and How It Affects You

Sports physiologist supporting athlete training at Performance Medicine

What Is Low Energy Availability (LEA)?

Do you have some or all of the following?

  • Non-stop injuries or illnesses
  • Taking a long time to recover from exercise
  • Not being as strong or fit during your workouts
  • Irregular menstrual cycles
  • Low libido or sexual function
  • Gastrointestinal complaints
  • Mood changes

What if I told you this could all stem from one underlying cause – low energy availability (LEA)?

LEA is common amongst athletes and dancers. Put simply, LEA results from not receiving enough energy from your diet to support your exercise in addition to your normal bodily functions. Something that appears so simple (reduced energy intake) can result in complex body system changes with consequences on health as well as performance.

How LEA Can Progress to REDs

As LEA worsens, it can lead to the more serious Relative Energy Deficiency in Sport (REDs).

REDs is a more complex and serious issue where you don’t have enough energy to support your body functions, leading to these functions slowing or even stopping.

All dance, like sport, requires a large amount of energy. This leaves people susceptible to not consuming enough to meet these demands.

Research has shown across sports, genders and ages that the prevalence of LEA is staggering:

  • 42.5% of female runners
  • 57% of adult ballet dancers
  • Up to 72% of adolescent dancers

That’s a lot of people not getting enough energy.

What Happens to Your Body With LEA?

When you don’t get enough energy in – or it’s simply not enough to meet your needs – your bodily functions suffer.

You may experience:

  • Changes in reproductive and sexual function
  • Weaker bones that are more susceptible to breaks
  • Muscles that injure more easily
  • Increased illnesses and longer recovery times (e.g. colds)
  • Gut upsets
  • Poor sleep
  • Heart damage

Your athletic performance suffers, too.

Those with LEA and REDs see:

  • More injuries
  • Longer recovery time from injury
  • Fewer gains from training

This means any training you do could result in injury. In addition, you may not gain as much from training compared to if you were getting the energy you need.

You need energy to repair and recover so you can train again in a safe and productive way.

Unfortunately, there is a clear link between REDs and restrictive eating disorders, which are some of the most serious mental health conditions.

Why Are Athletes and Dancers So Susceptible to LEA?

Many people are not aware that they are susceptible to LEA.

For example, many women using hormonal contraceptives might not menstruate. This makes detecting when menstruation has stopped due to REDs more difficult.

Other contributing factors include:

  • Lack of money or time
  • Difficulty planning meals ahead
  • Not having food available to meet energy needs
  • Weight-category sports (e.g. boxers)
  • Perceived performance benefits of lower body weight (e.g. runners)

These factors increase the risk of low energy availability in both athletes and dancers.

What Can We Do to Reduce the Risk of LEA?

It is so important to understand:

  • The signs of LEA
  • The energy demands of your life
  • The demands of your job
  • The demands of your sport

If you notice any of the signs mentioned above, or if you are struggling to consume enough energy for any reason, reach out for help.

Your GP can refer you to a qualified dietitian. You can also see one without a referral.

You might benefit from:

  • Mental health support from a qualified professional
  • Injury management support from a physiotherapist
  • Guidance from a sports doctor familiar with your sport’s demands

Early support can protect both your health and your performance.

Get Support for Low Energy Availability

male athlete training under high physical demands

If you’re concerned about low energy availability (LEA) or noticing any of the signs mentioned above, early support can make a significant difference. At Performance Medicine, we work with athletes, dancers and active individuals to optimise health, recovery and performance through evidence-based care.

Whether you need support with nutrition, injury management, hormonal health or performance optimisation, our team can help. Book a consultation to speak with our team today.

References:

Whitney KE, DeJong Lempke AF, Stellingwerff T, et al. Boston Marathon athlete performance outcomes and intra-event medical encounter risk associated with low energy availability indicators. British Journal of Sports Medicine 2025;59:222-230.

Whitney KE, Holtzman B, Cook D, Bauer S, Maffazioli GDN, Parziale AL, Ackerman KE. Low energy availability and impact sport participation as risk factors for urinary incontinence in female athletes. J Pediatr Urol. 2021 Jun;17(3):290.e1-290.e7.

Lye JCT, Chan TW, Lim HBT, Png JW, Taim BC. (2024). Low Energy Availability and Eating Disorders Risk: A Comparison between Elite Female Adolescent Athletes and Ballet Dancers. Youth, 4(2), 442–453. https://doi.org/10.3390/youth4020031

Allen N, Kelly S, Lanfear M, Reynolds A, Clark R, Mountjoy ML, et al. (2024). Relative energy deficiency in dance (RED-D). BMJ Open Sport & Exercise Medicine, 10:e001858. https://doi.org/10.1136/bmjsem-2023-001858

Mountjoy M, Ackerman KE, Bailey DM, et al. (2023). IOC consensus statement on Relative Energy Deficiency in Sport (REDs). British Journal of Sports Medicine, 57:1073-1098.

Vardardottir B, Olafsdottir AS, Gudmundsdottir SL. (2023). Body dissatisfaction, disordered eating and exercise behaviours: associations with symptoms of REDs. BMJ Open Sport & Exercise Medicine, 9:e001731. https://doi.org/10.1136/bmjsem-2023-001731

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