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Martin Šporin and Dorjana Zerbo Šporin

free mass per day (Nattiv et al., 2007). Energy intake below 30 kcal/kg
FFM/day is associated with disruption of luteinizing hormone pulsatility
(Loucks & Thuma, 2003).
The clinical presentation of RED-S is frequently broad and initially
nonspecific, which may delay recognition and lead athletes to consult
multiple healthcare professionals before a unifying diagnosis is estab-
lished (Gould et al., 2023). Early recognition and intervention are there-
fore essential to reduce the risk of serious adverse health consequences
(Mehta et al., 2018). Weight-control practices in combat sports may in-
crease athletes’ exposure to LEA, potentially contributing to physiologi-
cal and psychological disturbances associated with RED-S.
Accordingly, this contribution presents the key factors related to rapid
weight loss, low energy availability, and relative energy deficiency in sport
among young combat-sport athletes. It first provides an overview of the
risk factors, epidemiology, pathophysiology, and detection of LEA and
RED-S. It then outlines the specific features of these phenomena in com-
bat sports. Finally, it summarises approaches to identifying athletes at
risk of LEA and RED-S and discusses how these health issues can be ad-
dressed in wrestling and other combat sports.

Methods
Design and Conceptual Approach
This contribution was developed as a narrative review with a practical
orientation, examining rapid weight loss, low energy availability (LEA)
and relative energy deficiency in sport (RED-S) in combat-sport ath-
letes and their clinically relevant consequences. The review adopts a
descriptive, practice-informed framework: it synthesises key epidemi-
ological findings, summarises the principal pathophysiological mecha-
nisms underlying rapid weight loss, LEA, and RED-S, and outlines the
associated health risks. Particular emphasis is placed on translating cur-
rent evidence into clinically applicable insights for athlete monitoring,
risk recognition, and informed decision-making in applied combat-sport
settings.

Literature Search Strategy
To identify relevant literature on low energy availability, relative ener-
gy deficiency in sport, and their clinical consequences in combat-sport
contexts, targeted searches were conducted in PubMed/MEDLINE, Sco-
pus, Web of Science, and ScienceDirect. No publication-year restric-

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