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Rapid Weight Loss and Low Energy Availability

tions were applied. The search strategy used structured combinations
of keywords and subject terms capturing both (i) combat sports and (ii)
low energy availability and relative energy deficiency in sport, including
relevant clinical frameworks and associated health outcomes. Example
search strings included: (‘combat sport’ OR wrestling OR judo OR boxing
OR taekwondo OR karate) AND (RED-S OR ‘relative energy deficiency
in sport’ OR ‘low energy availability’ OR ‘energy deficiency’ OR ‘rapid
weight loss’) AND (syndrome OR disease OR ‘health risk’ OR hormonal
OR bone OR ‘health consequences’) AND (young OR youth OR child* OR
adolescen*).

Selection and Synthesis
Priority was given to literature that:
1. Identified and described health risk factors associated with rapid
weight loss, LEA, and RED-S in young combat-sport athletes;
2. Examined the clinical significance and physiological consequences
of rapid weight loss, LEA, and RED-S; and
3. Provided practice-oriented guidance, including screening, monitor-
ing, prevention, and intervention strategies aimed at reducing risks
associated with rapid weight loss, LEA, and RED-S in combat-sport
settings.
Review articles were primarily used to provide foundational informa-
tion regarding the definitions, epidemiology, pathophysiology, and iden-
tification of rapid weight loss, LEA, and RED-S, whereas peer-reviewed
original studies and systematic reviews were used to substantiate the rel-
evance and manifestation of these health concerns in wrestling and other
combat sports.
Articles involving exclusively adult populations, lacking full-text ac-
cess, or addressing sport in general without specific relevance to combat
sports were excluded during the selection process.

Scope and Limitations
As a narrative review, this contribution does not aim to provide an ex-
haustive or fully systematic synthesis of the entire body of evidence on
low energy availability and relative energy deficiency in sport. Rather,
it focuses on evidence with direct practical relevance for coaches, clin-
icians, and practitioners working with combat-sport athletes, with par-
ticular emphasis on clinically meaningful outcomes and actionable im-
plications for applied practice.

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