Photo via BBC Sport

Race, illness, injury, repeat - REDs and why men are suffering in silence

British long-distance runner Jake Smith has opened up about the hidden struggles of relative energy deficiency in sport (REDs), a condition that nearly derailed his career despite his early success. At just 23, Smith had already signed a professional deal with Nike and represented Great Britain internationally, but behind the scenes, his body was failing due to an extreme energy deficit from disordered eating and relentless training.

After returning from a camp in Uganda weighing just 51kg (8 stone) at 5ft 5in, he suffered two stress fractures in four months—a warning sign of REDs, which can cause bone stress injuries, hormonal disruption, and long-term health issues like osteoporosis. Though often associated with female athletes, the condition affects men just as severely, yet stigma and subtle symptoms mean many, like Smith, go undiagnosed for far longer.

Smith’s case highlights how REDs can manifest differently in men, with symptoms like fatigue and reduced testosterone levels often overlooked. While women’s menstrual cycle serves as a visible marker of hormonal health, men’s declining testosterone—linked to low energy and libido—goes unnoticed until severe damage occurs.

Experts warn that without proper treatment, the condition can lead to irreversible health consequences, yet it remains under-discussed in sports science. Smith’s diagnosis came after years of pushing through illness and injury, a pattern that nearly ended his career before age 30, as doctors had previously cautioned.

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