Coaches and parents do not need to diagnose RED-S. They do need to recognize when warning signs have crossed the line into referral territory.
Do not wait for confirmed diagnosis before changing the response
Missed periods, repeated bone stress problems, or major fatigue with performance decline are enough to escalate. Use the referral chain inside a school for who to tell, and in what order.
If the athlete is cutting intake, panicking around food, or showing compulsive exercise patterns, the threshold gets even lower.
The earlier referral path protects both health and the season.
Use direct, calm language about concern and next steps
Name the pattern you are seeing instead of accusing the athlete of doing something wrong.
Keep the conversation focused on health, safety, and support.
Specific concern plus a next action works better than a vague warning.