When to use this
The moment a pattern stops looking like normal athlete struggles — this sheet helps adults decide to refer instead of wait.
- Food rules, skipped meals, or body checking that keep escalating.
- Fatigue, stress injuries, or performance decline with no training explanation.
- A coach and parent comparing notes and wondering if it is 'bad enough' to call someone.
Advanced lab
The referral playbook
The sheet says refer early. Who to call in what order, what to say, and how coach and parent coordinate are here.
This framework supports early referral, not diagnosis. Any concern about rapid weight loss, fainting, or an eating disorder goes to the athlete's physician promptly, with an eating-disorder-informed sports dietitian added to the team.
Evidence sources
These references support the handout’s general education. Individual medical, supplement, laboratory, or injury questions should be handled by the appropriate qualified clinician.
- Thomas DT, Erdman KA, Burke LM. Nutrition and Athletic Performance. Med Sci Sports Exerc. 2016.
- Logue DM, Madigan SM, Melin A, et al. Low energy availability in athletes: a review of prevalence and practical implications. Eur J Sport Sci. 2018.
Where to go next
ToolWalk the referral toolA guided pass through the red flags and the right provider for each pattern.
PrintableScreen for RED-SThe warning-signs sheet covers the under-fueling pattern behind many referrals.
PrintableStart the food conversationFor the parent seeing the signs at home, this sheet gives the calm first response.
