For some time now, I’ve been interested in what sports physiologists call “low energy availability” (LEA). This could be translated as “deficit in available energy.”
In practical terms, this manifests as a general feeling of fatigue, difficulty recovering after physical activity, mood swings, irritability with simple daily tasks that seem exhausting, joint or bone pain, or even injuries, hormonal imbalances (which can range from amenorrhea—the absence of periods—to early menopause), a weakened immune system, and poor-quality sleep.
In short, you feel drained, even though you’re doing everything you can to stay in shape: we generally eat healthily (vegetables, fruits, and a variety of proteins; we may even have incorporated intermittent fasting), we monitor our sugar and calorie intake, we exercise very regularly, we practice yoga, and we receive stress-relieving messages. We should be feeling great, yet we’re exhausted almost all the time, never satisfied with our intellectual or physical performance, and we feel old and unmotivated.
Alarming Figures
A few days ago, I came across an article by Dr. Stacy Sims, whom I always appreciate for her modern and incisive perspective on these issues of society and women’s health in sports. In this article, she reports on the latest studies on LEA. Here are the staggering figures she shares:
- According to this study, nearly 80% of cross-country skiers are at risk for OED.
- 88% of professional female soccer players are diagnosed with OSA in this other study.
- 96% of ballet dancers have LEA, according to this study.
- 100% (!) of synchronized swimmers have a deficit in available energy, as shown by this study.
Looking at endurance sports, this 2022 study published in *Frontiers in Sport and Active Living*, which surveyed 200 female athletes, shows that 65% are at risk for EAT, 23% are at risk for severe exercise addiction, and 21% suffer from an eating disorder.
Dr. Sims—a former elite athlete and world-renowned specialist in female athlete physiology—emphasizes this point: energy deficit syndrome (EDS) is a problem she encounters daily in her practice; if it is not identified in time, it can severely harm women’s health, leading to the early onset of diseases such as osteoporosis.
“Energy-saving” mode
In short, it’s scary, so I think it’s really worth understanding the mechanism behind AED. AED, or available energy deficit, is defined as having insufficient available energy to support basic physiological functions once energy expenditure related to sports has been accounted for. In other words, people suffering from LEA do not eat enough to compensate for the energy expenditure associated with exercise and their basic biological needs. The body cannot provide the energy needed for both. So it rationing, and contrary to what one might think, it doesn’t necessarily conserve energy by reducing athletic performance.
What makes LEA particularly complicated is that this deficit in available energy allows the athlete to run, swim, cycle, lift weights, and complete their workouts (at least for a while); but the body no longer has enough calories for the organs to function optimally.
When we enter a state of LEA, it’s a bit like switching to “power-saving” mode. This is, in fact, how Dr. Katie Schofield, another researcher in this field, describes the process: Our phone switches to “power-saving” mode when the battery is low; it still works, but the screen dims, and certain apps close to conserve energy. In the case of our bodies, these apps are our organs, such as our reproductive and endocrine systems!
The Consequences
And here are the consequences of a long-term calorie deficit—are you ready? It’s not pretty.
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One of the primary consequences of LEA affects women’s reproductive systems. With a deficit in available energy, production of luteinizing hormone decreases, and this hormone plays a crucial role in ovulation and the regulation of the menstrual cycle. Many women, especially athletes, think it’s “normal” to stop having periods when they’re training. But it’s anything but normal.
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The effects on the skeletal system are also severe. Without sufficient energy available, osteoblasts (the cells responsible for bone density) cannot function properly, and bones become weakened. This can lead to stress fractures and an increased risk of osteoporosis.
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Other symptoms we’d rather do without include irritability, depression, confusion, a weakened immune system, loss of libido, digestive issues (constipation, diarrhea, bloating, among others), and anemia.
Obviously, LEA will eventually lead to a decline in athletic performance. But that’s where it gets complicated: it doesn’t happen right away, and even at first, you might feel like you’re making progress. That’s because you have enough energy to train; the problem is that there’s none left for anything else. That’s why you can be in a state of EAI for a long time before you feel like you’re plateauing or regressing athletically.
How to Break Out of It
OK, I think we’re convinced that it’s best to avoid this energy deficit—or to break out of this vicious cycle if we think we’re in it. How do we do that?
First, become aware of the deficit if it’s happening. This isn’t so obvious for some women, who have gotten into the habit of depriving themselves or controlling their eating and find their behavior reinforced by all the false beliefs about the “ideal” athlete’s body and socially accepted “miracle” diets. Many think they’re eating enough when they actually aren’t.
The most important thing is to eat before and, above all, after workouts. Without a quick source of calories, the brain interprets this as a signal to put the body into standby mode.
What should you eat? That’s where I won’t give any specific advice. First, because nutrition is highly individual, and I believe that intuitive eating is the healthiest approach. And also because we’re already bombarded with messages about healthy eating, and that can easily become yet another source of pressure in our lives, which are already overwhelmed with all sorts of other demands.
As my own coach, Megan Roche, says, “all food is good food.” So let’s eat. Okay, even though I don’t like to quantify things for the reasons explained above, here’s a rough estimate of the ideal number of calories for an athlete: 2,800 calories per day. That’s a far cry from the 1,200 calories that many active women think is enough.
If you think you’re teetering on the edge of LEA, don’t beat yourself up. You’re not alone. I speak from experience, having gone through a long period of athletic disappointment and general fatigue myself. Back then—about ten years ago—no one was talking about LEA yet. I thought I was eating more than enough; I led a generally healthy lifestyle, but my workouts were becoming increasingly difficult, I was losing my drive and motivation, everyday life was often exhausting, and my mood was all over the place. The first medical sign was anemia, with all its unpleasant symptoms.
Looking back, I think I was really running on empty; my “healthy” vegan diet at the time simply wasn’t providing me with enough energy to juggle my job as a teacher, an intense athletic regimen (triathlon), and life as a mom.
By eating more—without counting calories or restricting yourself—it’s entirely possible that you’ll feel your energy levels rise, see a significant improvement in your performance, and find that life feels easier overall.
Notes:
- I’m well aware that this type of topic is controversial and subject to strong opinions. Everyone has something to say on the matter, and “magic solutions” are everywhere online. I don’t want to add to the controversy or offer advice—the experts do that much better than I do. As a coach, I encounter this situation all too often: amenorrhea or early menopause, sleep disturbances, mood swings, fatigue, and a lack of energy. These situations are complex, and I in no way claim to have the solution. Here, I’m suggesting a risk-free avenue to explore. Simply becoming aware that you might not be eating enough can make a huge difference in your quality of life.
- I’ve focused on women here because Dr. Stacy Sims, with whom I completed my physiology training, specializes in this population. My intuition tells me that the same issue of insufficient available energy is present in male athletes, though perhaps not to the same extent or with the same consequences. This is still a relatively underdiscussed topic; I think there’s still a lot of reluctance among men to talk about eating disorders, decreased performance, or depressive moods. So this article isn’t just for women—gentlemen, this might apply to you, too.