Recovering from REDs (Relative Energy Deficiency in Sport) can bring up a lot of questions, especially around growth charts, ideal body weight, and weight restoration. While weight isn’t the only marker of recovery, it can play a key role in regaining lost function, growth, and performance. For athletes who’ve been underfueling, especially since adolescence, using growth charts can offer helpful insight into what their body may truly need to heal. In this blog post, we’ll dive into how to estimate ideal body weight in athletes using growth charts, especially for REDs recovery or catch-up growth.
Estimating Ideal Body Weight in Athletes Using Growth Charts
How Much Weight Do I Need to Gain?
If you’re an athlete in recovery from Relative Energy Deficiency in Sport (REDs) or low energy availability, you’ve probably asked some version of these questions:
“How much weight do I need to gain to…
“… get my period back?”
“… stop getting bone stress injuries?”
“… recover from REDs?”
These are common and valid questions I hear quite often from athletes I work with.
While not all athletes with REDs or low energy availability will lose weight, those who do will likely need to restore weight to reach recovery… but how much?
Like most nutrition-related topics, the answer is: it depends!
For athletes recovering from REDs, using growth charts can help estimate a realistic and supportive ideal body weight, especially when underfueling begins during adolescence.
Ideal Body Weight in Athletes: Why It’s Complicated
While weight is never my main focus, it can be helpful for some athletes and athlete providers to have a weight target to work towards. For athletes who display a fear of weight gain, normalizing and preparing for weight gain can be helpful. Athletes who lost weight during REDs may need to regain more than they expect, especially if underfueling disrupted growth during key developmental years.
It also gives athlete providers a data-driven tool to guide recovery decisions.
What Growth Charts Reveal About Missed Development
In an ideal world, we see an athlete as soon as they begin to experience symptoms of REDs (e.g., missed a period, feeling fatigued, etc), which may or may not be accompanied by weight loss. For these athletes, increasing energy availability and restoring any weight that was lost may be enough to get them out of the RED.
Unfortunately, there are many more athletes who we don’t see until years of amenorrhea and multiple stress fractures later.
For adolescent athletes or adult athletes who have been underfueling since they were teens, it’s not as simple as returning to the weight they were before, as it does not account for the necessary growth and development that should have occurred during this time. For reference, bone and brain development is not completed until 18-20 years of age for females and 21-25 years of age for males.
Growth charts, which plot weight-for-age and height-for-age along a percentile curve, can show if nutrition has impacted an athlete’s growth and development. This is where growth charts become a really helpful tool to estimate a target weight to aim for.
Case Example
Let’s say you’re working with a 19 year old athlete who has increased energy availability and restored weight, yet they still haven’t regained a menstrual cycle. If you can get access to their growth chart, you may be able to find that they were tracking on the 75th percentile for the majority of their childhood until high school when the underfueling began and they dropped to the 50th percentile. Even though the 50th percentile is “normal,” this athlete’s weight trends suggest that plotting along the 75th percentile (at their current age) may be a more appropriate target weight for this specific athlete.
This insight can guide catch-up growth and help achieve full recovery from REDs.
Catch-Up Growth in Athletes: Going Beyond the Charts
Athletes who have experienced significant low energy availability or REDs for many years may actually need to surpass their projected weight in order to support proper growth and development and recovery from REDs. We may also see a drop on the growth charts for height-for-age in these athletes with chronic low energy availability.
Similar to REDs not always being characterized by weight loss, weight gain does not rule out or negate REDs. Some athletes with REDs may actually gain weight as the body downregulates and metabolism slows.
Estimating Ideal Body Weight for REDs Recovery
To estimate ideal body weight in athletes, especially those recovering from REDs:
- Review growth chart history, focusing on percentiles prior to underfueling.
- Consider age and stage of development – brain and bone development continue into early adulthood.
- Use current percentiles as reference points, not fixed goals.
- Account for possible catch-up growth, especially if REDs lasted multiple years.
Ultimately, the goal is not just weight restoration, but recovery of full physical, hormonal, and metabolic function.
Support for Athletes in Recovery
Recovery from REDs takes time, trust, and a personalized approach. If you’re navigating this process or supporting someone who is, there’s no need to do it alone.
I’m here to help both athletes and providers so they can optimize nutrition, performance, and recovery.
Are you an athlete seeking support? Join the waitlist for my upcoming Athlete Nutrition Challenge.
Are you a provider looking for more information and training on REDs? Join the REDs Provider Masterclass!