![\"Howe](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2025\/11\/98412968548fae1364286b4178fde613c707e002.jpeg\")
<\/p>\nNormal text sizeLarger text sizeVery large text size<\/p>\n
Georgie Howe was excited when she heard her cousin would have his wedding in Oxford, the university town west of London. It was to be in December 2023 and she\u2019d fly over from Girona, Spain, where she\u2019d been based since late 2022 when she joined Liv AlUla Jayco, a professional women\u2019s road cycling team competing on the European circuit.<\/p>\n
Howe was one of those gifted athletic types who\u2019d represented Australia in two sports in the space of a decade. The first was rowing, in which she\u2019d excelled at Melbourne Girls Grammar then Princeton, the American university at which she rowed in three Ivy League championship teams, co-captaining the last, one of the few non-Americans to do so. Then came cycling, which she only took up during COVID-19 lockdowns as a way to keep fit, stave off boredom and stay in touch with her Princeton buddies, whom she\u2019d compete with from her North Richmond share house via a stationary bike and app. When lockdowns eased, she\u2019d go on long rides along Beach Road, Melbourne\u2019s premier cycling boulevard, where coach Nick Owen noted her pace and started training her in \u00adexchange for lattes. \u201cI never meant to go pro, I just wanted to see how fast I could ride,\u201d says the now 31-year-old, in the nonchalant way only those with talent can pull off.<\/p>\n
By the time she arrived in Oxford for her cousin\u2019s wedding, though, Howe felt none of the joy one might expect from someone living such a pro-athlete\u2019s dream. To the contrary, she was stressed \u2013 and hungry. \u201cI was aware of everything I put in my mouth,\u201d she says. \u201cI was the only tattooed, mulleted person at the wedding and I was the first to bed.\u201d<\/p>\n
<\/p>\n
Howe in 2024 racing for Team Liv AlUla.Credit: Getty Images<\/p>\n
A few months prior, she says, her team had delivered an unpalatable truth: Liv AlUla Jayco had not performed as well as they\u2019d liked in 2023. Everyone was being put under the microscope going into 2024, and to continue pulling her weight, Howe needed to lose some. The dominant thinking in road cycling is that the best are lean and light, all the better for pedalling uphill in unforgiving multi-day stage races like the Tour de France Femmes. If the 174-centimetre Howe could shed some of her 74 kilograms, the theory went, she\u2019d perform better. The goal, then, was nothing less than to change her body shape \u2013 to a kind she\u2019d never had in her life.<\/p>\n
\u201cI\u2019d always been built like a brick shithouse,\u201d Howe says bluntly. \u201cI came from rowing, so I had big shoulders and arms, and had been \u00adlifting weights since I was 13.\u201d<\/p>\n
With the help of the team dietitians, Howe says she cut her food intake pretty much in half. Where she might have had eggs on toast for lunch after a gruelling five-hour endurance ride, she now made do with a smoothie. With weigh-ins three times a week \u2013 she wasn\u2019t the only \u00adcyclist asked to shed kilos \u2013 she started taking two sets of scales with her wherever she went, one to measure what she ate, the other her weight.<\/p>\n
A strange thing happened, though, as the 2024 season got under way. After an initial drop of a few kilos, and despite continuing to eat abstemiously, Howe actually put weight on. What\u2019s more, while in 2023 she\u2019d mostly sat in the front half of the 130-odd riders in the peloton, in 2024 she was now sitting in the back 20 \u2013 sometimes pulled off the road mid-race, such was her slowing pace.<\/p>\n
Howe\u2019s inability to shed weight had stumped everyone, but when it started twinning with poor performance, they really sat up and took notice. Her blood tests, done quarterly for all riders, painted a worrying picture. \u201cDespite eating no fat and limited carbohydrates, her cholesterol was alarmingly high,\u201d says Dr Alice McNamara, a physician with the Victorian Institute of Sport who\u2019d looked after Howe on and off since her rowing days, and was asked by Howe to look over her results. Howe\u2019s iron stores were low, her liver strained, and her hormones, including her thyroid and reproductive ones, were suppressed. Her cortisol levels were high first thing in the morning, suggesting a baseline stress on her system. \u201cHer metabolism had almost come to a halt,\u201d says McNamara. \u201cThe body was in battery-saving mode; it was shutting down non-essential functions.\u201d<\/p>\n
\u2018Howe\u2019s metabolism had almost come to a halt. The body was in battery-saving mode.\u2019<\/p>\n
Dr Alice McNamara<\/p>\n
Howe hadn\u2019t had a period since September 2023, and a gynaecologist she saw in Europe told her she had the \u201cuterus of a 60-year-old\u201d. A team doctor diagnosed her with hypothalamic amenorrhea, which is when the hypothalamus causes your period to stop, typically due to excessive exercise, stress or under-\u00adeating. She was put on the contraceptive pill to stimulate a bleed \u2013 which some medicos argue actually masks problems by suppressing the natural hormonal cycle \u2013 and kept on riding.<\/p>\n
In mid-2024, after a final attempt to lose weight through altitude training in the Pyrenees, Howe had a flare up of ulcerative colitis. A kind of irritable bowel syndrome, its symptoms include diarrhoea, not good if you\u2019re sitting on a bike for hours on end. It became a line in the sand. Half an hour into a race in which she needed to perform well to continue cycling at elite level, she pulled out. \u201cI thought, \u2018If I have to contort my body into this shape for this lifestyle, I don\u2019t want it any more.\u2019\u2006\u201d<\/p>\n
It was July 2024, and while she didn\u2019t know it definitively at the time, Georgie Howe\u2019s professional cycling career was over. That wasn\u2019t the worst of it, though. Far worse was that her endocrine system was shattered. Ditto, her psyche. She\u2019d been riding professionally for 18 months. It would take another 12 months, and multiple sessions with physicians, psychologists and psychiatrists, for her to get them back on track. It would take time, too, for Howe to deal with the grief associated with a dream cut short \u2013 and to understand exactly what had happened to her, and why.<\/p>\n
We\u2019re sitting in the kitchen of the family home in Malvern in Melbourne\u2019s south-east: Howe, her mum, Sally, and dad, Nick. Focaccia and chocolate-chip biscuits have been laid out for lunch, and Sally is making a pot of coffee. Photos of Howe and her younger sister, Ellie, line the walls, showing them excelling at various athletic pursuits. A decorated oar from Ellie\u2019s school days hangs above the glass back doors. Howe\u2019s oars used to be up there but, once she\u2019d left school, Sally thought it unfair for Ellie to have to eat breakfast in the shadow, literally, of her older sister\u2019s sporting glory. Not that Ellie wasn\u2019t athletic; she also won a rowing scholarship to a US college, and now lives in San Francisco.<\/p>\n
We\u2019re here to talk about Relative Energy Deficiency in Sport, or REDs, which is what Howe was ultimately diagnosed with. In simple terms, it\u2019s when an athlete\u2019s physiological and psychological health suffers following a sustained or severe period of low energy availability, which comes about when what they\u2019re eating and drinking does not make up for what they\u2019re expending through exercise and on baseline bodily functions. Lack of periods are the \u201ccanary in the coalmine\u201d for women, with the pervasive sporting idea that if you bleed you\u2019re not training hard enough slowly making way for the understanding that, if you don\u2019t get your period for a sustained period of time, there could be a hormonal problem.<\/p>\n
![\"Howe](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2025\/11\/2546e9cc6a883ad6f1f380ef9eff776556f814d8.jpeg\")
<\/p>\n
Howe with her family, sister Ellie (at left) and parents Nick and Sally.Credit: Courtesy of Georgie Howe<\/p>\n
Ditto regular stress fractures or other breaks, which point to low bone density and, in some cases, osteoporosis, also caused by the down-regulation of hormones. Sleeplessness, anxiety and depression, together with the kind of blood results Howe returned, are other signs of REDs, all of it indicating an endocrine system seriously out of whack.<\/p>\n
\u201cThe biggest thing you lose is your intuition around appetite,\u201d says Howe of how it feels for the athlete. Howe has a pixie haircut, gold earrings up her lobes, and a mix of confidence and vulnerability in her big blue eyes. \u201cIn fact, your intuition around everything: fatigue, illness, emotions. You\u2019re very disconnected from your own body, and it takes a long time to get it back.\u201d<\/p>\n
Loading<\/p>\n
A relatively recent diagnosis, REDs was \u00adrecognised by the International Olympic Committee in 2014, via a consensus statement written by a global group of dietitians and medicos who agreed upon its core attributes. It was an update of sorts on the Female Athlete Triad, a term coined in 1992 to capture the congruence of menstrual irregularities, low bone density and low energy availability among some female athletes. The REDs statement extended the idea to men, with low libido and lack of morning erections their equivalent of disappearing periods. The IOC group updated the statement in 2023<\/a> to reflect a more \u00adnuanced understanding of its multiple factors, and to include a diagnostic tool for clinicians.<\/p>\n It\u2019s an issue in dance, too; a risk, really, in any athletic pursuit where weight is closely linked to performance and aesthetics. Which is many, because when it comes to women, \u00adaesthetics are closely tied to sponsorship \u00addollars, which means the pressure is often on female athletes and dancers to be super slim.<\/p>\n Howe has made it her mission since returning to Australia late last year to help spread the word on REDs, not only among professional athletes but amateurs, too. You know, those of us signing up to do marathons, triathlons and other endurance sports. (If you\u2019re not middle-aged and training for a marathon these days, are you really middle-aged?) And those of us who cherry-pick bits of the intermittent fasting fads sweeping the world (guilty) without understanding what\u2019s safe and what isn\u2019t. Those of us, too, who watch health influencers parade their lithe bodies across social media and think, if I just eat less and train more, maybe I can look like that, too.<\/p>\n \u201cThere\u2019s a boom in people interested in \u00adendurance sports; many run, cycle, do triathlons these days for their mental health,\u201d says Alice McNamara. \u201cThey\u2019re also juggling work, study, parenting, so they have a high life load. What crops up a lot is stress fractures, so you look at the reasons they might have developed them.\u201d McNamara is among a number of medicos who report seeing 20- and 30-somethings with hip fractures or \u201cbones like dust\u201d, two things that should not be present at that age.<\/p>\n In some sporting circles, REDs is a bit like attention deficit hyperactivity disorder (ADHD), chronic fatigue syndrome and repetitive strain injury have been over the decades \u2013 that is, a hot-button topic du jour. Podcasts, social media posts and online articles on REDs have mushroomed, mostly led by athletes who have had it, or the sports medicos, physiologists and dietitians who work with them on recovery. Pippa Woolven, a star British long-distance runner who developed REDs while on an athletics scholarship to America\u2019s Florida State University, went as far as to establish a website, Project RED-S<\/a>, to provide \u00adinformation, advice and tools for athletes \u00adsuffering from it.<\/p>\n Long-distance runner Pippa Woolven took nearly a decade to recover from REDs.Credit: Courtesy of Pippa Woolven<\/p>\n London endocrinologist Nicky Keay treats many with REDs. She\u2019s developed a free questionnaire for people to generate their own risk score<\/a>. \u201cIt\u2019s more widespread than we would have thought,\u201d she says. \u201cLots of people come to see me and almost apologise; they say, \u2018I can\u2019t have REDs, I\u2019m not an athlete.\u2019 They tell me what they\u2019re eating and what training they\u2019re doing. And I say, \u2018You\u2019re doing what an Olympic athlete would do, plus you\u2019re trying to hold down a full-time job and run a family; that\u2019s a huge load. Yes, you can have REDs. You do have REDs.\u2019\u2006\u201d<\/p>\n Dietitian Renee McGregor, who helped Howe recover, believes numbers could spiral in an era of unrealistic body and performance goals. \u201cThere are hundreds of influencers working with brands now, encouraging over-training and under-fuelling,\u201d she says from her home in England\u2019s Lake District. \u201cHealth has changed, the look of it has changed. It\u2019s now portrayed as someone running in a crop top and shorts and drinking a matcha latte; that scares me.\u201d<\/p>\n Organisations around the globe are starting to grapple with the syndrome. London\u2019s Royal Ballet School now has an annual spotlight on REDs week, while the International Federation of Sports Climbing blazed a trail last year when it introduced REDs screening requirements for climbers. The Cyclists\u2019 Alliance, a member organisation for female cyclists, has called on its world governing body, the Union Cycliste Internationale, to introduce similar screening, while over in Boston, Harvard Medical School associate professor and sports endocrinologist Dr Kathryn Ackerman \u00adrecently launched the Women\u2019s Health, Sports and Performance Institute, a centre that offers a multidisciplinary approach to the health woes of female athletes, including REDs, as well as conducting research into their issues.<\/p>\n Closer to home, the Australian Sports Commission has included REDs in a position statement on disordered eating and added a module dealing with it to its Female Performance and Health Initiative, while the Australian Institute of Sport and Australian Catholic University got stuck into the issue last month, with a two-week study into the energy availability levels of the women\u2019s water polo team.<\/p>\n \u2018I wanted to do what was right for the team, so I thought, \u201cOK, I\u2019m a team player, I can do this. I\u2019ll lose weight.\u201d \u2019<\/p>\n Georgie Howe<\/p>\n As with chronic fatigue and ADHD, though, scepticism abounds. There\u2019s no hard data on how many people have REDs, what the breakdown is between men and women, or even whether diagnoses are increasing. According to the 2023 IOC statement, between 23 per cent and nearly 80 per cent of female athletes, and 15 per cent and 70 per cent of their male counterparts, have some indicators of REDs. That variation causes some raised eyebrows, including by the IOC statement authors themselves, who sheet the parameters wide-enough-to-drive-a-bus-through home to the lack of a singular definitive diagnosis and issues around the veracity of various REDs studies.<\/p>\n All this inevitably prompts questions. Such as: is REDs just a more palatable term for an eating disorder? Aren\u2019t some health challenges the cost of being an athlete? Suck it up princess, elite sport ain\u2019t for the faint-hearted. And does REDs really exist at all?<\/p>\n Georgie Howe was somewhat surprised by the edict to lose weight ahead of the 2024 season, as she thought she\u2019d had a good 2023, acquitting herself in her inaugural Tour de France Femmes and finishing in the top 10 at the Road World Championships time trials in Glasgow that August. \u201cBut I wanted to do what was right for the team, so I thought, \u2018OK, I\u2019m a team player, I can do this. I\u2019ll lose weight.\u2019\u2009\u201d<\/p>\n Her mum noticed Howe\u2019s new approach to food when she came home for Christmas 2023. \u201cShe\u2019d stand and stare at the pantry, or open the fridge and just gaze inside,\u201d says Sally, pulling out the red scales her daughter used to weigh her food. \u201cI didn\u2019t like all the measuring but didn\u2019t want to interfere. When I did say something, Georgie would say, \u2018Mum, I\u2019m a professional athlete now, this is what we do.\u2019\u2006\u201d<\/p>\n Sally\u2019s worry grew in 2024 when she saw her daughter on FaceTime, puffy and anxious \u2013 then on TV. \u201cI remember watching her in a race in Belgium at midnight one night and Nick [Owen] texted me and said, \u2018Something\u2019s not right,\u2019\u2006\u201d Sally says. \u201cShe wasn\u2019t racing with her usual tenacity. She didn\u2019t look like the Georgie we were used to seeing.\u201d<\/p>\n That Howe had lost her mojo was no surprise, given she was failing at the two things she\u2019d been charged with doing: losing weight and performing. She wasn\u2019t used to failure; like most athletes, talent, hard work and sheer determination had always got her where she needed to go. So she kept on pushing.<\/p>\n To McGregor, this is typical elite-athlete \u00adbehaviour. \u201cWe can\u2019t forget the athletes\u2019 part in all this,\u201d she says. \u201cThey will be a certain type: high achievers, critical of themselves, perfectionists.\u201d That works for them \u2013 until it doesn\u2019t. The job of their health teams, then, is to teach them when to keep pushing, and when, for the sake of their health, to pull back. That can be diabolically difficult for athlete and medico alike, given the short time frames in which athletes have to achieve their goals and the opaqueness around when they\u2019re actually in a dangerous period of low energy availability (more on which, later). Taking time out for a broken arm is relatively straightforward. For a broken endocrine system, which might take a year or more to recover from \u2013 with the athlete still on the payroll \u2013 much less so.<\/p>\n Luca Pollastri is medical co-ordinator with GreenEdge Cycling, which owns the team Howe rode for. He agrees that knowing when to pull an athlete out of training or competition can be \u00addifficult, and says they use red and \u00adyellow flags in their assessment. Red flags are fairly simple: if an athlete falls below a certain body-fat ratio, or loses a set amount of weight within a month, or hasn\u2019t had their period for months, the medicos might pull them. Yellow flags are where it gets tricky: if it\u2019s been fewer than 45 days since their last period, if things were moving in the right \u00addirection but start going backwards, that\u2019s when a judgment call is made. With a psychological component, trust between medico and athlete is key to deciding what to do in such cases, and that\u2019s highly individual. \u201cThere\u2019s not one single protocol we can follow that is fit for everyone. Within one group of doctors you can have different opinions.\u201d<\/p>\n On Howe\u2019s case, and why she wasn\u2019t pulled off the bike despite those worrying blood tests, a spokesperson for Liv AlUla Jayco declined to comment. Pollastri, who was not Howe\u2019s doctor, says the team screens all riders for REDs at the start of each season via a questionnaire, and that any edict to lose weight would be done in consultation with the cyclist. \u201cI don\u2019t think it\u2019s a directive to lose weight,\u201d he says. \u201cWe discuss the goal for them, with them.\u201d<\/p>\n Loading<\/p>\n Endocrinologist Nicky Keay sees an education job ahead, in part to teach those running various sports to prioritise hard health data and actual performance over arbitrary weight and skinfold goals. \u201cIt\u2019s the pervasive cultures: the weigh-ins, measuring body composition,\u201d she says. \u201cMy message is to look after the health first, and the performance will follow.\u201d<\/p>\n Many refer to sports dietitian Louise Burke as the godmother of REDs, so I call her at the Australian Catholic University, where she\u2019s a professorial fellow at the Centre for Human Performance & Metabolism, for a deeper understanding of the syndrome. Burke, who worked at the Australian Institute of Sport for three decades, was one of the co-authors of the 2014 and 2023 IOC statements. She calls REDs a clinical diagnosis of exclusion, made once other potential causes of health and performance problems are ruled out. It all revolves around low energy availability (LEA); in short, not \u00adeating enough for all that training. Not that all cases of LEA are bad. \u201cGiven obesity levels, much of the world could do with some LEA,\u201d Burke says, \u201cbut too much of it is a problem.\u201d<\/p>\n She explains that REDs can occur intentionally, for example when the athlete does have an eating disorder, or unintentionally, such as when they don\u2019t realise they should be eating more for the training they\u2019re doing. A 100-kilogram rower might be training so much they cannot eat enough food to make up for it. Alternatively, \u201csome athletes who get sporting scholarships to the US might not have enough money to buy enough food\u201d, Burke says. \u201cNor might some athletes in Third World countries.\u201d<\/p>\n Pippa Woolven, the former athlete behind the Project RED-S website, says it took her the best part of a decade to recover from REDs, involving not just eating more and training less but unravelling the vilifying \u00adbeliefs she\u2019d internalised about fats and carbohydrates. \u201cI had to show myself that if I ate properly, nothing bad would happen,\u201d she says. \u201cIt was sometimes two steps forward, one step back, but I\u2019m arguably the healthiest now that I\u2019ve ever been.\u201d<\/p>\n Woolven with her husband, Rich, and son, Lawrence.Credit: Courtesy of Pippa Woolven<\/p>\n Woolven is holding five-week-old baby Lawrence when we catch up on a video call from her home in Henley-on-Thames. She and her husband, Rich, a software engineer and former elite athlete who helped her design the Project RED-S website, also have a two-year-old, Alistair. \u201cI never thought it would be possible for me to be a mum,\u201d Woolven says, smiling broadly. \u201cIt\u2019s not all doom and gloom. This is a condition you can recover from.\u201d<\/p>\n A former competitive cyclist \u2013 \u201cI was a serious amateur, not at Georgie\u2019s level\u201d \u2013 Jos\u00e9 Areta is associate professor in exercise physiology and metabolism at Britain\u2019s Liverpool John Moores University. He also works privately with athletes to \u00adimprove their health and performance. Argentinian by birth, Areta spent six years in \u2009Melbourne completing his PhD in sports nutrition in the early 2010s.<\/p>\n \u201cI loved it,\u201d he tells me on a video call from Liverpool. \u201cThe coffee culture was unreal. I didn\u2019t drink coffee before going to Melbourne. I did a lot of road cycling there, too.\u201d A biologist by training, he sees sports nutrition through \u201can evolutionary paradigm\u201d, which gives him a different perspective to many \u00adothers working in the area.<\/p>\n Areta was one of eight authors behind a 2024 paper in Sports Medicine journal that threw the cat among the pigeons with the \u00adprovocative title, \u201cDoes Relative Energy Deficiency in Sport (REDs) Syndrome exist?\u201d Their main point was that declines in an athlete\u2019s health and performance might be due to low energy availability but might also be due to other things. Stress. Lack of sleep. Anxiety. Infection or some other undiagnosed medical issue. Things happening in their life that are completely unrelated to what they eat and drink and how hard they train. \u201cWe say there are many things that can cause these symptoms, which are very generic, and energy deficit is not the only thing,\u201d Areta says. \u201cWe don\u2019t have enough data to establish causality.\u201d<\/p>\n Associate Professor Jos\u00e9 Areta has questioned whether REDs exists.<\/p>\n Part of the problem, he says, is how difficult it is to measure energy input and output, which \u201clooks straightforward but isn\u2019t\u201d. This helps explain why pro-athletes with dietitians on the payroll can fall into LEA \u2013 because working out what to eat for your particular size, genetic make-up and training regimen, as anyone who has done any diet will tell you, is an inexact thing.<\/p>\n There\u2019s also the awkward fact that being lighter can be a competitive advantage. Areta points to research he did on Georgie Howe during the 2023 Tour de France Femmes. Despite already having infrequent periods, indications of an underactive thyroid and a negative energy balance, plus losing 2.2 kilograms during the eight-day race, Howe rode at world-tour level and had her \u201cbest performance yet\u201d in the race\u2019s final stage. Two weeks later, she finished in the top 10 at the world time trials in Glasgow. Asks Areta: \u201cWould she have performed better if she\u2019d had more food? We don\u2019t know. What we can say is it appears high performance can be compatible with a state of energy deficit.\u201d<\/p>\n Similarly, 2025 Tour de France Femmes winner, Pauline Ferrand-Pr\u00e9vot, dropped a lot of weight before the race, causing much talk in cycling circles. \u201cI can\u2019t say she won the race because she dropped a lot of weight, but she won the race having lost weight,\u201d says Areta. \u201cIt\u2019s quite a complex topic and I can understand how it can be polarising.\u201d<\/p>\n Letters went back and forth after the \u201cDoes REDs exist?\u201d paper. \u201cYes REDs does exist!\u201d was the title of a letter to the editor in which 17 authors, including Louise Burke, said that while they agreed with much of what Areta and co said \u2013 yes it is difficult to accurately measure energy availability, yes it can be over-simplified \u2013 waiting for long-term studies to establish causality would be both \u201cunfeasible and unethical\u201d. They concluded with the punchy statement that \u201cas sports medicine physicians, psychologists, physiologists, scientists, dietitians, coaches and athletes, we \u2013 the IOC consensus co-authors \u2013 know that REDs exists. We see and treat it in our athletes daily.\u201d<\/p>\n Areta and his colleagues returned fire, arguing that a statement like \u201cwe know that REDs exists\u201d was \u201cnot compatible with the scientific process\u201d and that \u201cwe believe it is important to challenge dogmas and encourage rigorous \u00adscientific processes\u201d.<\/p>\n Those working on the diagnosis frontline stress that REDs is a clinical call, made on a patient in front of them, based on what they see and hear from that patient, ruling things like Areta\u2019s other reasons for problems in and out. Renee McGregor does not dispute that Howe performed well while in a state of LEA during Areta\u2019s trial, and agrees that lighter can lead to better results in the short term. Hence, many athletes successfully manipulate their weight in the lead-up to competition.<\/p>\n Dietitian Renee McGregor helped Howe recover after her diagnosis.<\/p>\n In the longer term, however, she argues, it will catch up with them. In Howe\u2019s case, it was eight or so months after Areta\u2019s research on her that everything started going wrong. \u201cPeople can get away with under-fuelling for up to 18 months before seeing negative consequences,\u201d McGregor says. \u201cBy the time they turn up to me with a problem, their body is often in a pretty poor place and they can\u2019t identify the behaviour that\u2019s got them to where they are.\u201d<\/p>\n What they all agree on is that more research needs to be done: on the causality links between weight loss, health and performance, on why some athletes who lose weight rapidly will develop REDs and others won\u2019t, on how an athlete\u2019s particular genetic make-up plays into all this, just for starters. On women athletes in general, on whom only 6 per cent of sports medicine research has traditionally been done. As physiologist Stacy Sims is fond of saying, \u201cWomen are not small men\u201d \u2013 meaning systems designed for male athletes can\u2019t always be simply transferred across to women. The difference in women\u2019s physiology and psychology needs to be better understood, and adaptations made where required.<\/p>\n Given the rising numbers of women participating in sport, and an associated flow of money into it, there\u2019s hope more \u00adresearch will eventuate. Meanwhile, the question we should be asking, Areta says, is: \u201cWhat price are you willing to pay to win the race? And is this a price you should pay?\u201d What price, indeed.<\/p>\n In mid-2024, after Georgie Howe pulled out of that final race, she caught the train to Paris, where she met her parents and friends ahead of the Olympics. They went for dinner to a local wine bar, where Howe ordered steak frites, and drank beer. She measured nothing. \u201cI saw the joy start to come back in her eyes,\u201d says Sally. One day, Howe went for a leisurely cycle along the road race route. \u201cI\u2019d stop at boulangeries and get a croissant if I felt like it,\u201d she recalls. \u201cPreviously I\u2019d have said, \u2018No, not today, you don\u2019t need that today.\u2019\u2009\u201d<\/p>\n I ask Sally and Nick whether, knowing what they know now, they\u2019d encourage their daughter into pro-cycling. No, says Nick, a Tour de France tragic: \u201cThere\u2019s always sacrifice, a lot of social activity you miss out on, but I don\u2019t think any young person expects to have their health permanently impacted by pursuing a particular sport.\u201d Sally, a former nurse and health administrator, and a former board member of Swimming Australia, says no, too. She says she\u2019ll know things have improved when endocrinologists are par for the course on sport medical teams. \u201cDo no harm \u2013 that\u2019s the first rule, isn\u2019t it? That\u2019s the lens that should be put over every decision. And too often, it isn\u2019t.\u201d<\/p>\n Loading<\/p>\n Howe recently had her 12th menstrual cycle in a row, a sign she\u2019s coming out of REDs. She\u2019s been working in a friend\u2019s bike shop in Collingwood and writing and podcasting for various cycling publications. Last month, she began a new job with a sports marketing firm, and she\u2019s looking to move out of home again with some mates. She\u2019s getting her mojo back \u2013 but the costs are still front of mind. Recovery is still a work in progress.<\/p>\n \u201cThe penny really dropped for me when I went to see my psychiatrist recently, and he validated my feeling that sometimes being an athlete is the worst job in sport,\u201d she says. \u201cBecause you retire and in the transition out you realise, \u2018Holy shit, I really was just a commodity. They really didn\u2019t care about me.\u2019\u2009\u201d<\/p>\n To read more from Good Weekend magazine, visit our page at The Sydney Morning Herald<\/a>, The Age<\/a> and Brisbane Times<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"Normal text sizeLarger text sizeVery large text size Georgie Howe was excited when she heard her cousin would…\n","protected":false},"author":2,"featured_media":267058,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[569],"tags":[64,63,784,85],"class_list":{"0":"post-267057","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-cycling","8":"tag-au","9":"tag-australia","10":"tag-cycling","11":"tag-sports"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/267057","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=267057"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/267057\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/267058"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=267057"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=267057"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=267057"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"Long-distance](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2025\/11\/e7a02ae897bc338f5fa391bdf6d1e12b5164c3dc.jpeg\")
<\/p>\n![\"Woolven](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2025\/11\/29efb4e1a05314e4d0b58adbe10626749b13d90d.jpeg\")
<\/p>\n![\"Associate](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2025\/11\/07c4969eb9992c98c488d6e39c7ccb76526161b1.jpeg\")
<\/p>\n![\"Dietitian](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2025\/11\/de21154f825c7355566404ed0b72cda5b2133269.jpeg\")
<\/p>\n