Following the resignation of two doctors from the IFSC Medical Commission citing a lack of action, and public criticism from athletes including Olympic champion Janja Garnbret (UKC News), the IFSC has released a further statement on RED-S (Relative Energy Deficiency in Sport) and athletes' health.

The statement, which was emailed to press but has not yet been published online, reads:

'Further to our statement issued on 06 July 2023 on Athletes' Health and the IFSC Medical Commission, the International Federation of Sport Climbing wishes to reiterate our position and approach to the issue of Relative Energy Deficiency in Sport (RED-S).
 
Protecting our athletes from any form of harm remains a top priority for the IFSC. Our focus in this area is and has always been on the importance of education, beginning with the athletes and their entourage.
 
The issue of RED-S was first brought to the attention of the IFSC Medical Commission last year by the IFSC Sport Director. Since then, our experts have worked diligently on measures to limit the prevalence and increase awareness of the syndrome in our sport.
 
They have done so together with a range of stakeholders, including the International Olympic Committee (IOC), the IOC Medical Commission, ASOIF'S Science and Medical Working Group, and leading medical experts from around the world. The Medical Commission is also in constant two-way communication with our Athletes Commission.

It is important for our community to understand all the ways the IFSC is working to protect our athletes and the integrity of our sport. Our IFSC-led initiatives are focused on education and inclusion rather than sanctions in the first instance.
 
As a global governing body, we must consider each issue from all angles and consider every possible ramification of any decision taken, which is especially crucial when it comes to the health of our athletes.
 
The IFSC would like to thank those in the community who are already doing their part in the education and elimination of RED-S and other eating disorders from our sport. We encourage the Sport Climbing community in its entirety, in particular athletes, coaches, and National Federations, to join us in this team effort to make our sport a safe and healthy environment for all.
 
For a summary of the work already undertaken by the IFSC, with new rules in established in 2023 with the help of the National Federations, and an overview of the current measures in place that have been implemented, click here.'

According to the IOC Medical Commission, RED-S is defined as 'impaired physiological functioning caused by relative energy deficiency and includes, but is not limited to, impairments of metabolic rate, menstrual function, bone health, immunity, protein synthesis and cardiovascular health.'

The root cause of the syndrome is Low Energy Availability, when an athlete does not consume enough calories to support their energy expenditure through physical activity, leaving inadequate energy to support the functions required by the body to maintain optimal health and performance.

Dr Eugen Burtscher, chair of the IFSC medical commission, and Dr Volker Schöffl a member of the commission, resigned from their voluntary positions earlier in July.

Dr Schöffl wrote online that despite over ten years of researching the health of climbing athletes and advising the IFSC, 'as medical doctors [they can] no longer accept the non-action of the IFSC concerning the RED-S problems of [their] athletes.'

Notably, the IFSC's claim that 'the issue of RED-S was first brought to the attention of the IFSC Medical Commission last year by the IFSC Sport Director' contradicts Dr Schöffl's claim on social media that throughout his ten years of collecting data on and discussing the topic with the Commission, its members had 'pointed out the problem and possible solutions to the sports director and board continuously and repeatedly.'

According to sources who attended the technical meeting before the IFSC World Championships in Bern on Monday, BMI testing is planned to be reintroduced during the semi-final rounds of all disciplines this week.

The summary of the IFSC's work on RED-S and eating disorders to date linked in the statement reads:

IFSC Medical Commission is developing a comprehensive plan to transition the IFSC towards a more robust policy relating to RED-S in 2024. A summary of the work already undertaken follows:

1. Finalisation of medical details:

a) best available screening methods;

b) thresholds of results; and

c) evidence-based indicators of RED-S.
 

2. Development of logistical management of screenings:

a) how/when they are requested by the IFSC;

b) independent review of screenings;

c) outline for monitoring athletes with view to a return to competition;

d) data protection and privacy; and

e) education.
 

3. Other bio-social-psycho considerations include:

a) wider mental health initiatives;

b) education on safe practice of weight cutting;

c) female health; and

d) eating disorders.

Items already being actioned include:

1. Immediate planning of screenings at IFSC World Cups and World Championships;

2. Medical Commission meeting on RED-S;

3. Coaches Commission meeting on RED-S;

4. Athletes Commission updated on latest developments;

5. Consultation with IOC;

6. Consultation on next steps for replacement of Medical Commission Members;

7. Consultation on suitable independent expert review of documentation presented by Athletes/National Federations; and

8. Immediate planning of education on RED-Sto begin at the end of summer or beginning of fall 2023.

As a global governing body, the IFSC must consider each issue from all angles and also consider every possible ramification of any decision taken. Our focus is and has always been about education before creating sanctions, and as such we cannotrush our judgements or enact policies with undue haste, especially if such an approach could unjustly prohibit an otherwise healthy athlete from participating at our events. 

New measures in 2024: based on the latest and best science available, advice from and coordination with leading stakeholders, including the IOC, the IOC Medical Commission, ASOIF'S Science and Medical Working Group, and medical experts.

The IFSC thanks those in the community that are already doing their part in the education and elimination of RED-S and other serious eating disorders from our sport and encourages the Sport Climbing community in its entirety, including athletes, coaches, and National Federations, to do the same. 

New rules in place (March 2023) with the aim to involve National Federations monitoring their athletes:  https://t.ly/z8JU