Jake Smith details REDs recovery after Berlin marathon personal best

British distance runner Jake Smith has described his recovery from relative energy deficiency in sport after recording a marathon personal best in Berlin. In a BBC Sport report published on Tuesday, the 28-year-old said his ambition remains the 2028 Olympics, but protecting his health now takes priority over attempts to become lighter.

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Smith sought professional help after suffering two stress fractures within four months and was diagnosed with the condition, known as REDs. According to the BBC, he had combined demanding training with disordered eating despite already earning a professional contract and representing Great Britain. He recently completed the Berlin marathon in 2:09:24.

The International Olympic Committee's 2023 consensus statement describes REDs as a condition affecting both women and men when insufficient energy is available relative to exercise demands. Its definition covers physical and psychological impairment associated with prolonged or severe energy deficiency, rather than treating the issue solely as a question of body weight or as a problem confined to female athletes.

Published in the British Journal of Sports Medicine, the statement identifies potential effects across several body systems, including bone and muscle health, immunity, reproductive function and cardiovascular health. Those effects can increase injury risk and reduce sporting performance. The researchers also describe a complex relationship between energy availability, individual factors and outcomes, distinguishing problematic exposure from changes to which athletes can adapt.

The IOC update introduced a revised clinical assessment tool intended to help clinicians identify REDs and assess its severity. It links risk assessment with recommendations about training and competition, alongside principles for prevention and treatment. The authors also highlighted developing evidence concerning male athletes, carbohydrate availability and the relationship between mental health and REDs.

For Smith, the recovery has brought both improved performances and a different outlook. He told the BBC he is happier and heavier than during his earlier struggles, and continues to share his experience publicly. His stated aim is to reach future start lines healthy while pursuing his Olympic ambition.