Does better education around period health, proper fueling, and Relative Energy Deficiency in Sport actually lead to healthier behaviors in female athletes? In this episode, Opal’s Director of Exercise + Sport, Kara Bazzi, LMFT, sits down with seasoned provider Heather Caplan, RDN to share what they’re seeing firsthand in their clinical work. Together, they unpack the systemic pressures that push teen and young adult athletes to prioritize performance over long-term health.
Heather also shares how she supports young athletes in restoring their period health—and speaks candidly about what still needs to change in our culture to truly protect and empower them in today’s increasingly intense, professionalized youth sports environment. Coaches, parents, athletes—this conversation is for you.
Links:
Lane 9 project Lane 9 Project – Clinician Directory
Heather’s website Heather Caplan | Weight-Inclusive Dietitian
Stanford FASTR Stanford FASTR Program
Link to article I read: Built for Someone Else: Why Female Athletes Are Still Pushing Through Systems That Don’t Support Them – JRN | The World’s Leading Rowing Platform
Connect with Opal:
Thank you to our team…
Editing by David Bazzi
Music by Aaron Davidson: https://soundcloud.com/diet75/
Sound engineering by Ayesha Ubayatilaka at Jack Straw Studios
Transcription summary provided by Rev.com
This was an interview with Heather Kaplan, an anti-diet dietitian, hosted by Kara Bazzi of The Appetite podcast. The conversation centered on the systemic and cultural issues that prevent athletes, particularly female-bodied athletes, from addressing menstrual health and proper fueling. They discussed how the silence around periods in society is amplified in sport culture, leading to the normalization of amenorrhea (loss of a period) as a sign of being a “serious athlete.” Heather Kaplan detailed the gap between the growing awareness of Relative Energy Deficiency in Sport (RED-S) and the actual implementation of behavioral changes by athletes and coaches. She explored the psychological barriers athletes face, such as the fear of the unknown, body changes, and loss of fitness, which she framed as a grief process. The discussion also covered the increasing pressures in youth sports and Kaplan’s clinical approach to working with athletes, many of whom are high schoolers who have never had a period and are often dealing with bone stress injuries.
Interviewee Background
Heather Kaplan was identified as an anti-diet, weight-inclusive dietician who had worked with athletes for over 15 years. She was also the co-founder of The Lane Nine Project, an organization featuring a podcast, a weekly substack, and a community of providers working to reduce Relative Energy Deficiency in Sport (RED-S). It was noted that she had lived experience with hypothalamic amenorrhea.
Key Points
- Cultural norms that discourage open conversation about menstruation were reflected and magnified within sport systems, often leading to the dangerous misinterpretation of a lost period as a sign of peak fitness.
- While awareness of RED-S and the importance of period health had increased, there was a significant gap between this knowledge and the implementation of necessary behavioral changes by both athletes and coaches.
- Athletes often experienced a form of grief when confronted with the need to change their fueling and training, fearing the unknown outcomes related to their body, fitness level, and identity.
- The hyper-competitive and increasingly professionalized nature of youth sports in the United States was identified as a major systemic factor that pressures young athletes to prioritize short-term performance over long-term health.
- A growing trend in Kaplan’s practice was seeing high school athletes who had never had a period, often referred to her only after sustaining a significant injury like a bone stress fracture.
- Kaplan’s clinical approach involved working with a collaborative care team and directly addressing an athlete’s fears (e.g., “What if you lose your fitness?”) rather than offering simple reassurance, in order to explore the potential consequences of both action and inaction.
Notable Quotes
- “What we see culturally, politically and socially is also what we often see reflected in sports for better or worse.” (6:25) – This was said in the context of explaining why the societal tendency to keep menstruation private is mirrored in athletic environments.
- “I see all the stages and it makes sense You are losing kind of like this version of yourself and even if what might be on the other side of this process is a healthier body… the gap between point A and point B is scary.” (19:26) – Kaplan stated this while describing the grief process athletes go through when facing the need to change their eating and training habits to regain their health.
- “The way sports are prioritized right now is so scary.” (24:41) – This quote was in response to discussing the trend of early sport specialization and the intense pressure placed on very young athletes, which prioritizes sport over fundamental health milestones.
- “If you decide not to take time off now, at some point your body will decide for you.” (44:40) – Kaplan used this line to explain the inevitable health consequences for athletes who continue to underfuel and overtrain, emphasizing that a breakdown is a matter of when, not if.
