IFSC Medical Commission Members Resign Over “Inaction”
This article originally appeared on Climbing
On July 5th, IFSC Medical Commission President Dr. Eugen Burtscher and Germany's Dr. Volker Schoeffl resigned from their positions on the committee, citing the IFSC's repeated and prolonged inaction in instituting adequate measures to safeguard athletes against eating disorders.
Dr. Schoeffl, who has served on the committee since 2009, told Climbing over the phone, "Eugen and I discussed the point of no return last year. The IFSC promised us they'd do something at the start of the season. I don't know why they don't communicate. I don't know where the real problem lies. But somehow they just don't want to go forward."
Dr. Schoeffl said that, as someone who has been studying the prevention of eating disorders in climbing for the last decade, he believes that the problem has only progressed. RED-S, or relative energy deficiency in sport, is a syndrome that occurs when the athlete does not consume enough food to meet their day-to-day demands. It can have lasting detrimental effects on health, including bone loss, cardiovascular damage, decreased immunity and metabolism, and harm to reproductive function and psychological health. "The ultimate goal [of our recommendations] is to see if athletes have RED-S or not, and if they do, then we would want to ban that athlete," says Dr. Schoeffl. "We wanted to limit self-harm and also not set a bad example for the next generation."
The IFSC has sporadically measured athletes' BMIs since 2012 and, in 2021, began regular screening procedures for all semifinalists in Boulder and Lead World Cups. (Body mass index, or BMI, is a weight-to-height ratio used for predicting RED-S risk. As the World Health Organization proposed, BMI is still the standard, although many condemn it for being too general and a non-indicator of body tissue composition, which is a better determinant of health status. Although imperfect, BMI is still widely considered the best tool for initial health screening procedures because it can be used by anyone anywhere in the world.) If an athlete's BMI was found to be below 17.5 and 18.5 for women and men, respectively, then their National Federation was notified. A signed form indicating acknowledgment of receipt was required, but beyond that, the flagged athlete faced no further repercussions.
The Medical Commission recommends including BMI screenings as a first step in evaluating RED-S risk, but they propose more stringent numbers, up to 18 for women and 18.5 for men. Following screenings, flagged athletes would be asked to undergo further medical screenings for RED-S, which includes blood work, bone density tests, and psychological assessments. The IFSC would then, using a classification system devised in conjunction with the International Olympic Committee, assess risk of disease and categorize athletes as red (most at risk), orange, or green. "Red" athletes would be banned from competing, while "orange" athletes would be allowed to compete under medical supervision.
"BMI shouldn't be used as a tool to ban somebody, but rather it should be used as a filter, "says Dr. Schoeffl. "And whoever falls under the filter would go through a very detailed medical and psychological evaluation."
In January this year, the IFSC did announce that it was planning to re-evaluate its testing protocols to protect athlete health. But the measures, the press releases stated, would not go into effect until 2024. And despite stating a renewed commitment to protect athletes, no screenings have been conducted this year. According to Dr. Schoeffl, that is because no Commission volunteers were available, which brings up another recommendation: That the IFSC hire a designated employee to attend every World Cup. Although the IFSC does pay volunteers to be there, many of the current Commission members are also National Team physicians who work at events when there is no conflict with their National Team.
As indicated by a more recent press release published on July 6th, the IFSC is unmoved in its timeline. The press release did, however, add that BMI screenings will resume for the remainder of the year. It did not shed light on why further action isn't being taken sooner, and the IFSC has not responded for further comment.
Athletes have increasingly spoken out against the IFSC's current protocols, demanding stronger consequences. Earlier this year in an interview with Peter Stafford at an IFSC Summit, Janja Ganrbret asked the IFSC for strict BMI limits that would prohibit underweight athletes from competing. She went on to say, "We have to ask ourselves, what kind of message do we want to send to others? Do we want to raise the next generation of skeletons? It's definitely not going in the right direction."
[Read: Should Climbers Face Strict BMI Rules?]
At the Innsbruck women's Bouldering World Cup final in June, Canada's Alannah Yip also called out the IFSC while live commentating. Following the event, she stated on Instagram: "The IFSC is currently working on a new set of regulations around athlete health. But they need to do more sooner for the benefit of both the athletes and climbers who look up to them."
A study published in the journal of Frontiers in Sports and Active Living in August 2022 has also added fuel to these ongoing conversations. The study attempted to establish the prevalence of amenorrhea in female World Cup athletes. Amenorrhea is the absence of a menstrual cycle and is a primary indicator of RED-S. A survey was sent out to female athletes with an IFSC license. Less than one percent of the recipients answered all of the questions. Of those who answered, 15.8% presented with current amenorrhea. While there are huge biases involved with any self-selecting study, especially one that is so limited, the results are reflective of the problem our community faces.
"Climbing is not the only sport with a weight-related problem," says Dr. Schoeffl added. "It’s something we see in track and field and trail running in ski mountaineering. But we are at a stage right now where we have the best data on all of our athletes--we measured every World Cup last year, and we have the subcutaneous fat mass measurements. We have the ability to work on the problem better than other sports because we have better knowledge and more data. And we should take a lead here."
Also Read
For exclusive access to all of our fitness, gear, adventure, and travel stories, plus discounts on trips, events, and gear, sign up for Outside+ today.
