Extreme weight-loss strategies among cage fighters alarming

Cage fighting is increasingly popular, with more than 800 million people across the globe now tuning in to watch the sport. While cage fighting in itself is considered dangerous, a new study has raised concern about the extreme tactics contestants use in order to lose weight before a fight.

Water loading, fasting and use of solutions that increase sweating are just some of the methods widely used by cage fighters to lose weight before a fight.

Study author Dr. James Morton - of the Research Institute for Sport and Exercise Sciences at the Liverpool John Moores University in the UK - and colleagues publish their findings in the British Journal of Sports Medicine.

Cage fighting, or mixed martial arts (MMA), is an extreme combat sport that involves a variety of fighting techniques, including those used in boxing, kickboxing, wrestling, karate and judo.

The popularity of cage fighting began to grow among Western countries in the early 1990s, with the introduction of the Ultimate Fighting Championship (UFC) - a US-based promotion company that organizes cage fighting events all over the world.

There are 11 different weight classes for contestants, though Dr. Morton and colleagues note that most cage fighters want to compete in the lowest weight class. Contestants are weighed around 24-36 hours before their fight, before being allocated to a weight category.

As a result, many competitors adopt extreme dehydration methods, such as saunas, sweat suits and the use of diuretics - drugs that help rid the body of excess fluids - in a bid to lose weight before a fight.

While there is limited data on how extreme weight-loss techniques impact the health of cage fighters, the researchers note that some contestants pull out of a fight due to negative health effects of such methods, including nausea, vomiting, headaches and seizures and cramping.

The team also cites the potential life-threatening implications of extreme weight-loss techniques, pointing to an incident in 2013 in which a Brazilian cage fighter named Leandro Souza died in a sauna after attempting to lose 15 kg in only 7 days.

Fasting, dieting and water loading common before a weigh-in

For their study, Dr. Morton and colleagues set out to investigate the extent to which cage fighters are engaging in extreme weight-loss techniques before a weigh-in.

The researchers surveyed 30 cage fighters from the UK who were competing in five different weight classes, from flyweight (115-125 Ibs) to welterweight (155-170 Ibs).

Each cage fighter was asked whether they adopted extreme weight-loss methods before a weigh-in and which methods they used.

The team found that all cage fighters either fasted or adopted a low-carbohydrate diet 3-5 days before their weigh-in, which they note increases the risk for energy deficiency.

What is more, only 20% of the athletes received dietary advice from a qualified sports nutritionist or dietician, with the majority of fighters turning to the Internet, their coaches or other competitors for dietary advice.

Around 67% of the cage fighters surveyed reported use of a dehydration method called "water loading" before a weigh-in, which involves consuming large amounts of water (around 20-23 liters over 3 days) and reducing sodium intake with the aim of inducing excessive urination.

The use of solutions that increase sweating by blocking pores or boosting circulation was reported by 17% of cage fighters.

Around 37% of the athletes reported using over-the-counter or prescription diuretics before a fight, while around 13% reported using intravenous lines and glycerol in order to boost rehydration following their weigh-in.

Nutritional supplements were used by 73% of the cage fighters prior to a weigh-in. Of these, 61% were unaware whether the supplements they were taking were tested for banned substances. The researchers note that random drug testing procedures were put in place for all UFC fighters from July 1st this year, and from October 1st, use of intravenous drugs after weigh-ins will not be allowed.

Better regulation needed

The researchers say their findings are "alarming," particularly those involving dehydration techniques.

"The effects of dehydration on brain trauma risk is especially concerning for MMA given that, unlike boxing, head trauma can occur after an athlete has lost consciousness," the team explains. "On average, 2.6 head strikes are delivered after an opponent has lost consciousness, which could potentially increase the risk of traumatic brain injury."

Of particular concern, note the authors, is that there is no regulatory body for cage fighting in the UK that sets health and safety and antidoping guidelines for cage fighters - something Dr. Morton and colleagues say needs to change.

The team recommends the introduction of additional weight classes and the restructure of existing weight classes in order to close the gap between categories, particularly among lower-weight classes.

They also recommend that the time between weigh-ins and fights be shortened, and suggest the implementation of educational packages to promote safer weight loss among cage fighters.

The researchers conclude:

"We encourage the MMA community to embrace quality research, injury surveillance and health monitoring. This will provide the basis for appropriate policy to ensure the safety of MMA athletes."

Earlier this year, Medical News Today reported on a study that linked repeated head trauma among boxers and martial arts fighters with brain shrinkage and poorer cognitive function.

Written by Honor Whiteman

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