Why Cutting Weight Is Often Unsafe for Athletes

Unsafe weight loss methods continue to be an issue for competitive athletes and active adults. According to an article published in the Journal of the International Society of Sports Nutrition (JISSN), athletes are achieving rapid weight loss through aggressive nutritional strategies placing them at high risk for adverse health effects. The National Collegiate Athletic Association (NCAA) implemented a successful weight management program after the deaths of three collegiate wrestlers using rapid weight loss regimes. A similar healthy weight management program is being proposed for judo athletes who, like wrestlers, use weight class protocols.

The Problem: Unhealthy Weight Loss

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Athletes often feel pressured to maintain ideal body composition for their sport by implementing unhealthy methods to achieve this goal, but research indicates that unsafe weight loss practices can negatively impair health and athletic performance. The National Athletic Trainers' Association felt it necessary to improve this problem by implementing safe weight loss and management guidelines.

Who Is at Risk?

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Wrestling, football, and boxing have implemented weight classifications for health, safety, and equal competitive participation. There are other sports where body weight and composition also play a role, but without weight management guidance. Devoid of weight classification or weight loss accountability programs in place, the following athletes also commonly use unsafe weight loss methods:

Common Unsafe Weight Loss Methods

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Athletes and active adults are always looking for ways to improve athletic performance and body composition. Although some athletes may use healthy strategies to reach their goals, many choose to implement unsafe weight loss methods. According to the Journal of Athletic Training, unsafe practices may include self-deprivation techniques causing dehydration, self-starvation, and disordered eating. According to other research, it’s common for an athlete to combine severe caloric restriction and dehydration methods to reduce body fat. The following common unsafe weight loss practices were outlined in the National Athletic Trainers' Association Position Statement:

  • Voluntary dehydration includes a variety of common rapid weight loss methods among athletes who desire to reach a lower body weight for competition. This can include active dehydration which is excessive sweating during exercise while wearing heavy clothing or rubber suits. Passive dehydration is the practice of food restriction and eating a diuretic diet promoting fluid loss. Stimulated dehydration is achieved through diuretic medications increasing urine production. Prescribed diuretics “have been misused by athletes seeking rapid weight loss for competition.” Intravenous removal of blood for an athlete to make weight for competition has also been used. The blood is reinfused after the athlete makes weight for competition but there is limited information on this method of dehydration.
  • Caloric restriction is another common weight loss method among athletes. Very low-calorie diets (VLCDs) restrict one or more macronutrients essential to health and athletic performance.
  • Disordered eating is prevalent in male and female athletes. Disordered eating behaviors are linked to rapid weight loss and may lead to unhealthy body fat percentages. “Athletes competing in aesthetic sports had the highest indicators of eating disorders.”

Adverse Health Effects

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According to Sports Health, rapid weight loss is never safe and can lead to adverse health effects. The NCAA has approved new rules to help prevent rapid weight loss strategies, but unsafe methods still occur in many athletes.

The unsafe practices as described above have been shown to negatively affect health and athletic performance in athletes and active adults: 

  • Voluntary dehydration is considered an unsafe method of rapid weight loss and includes active, passive, caloric restrictive and pharmaceutically stimulated fluid loss. Dehydration can negatively affect athletic performance and overall body functioning. Research indicates athletes dehydrated greater than 2% of their body weight can experience the reduced aerobic performance, decreased strength, power, and endurance. Neurological function, oxygen consumption, and temperature regulation are also impaired. Dehydration levels over 4% may cause significant deterioration of oxygen consumption, the ability to perform, and adverse health effects which may require medical attention. 
  • Caloric restriction is another method athletes use for rapid weight loss and includes very low-calorie diets (VLCDs). According to research, VLCDs can negatively affect the cardiovascular system and actually cause damage to the heart muscle. Caloric restriction is also said to cause increased blood pressure and impair hormone function. Without adequate nutrients, the hormone factors for muscle growth and development are limited and strength gains unable to be realized. VLCDs can also decrease bone formation potentially causing stress fractures and osteoporosis. Caloric restriction is also said to impair thyroid function. In response to thyroid hormone imbalance, basal metabolic rate (BMR) is decreased and adrenal glands are stimulated to release more cortisol. This negative hormone cascade stimulates the pituitary gland to reduce levels of follicle stimulating hormone (FSH) lowering estrogen levels leading to menstrual dysfunction. Research further shows VLCDs to significantly impair the immunity system at the cellular level which may lead to chronic illness and infections.
  • Disordered eating can be mild to severe in athletes. According to research, disordered eating affects 62% of athletes with the highest in weight class events and aesthetic competitions. Early stage disordered eating may start as a healthy diet plan to improve athletic performance or body composition but develops into extreme caloric restriction. The pressure of competitive sport and achieving ideal bodies are said to cause dysmorphia, disordered eating, and eating disorders in both male and female athletes. Adverse health effects are similar to those described under caloric restriction, but disordered eating also contains a psychological component requiring professional counseling to overcome the behavior. 


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Unsafe weight loss methods and management programs are lacking for athletes and active adults. These practices have been shown to adversely affect health and compromise athletic performance. The National Athletic Trainers' Association published recommendations providing health professionals, trainers, and dietitians with safety guidelines for athletes and active adults who want to achieve weight loss and body composition goals. Also indicated was the importance for athletes, parents, and coaches to become educated on how to determine the healthy weight and body composition to safely meet athletic requirements. Safe practices would allow athletes to “meet their energy and nutritional needs for optimal health and performance.” 

The National Athletic Trainers' Association has compiled sound guidelines for safe weight loss and weight maintenance based on chronic research and literature. The Strength of Recommendation Taxonomy criterion scale was the template for the following categories and recommendations: 

  • Evidence category A (well-designed experimental, clinical studies support the recommendation)
  • Evidence category B (experimental, clinical studies provide a strong theoretical rationale for the recommendation)
  • Evidence category C (unreliable evidence at this time for the recommendation)

The following recommendations appear in the National Athletic Trainers' Association Position Statement for assessing body composition and weight for athletes and active adults. Each recommendation is categorized by the level of scientific evidence to support the recommendation at this time:

Evidence category A: not enough clinical support to place a recommendation in this category

Evidence category B: 

  • Body composition assessments determining safe body weight and body composition goals should be used. 
  • Body weight should be determined in a hydrated state. 
  • Body composition should be managed using both diet and exercise. 
  • Total caloric intake should be calculated using a basal metabolic rate (BMR) and the energy needs for activity. 
  • A sound, healthy diet plan supplying adequate energy and nutrients should be maintained year round.
  • Metabolism during activity should be considered to calculate each energy-producing nutrient in the diet. 

Evidence category C:

  • Body composition stats should be taken, overseen, and used in the same way as personal and confidential medical information.
  • The body composition assessor should be properly trained and use valid and reliable body composition assessment techniques. 
  • Goal weight should be determined by assessing body weight relative to body composition. (assessment should occur twice annually for most people, with no less than 2 to 3 months between measurements).
  • Private assessments to track personal progress in the areas of weight and body composition goals should be used. They should be scheduled at appropriate intervals to guide progress and reinforce reassessment cycles.
  • More frequent body weight assessments are recommended when hydration is a concern. 
  • Active adults and athletes participating in weight classification sports should not lose or gain excessive amounts of body weight during their training cycles. 
  • Caloric intake should be based on individual body weight goals.
  • Adequate nutrient intake can be determined using the U.S. Department of Agriculture's Food Pyramid Guide as a safe method. 
  • Safe and appropriate aerobic exercise will assist weight and body fat loss.
  • Body composition changes should be gradual, without excessive restrictions or use of unsafe behaviors or products.
  • Weight management and body composition goals combined with physical conditioning goals will help active adults and athletes reach healthy weight goals.
  • Ongoing education and discussions on safe dietary and weight management practices should occur on a regular basis.
  • Individual dietary or body composition needs should be discussed privately with appropriately trained nutrition and weight management experts.
  • Ergogenic and dietary aids should be consumed cautiously and only under the recommendation of appropriately trained fitness professionals with knowledge of the sport and governing organization requirements.
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