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Association of Ringside Physicians Launches New Crusade Against Unhealthy Weight-Cutting in Combat Sports


(Photo via Andrew Mills/The Star Ledger)

In late January, the Association of Ringside Physicians released a public statement calling for the end of therapeutic use exemptions for testosterone replacement therapy in combat sports. Though the ARP is simply an advocacy group that promotes fighter-safety, and has no official ties to state athletic commissions, the resulting publicity kicked off the final wave of anti-TRT sentiment in the world of mixed martial arts. A month later, the Nevada State Athletic Commission banned testosterone therapy for combat sports athletes.

Fresh off that success, the Association of Ringside Physicians is now setting its sights on another controversial facet of professional fighting that is just as damaging to athletes’ health as PED use — improper weight cutting. Check out the ARP’s new statement on weight management below, which summarizes the health risks associated with significant and repeated weight cuts, and suggests how the situation can be improved.

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For Immediate Release
March 24, 2014

Association of Ringside Physicians Releases Consensus Statement on Weight Management in Professional Combat Sports

The Association of Ringside Physicians (ARP), an international, non-profit organization dedicated to the health and safety of the boxer and mixed martial arts athlete, has released a consensus statement on weight management in professional combat sports as follows:

Introduction
Unhealthy and sometimes dangerous weight loss practices continue to be a significant problem in amateur and professional combat sports. The ARP recommends that regulatory bodies adopt standardized weigh-in policies in conjunction with year-round weight management and educational programs.

Discussion
There is a growing body of information in the medical literature that presents unequivocal evidence of the danger of excessive weight loss, rapid weight loss, and repeated cycling of weight gain and loss. Rapid weight loss and dehydration have been proven to negatively affect a number of health-related parameters including: physical performance, cardiovascular function, temperature regulation, hormonal balance, nutritional status, neurologic function, mental performance, and energy utilization. These may cause life-threatening muscle breakdown, shock, heat illness, kidney failure, and electrolyte imbalances, in addition to placing the athlete at increased injury risk, Additionally, the possible relationship between dehydration and predisposition to concussion requires more investigation. Significant dehydration also puts the athlete at risk of improper rehydration techniques — when, in reality, proper re-hydration requires hours to days.

The prevalence of these problems is significant. One recent study found that 39% of MMA fighters were entering competition in a dehydrated state. Many cases of dehydrated athletes using intravenous fluids to rehydrate after weigh-ins have been reported — considered a doping violation with several international organizations. Heat illness and death in athletes have been previously documented in the sports of wrestling and MMA. Weight management regulations for boxing/MMA competitors are warranted to mitigate improper weight loss techniques contributing to severe dehydration and starvation and their complications.

A number of organizations including the National Collegiate Athletic Association (NCAA) have adopted rules to minimize unhealthy weight loss in weight-classified sports. The rules emphasize hydration and body composition assessment to identify an individual’s proper weight class, and provide a safe, gradual, weekly weight control plan (gain or loss) to achieve same if desired. The new regulations were subsequently investigated for their effectiveness and were reported to be successful by minimizing unhealthy weight loss, excessive weight fluctuations, and competition at weight classes inappropriate for a given athlete. It is noted that the effectiveness and success of protocols such as same day weigh-ins are directly tied to proper weight management.

Recommendations
The ARP recommends standardized weigh-in policies in conjunction with year-round weight management programs. These would include scheduling weigh-ins twenty four hours or less before the start of competition. Therefore, establishing a lowest allowed fighting weight (weight class) for competitors through body composition and hydration assessment is essential. Combatants should be assessed and certified at their appropriate weight annually. This assessment should be completed by non-biased examiners, in conjunction with licensure, and stored in an international data bank accessible to athletic regulatory bodies, In this light, the ARP will be establishing a medical database to provide this and other resources. Regulatory bodies should also consider adding additional weight classes in certain sports where needed.

Additionally, in order for an athlete to maintain proper weight control and optimal body composition, a continual commitment to proper diet and training is required. Educational programs should be established to inform coaches, athletes, administrators, promoters and sponsors about the adverse consequences of prolonged fasting and dehydration on performance and health. These programs should discourage the use of extreme methods for making weight; i.e., excessive heat methods (such as rubberized suits, steam rooms, hot boxes, saunas), excessive exercise, induced vomiting, laxatives and diuretics. Nutritional programs should also be instituted to emphasize and meet an athlete’s individual needs for adequate daily caloric intake from a balanced diet high in healthy carbohydrates, the minimum requirement of fat, and appropriate amounts of protein.

The ARP wishes to thank Alan C. Utter, Ph. D., M.P.H., FACSM, Appalachian State University, Boone, NC for his dedicated assistance in the development of this consensus statement.

For more about the ARP, visit its website at www.associationofringsidephysicians.org.

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