Weight cycling practices in sport: A risk factor for later obesity?

Clear Yet Crossed: Athletes' Retrospective Reports of Coach Violence

AIMS

This study aimed at examining coach-athlete violence based on the retrospective reports of adults who had been athletes as children and adolescents; predict variables that contribute to the existence of such violence; describe difficulties that the participants encountered as young athletes following such violence; and reveal the outcomes of such violence on their emotions and behaviors, in the past and present.

METHODOLOGY

The applied mixed methods comprised quantitative self-reporting questionnaires and qualitative interviews. The former included 440 participants (mean age 27.6) who had trained for at least one year in a sports union youth department; the latter included 14 participants (aged 23-37). These competitive athletes came from eight branches of sports. The interviews were analyzed based on the Narrative Approach.

RESULTS

According to the quantitative study, all participants had experienced coach violence at least once during their career, mainly psychological violence and neglect, followed by physical violence. Sexual violence was least reported. The age of their retirement from sports and the number of coaches that they had had were significant predictors of violence. Thematic analysis of the qualitative interviews resulted in six types of coach-athlete violence: (1) psychological violence; (2) verbal violence; (3) starvation and food fattening; (4) non-proportional punishing; (5) physical violence; and (6) sexual violence.

CONCLUSIONS

It is vital that coach-athlete violence is addressed in public discourse, that the topic of young athletes' safety is introduced into coaching education, and that a position holder is nominated to be in charge of such safety in all sports organizations.

The relationship between psychological distress and weight maintenance in weight cycling: mediating role of eating behavior

BACKGROUND

Obesity is a global public health concern. The goal of this study was to see if eating habits could mediate the relationship between psychological distress and weight maintenance in a population with a history of weight cycling.

METHODS

A 3-month outpatient intervention consisting of a diet and exercise program was provided to 153 participants. Psychological distress, appetite, and behavior were assessed at the beginning and end of the study. Anthropometric measurements were taken at baseline and six months.

RESULTS

After the structural equation model was developed, it was discovered that the psychological status of people with obesity and weight cycling histories correlated with the weight loss outcome effect (three and six months). This effect was mediated by factors related to eating behavior. Associative psychological factors had a direct effect on eating behavior (three months: β = 0.181, 95% CI: 0.055-0.310; six months: β = 0.182, 95% CI: 0.039-0.332) and appetite had a direct effect on eating behavior (three months: β = 0.600, 95% CI: 0.514-0.717; six months: β = 0.581, 95% CI: 0.457-0.713), both of which were significant (p < 0.01). At three months, psychological distress has a more substantial positive impact on weight change, with eating behavior acting as a partial mediator. At six months, there was no support for appetite's moderating role in eating behavior.

CONCLUSIONS

The findings suggest that psychological interventions should be strengthened to improve weight loss effectiveness, particularly in participants with a history of weight cycling, making weight loss more complicated and prone to rebound.

CLINICAL TRIAL REGISTRATION

The study has been registered in Clinical Trials (NCT05311462).

Weight regain, body composition, and metabolic responses to weight loss in weight cycling athletes: A systematic review and meta-analyses

Depending on the nature of their sports, athletes may be engaged in successive weight loss (WL) and regain, conducing to "weight cycling." The aims of this paper were to systematically (and meta-analytically when possible) analyze the post-WL recovery of (i) body weight and (ii) fat mass; fat-free mass; and performance and metabolic responses in weight cycling athletes (18-55 years old, body mass index < 30 kg.m-2 ). MEDLINE, Embase, and SPORTDiscus databases were explored. The quality and risk of bias of the 74 included studies were assessed using the quality assessment tool for quantitative studies. Thirty-two studies were eligible for meta-analyses. Whatever the type of sports or methods used to lose weight, post-WL body weight does not seem affected compared with pre-WL. While similar results are observed for fat-free mass, strength sports athletes (also having longer WL and regain periods) do not seem to fully recover their initial fat mass (ES: -0.39, 95% CI: [-0.77; -0.00], p = 0.048, I2  = 0.0%). Although the methods used by athletes to achieve WL might prevent them from a potential post-WL fat overshooting, further studies are needed to better understand WL episodes consequences on athletes' performance as well as short- and long-term physical, metabolic, and mental health.

Physiological Perturbations in Combat Sports: Weight Cycling and Metabolic Function-A Narrative Review

Combat sports athletes seeking a competitive edge often engage in weight management practices to become larger than their opponents, which ultimately includes periods of gradual weight loss, rapid weight loss, and weight regain. This pattern of weight loss and regain is known as weight cycling and often includes periods of low energy availability, making combat sports athletes susceptible to metabolic dysfunction. This narrative review represents an effort to explore the metabolic perturbations associated with weight cycling and outline the short-, medium-, and long-term effects on metabolic flexibility, function, and health. The short-term effects of rapid weight loss, such as a reduced metabolic rate and alterations to insulin and leptin levels, may prelude the more pronounced metabolic disturbances that occur during weight regain, such as insulin resistance. Although definitive support is not currently available, this cycle of weight loss and regain and associated metabolic changes may contribute to metabolic syndrome or other metabolic dysfunctions over time.

Body composition as a marker of performance and health in military personnel

Introduction

Body composition standards are set to ensure operational readiness in active-duty military personnel. To meet body composition standards, some individuals, however, may engage in unhealthy weight control behaviors (i.e., weight cycling and disordered eating). The objectives of this review are to: (1) evaluate the evidence regarding body composition and the associations to physical and military specific performance; (2) discuss body composition and potential health consequences; and (3) examine the evidence of weight cycling and disordered eating behaviors in military personnel for weight control.

Methods

A systematic search to identify peer-reviewed research articles was conducted in PubMed on 2/20/2023 using Medical Subject Headings (MeSH) including but not limited to "Military Personnel", "Tactical Athlete", "Weight Loss", "Body Composition", and "Weight Cycling".

Results

A total of 225 research articles were identified. The list was narrowed down to articles from the last 20 years (2003-2023) in military personnel. Only studies in which percent body fat was directly measured were included resulting in 17 research articles for this review.

Discussion

Evidence-based research is limited on the relationship between body composition and operational readiness. Weight cycling and disordered eating behaviors also has been reported for weight control, yet additional research is needed. Specifically, future research should focus on female service members, racial and ethnic differences, age, and postpartum status and include other service branches (i.e., Air Force and Navy). A comprehensive survey on weight cycling, disordered eating, and weight management would be valuable to determine the prevalence and extent of this issue. This information along with performance data would guide policy makers on the relevance and appropriateness of existing body composition standards.

Is dieting a risk for higher weight gain in normal-weight individual? A systematic review and meta-analysis

While there is an increasing prevalence of dieting in the overall population, weight loss (WL) practices could be a risk factor for weight gain (WG) in normal-weight (NW) individuals. The aim of the present work was to systematically review all the studies implicating diet restriction and body weight (BW) evolution in NW people. The literature search was registered in PROSPERO (CRD42021281442) and was performed in three databases from April 2021 to June 2022 for articles involving healthy NW adults. From a total of 1487 records initially identified, eighteen were selected in the systematic review. Of the eight dieting interventional studies, only one found a higher BW after weight recovery, but 75 % of them highlighted metabolic adaptations in response to WL favouring weight regain and persisting during/after BW recovery. Eight of the ten observational studies showed a relationship between dieting and major later WG, while the meta-analysis of observational studies results indicated that 'dieters' have a higher BW than 'non-dieters'. However, considering the high methodological heterogeneity and the publication bias of the studies, this result should be taken with caution. Moreover, the term 'diet' was poorly described, and we observed a large heterogeneity of the methods used to assess dieting status. Present results suggest that dieting could be a major risk factor for WG in the long term in NW individuals. There is, however, a real need for prospective randomised controlled studies, specifically assessing the relationship between WL induced by diet and subsequent weight in this population.

Best practice recommendations for body composition considerations in sport to reduce health and performance risks: a critical review, original survey and expert opinion by a subgroup of the IOC consensus on Relative Energy Deficiency in Sport (REDs)

BACKGROUND

The assessment of body composition (BC) in sport raises concern for athlete health, especially where an overfocus on being lighter or leaner increases the risk of Relative Energy Deficiency in Sport (REDs) and disordered eating.

METHODS

We undertook a critical review of the effect of BC on performance (29 longitudinal, prospective or intervention studies) and explored current practice related to BC considerations via a follow-up to a 2013 internationally distributed survey.

RESULTS

The review found that a higher level of body fat was negatively associated with endurance performance, while a gain in muscle mass resulted in performance benefits across sports. BC did not contribute to early talent identification, and no unique cut-off to signify a performance advantage for BC was identified. BC appears to be one of an array of variables impacting performance, and its influence should not be overstated. The survey (125 practitioners, 61 sports and 26 countries) showed subtle changes in BC considerations over time, such as an increased role for sport dietitian/nutrition practitioners as BC measurers (2013: 54%, 2022: 78%); less emphasis on reporting of body fat percentage (2013: 68%, 2022: 46%) and reduced frequency of BC assessment if ≥every fourth week (2013: 18%, 2022: 5%). Respondents remained concerned about a problematic focus on BC (2013: 69%, 2022: 78%). To address these findings, we provide detailed recommendations for BC considerations, including an overview of preferable BC methodology.

CONCLUSIONS

The 'best practice' guidelines stress the importance of a multidisciplinary athlete health and performance team, and the treatment of BC data as confidential medical information. The guidelines provide a health focus around BC, aiming to reduce the associated burden of disordered eating, problematic low energy availability and REDs.

Lightest weight-class athletes are at higher risk of weight regain: results from the French-Rapid Weight Loss Questionnaire

CONTEXT

Rapid weight loss (RWL) is a common precompetitive strategy used by athletes in weight-class sports and carries with it an increased risk to future cardiometabolic health. The Rapid Weight Loss Questionnaire (RWLQ) is a self-reported tool designed to identify and characterize such weight loss practices.

OBJECTIVES

After developing a reliable and reproducible French version of the RWLQ (RWLQ-FR), the present study aims to analyse RWL patterns among French weight-class athletes and to point out potential relationships between such practices and risk of subsequent weight gain.

METHODS

A test-retest analysis was performed in 54 athletes to test the questionnaire reproducibility before applying it in a cohort of 168 weight-cycling athletes (23.78 ± 9.25 y, 67.6 ± 12.6 kg, 81 males and 87 females, n = 24 strength sports and n = 144 various combat sports).

RESULTS

The test-retest showed good agreement of the RWLQ-FR (Rho = 0.794, [0.696-0.893]). Athletes reported losing an average of 4.1 ± 2.9% of their initial weight in 13.1 ± 9.6 days, with the main methods used being an increase in exercise, training in rubber or plastic suits, and gradual dieting. The average weight recovery in a week was 3.5 ± 2.8% and results showed that the athletes with the lower inter-season weight (weight outside of the training and competition season) regained the more weight (p = 0.025). The average RWLQ-FR score was 31.9 ± 17.3 and athletes who began to lose weight earlier in their competitive carrier had the higher scores (p = 0.032).

CONCLUSION

The present study demonstrates relationships between the pattern of RWL practices and potential increased risk of subsequent weight gain in weight-cycling athletes, and the need to better understand the long-term health-related risks.

Training Conditions and Psychological Health: Eating Behavior Disorders in Spanish High-Performance Women's Olympic Wrestling Athletes-A Qualitative Study

(1) Background: the aim of this study was to determine the factors that affect the occurrence of behaviors related to possible eating disorders in Spanish high-performance Olympic wrestling athletes. (2) Methods: The sample consisted of 22 elite female wrestlers selected through purposive sampling with inclusion criteria of (i) having been a national champion, (ii) having been part of the Spanish team, and (iii) suffering or having suffered from an eating disorder. The semistructured interviews were conducted online and lasted between 20 and 40 min. A statistical analysis was performed with NVivo10 software. (3) Results: the athletes showed a series of issues grouped into three main themes, which were divided into the following categories-firstly, the reasons why wrestlers lose weight; secondly, the inadequate procedures they use; and, finally, the reference persons involved in the process. (4) Conclusions: The training conditions in high-performance sports have psychological and behavioral effects on wrestlers. Wrestlers have to move down to lower categories; however, they do not take into account how this practice influences their health when using inadequate procedures. Rapid and significant weight loss produces negative effects, especially in the female population, generating an incidence of eating disorders. The information obtained provided elements of interest for reflection on possible solutions to prevent existing eating disorders.

Development and test–retest reliability of the Combat Sports Post-Career Health Questionnaire (CSPCHQ)

The long-term impact of weight cycling on health status, eating habits, physical activity and the lifestyle of former combat sports athletes is still insufficiently explored. Therefore, a novel questionnaire in English, Portuguese, Spanish and Croatian language was constructed. To determine the reliability and the content/face validity, a total of 110 participants filled the questionnaire on two occasions. With the majority of intra-class correlation coefficient values above 0·75, the questionnaire items were shown to be very stable. Additionally, according to κ values, the questionnaire has fair test–retest reliability, with only one coefficient being labelled as poor (Q40 in ESP). All questionnaire sub-scales showed moderate to very good internal consistency when the overall sample was observed (α ranging from 0·605 to 0·802). Poor α values were found only in Godin-Shephard Leisure-Time Physical Activity Questionnaire for CRO and ESP samples. Wilcoxon’s signed rank test showed significant differences only in the Mindful Eating Questionnaire sub-scale scores (overall: P = 0·002, effect size = −0·208 [moderate]; CRO: P = 0·005, effect size = 0·303 [moderate]). It can be concluded that the newly developed questionnaire had strong test–retest reliability. Further validity research in a larger sample of former combat sports athletes should be considered.

Rapid Weight Loss of Up to Five Percent of the Body Mass in Less Than 7 Days Does Not Affect Physical Performance in Official Olympic Combat Athletes With Weight Classes: A Systematic Review With Meta-Analysis

Given the relevance of the effects that weight loss can generate on the physical performance in athletes, this study performed a systematic review with meta-analysis of the published literature on rapid weight loss (RWL) and examined its impact on the physical performance in Official Olympic combat sports athletes. The “Preferred Reporting Items for Systematic Reviews and Meta-Analysis” (PRISMA) guidelines were followed to ensure an ethical and complete reporting of the findings. PubMed, SPORT Discus, and EBSCO were the electronic databases explored for article retrieval and selection. The following string was applied: “RWL” OR “weight loss” OR “weight reduction” AND “judo” OR “wrestling” or “taekwondo” or “boxing” AND “performance.” Based on the quality analysis, conducted according to the “Tool for the assessment of study quality and reporting in exercise training studies” (TESTEX), ten articles achieved a score >6 points. The meta-analysis showed a significant difference in pre- vs. post-weight loss (p = 0.003) and no effects in pre- vs. post-power and strength performance analysis (p > 0.05 for both results). Based on our systematic review and meta-analysis of the literature, RWL up to ≤5% of the body mass in less than 7 days does not influence performance outcomes in Official Olympic combat athletes with weight classes, considering the strength and power measures.

Body Composition and Bone Health Status of Jockeys: Current Findings, Assessment Methods and Classification Criteria

Jockeys are unlike other weight-making athletes as the sport of horse racing requires strict weight management to meet the racing stipulations, protracted working hours and an extended racing season with limited downtime. Several studies have reported on the body composition and bone status of male and female professional and retired jockeys, yet the variety of assessment techniques, lack of standardised testing protocols and classification inconsistency make interpretation and comparison between studies problematic. This review aimed to appraise the existing body composition and bone health evidence in jockeys and evaluate the assessment methods and classification criteria used. Dual-energy X-ray absorptiometry (DXA) has been used most frequently in jockey research to assess body composition and bone status, while various generic skinfold equations have been used to predict body fat percentage. Evidence indicates flat jockeys are now taller and heavier than the data reported in earlier studies. Absolute fat mass has steadily increased in male jockeys in the last decade. The bone status of male jockeys remains a concern as constant low bone density (BMD) is evident in a large percentage of young and experienced professional jockeys. Due to limited studies and variations in assessment methods, further research is required to investigate bone turnover markers in male and female jockeys. A standardised testing protocol using internationally recognised assessment guidelines is critical for the accurate interpretation and evaluation of body composition and bone health measurements. Furthermore, establishing jockey-specific BMD and bone turnover reference ranges should be considered using existing and future data.

Weight cycling in combat sports: revisiting 25 years of scientific evidence

BACKGROUND

As combat sports are classified by body mass, many athletes engage in rapid weight loss (RWL) prior to competition so they can gain an advantage over lighter opponents. Following the weigh-in, athletes engage in rapid weight gain (RWG), whereby some athletes have been able to compete up to three weight categories greater than the official division weighed in at.

RESULTS

Although the impact of weight cycling on performance remains equivocal, robust scientific evidence indicates serious acute and chronic negative consequences on physiological and health-related parameters. Still, weight cycling remains highly prevalent in combat sports, and interventions to limit or stop this cultural norm are recommended.

CONCLUSIONS

Weigh-ins for combat sports should be transitioned to take place closer to the start of competition. This reduced time and access to engage in RWG will cut down, if not completely prevent, weight cycling. These rule changes that aim to benefit athlete's health and promote fairness must be made at the international level, which will promote them at those levels below, as well, given qualification protocols.

Principles of Rapid Weight Loss in Female Sambo Athletes

In combat sports, competitors are separated into weight divisions, to create equality between the athletes. Consequently, rapid weight loss (RWL) is a common practice in combat sports. Although the methods used to induce RWL are similar among athletes, currently, there are limited data concerning the RWL methodologies used by sambo athletes. Therefore, this study aimed at determining RWL procedures among female sambo athletes. Participants in the study were top-level athletes competing at the World Sambo Championship held in Novi Sad. A total sample of 47 female sambo athletes, of whom 24 were seniors (27.3 ± 4 year/age, 1.61 ± 0.09 m/height, 61.8 ± 8.87 kg/weight) and 23 juniors (18.7 ± 0.8 year/age, 1.66 ± 0.07 m/height, 63.7 ± 12.1 kg/weight), were examined in the study. To determine RWL methods, data were collected through a standardized questionnaire. As a result, 88.7% of the female sambo athletes declared that they intentionally cut their weight before the competition. The most commonly used methods were gradual dieting, followed by sauna, fluid restriction, and skipping meals. The most considerable influence on the RWL strategies of athletes came from coaches and personal trainers, while physicians and dietitians were far less influential. The results obtained from this representative sample highlight the most common practices concerning weight cutting prior to competition among females. Therefore, there is a need to inform and educate both athletes and coaches about the potentially harmful effects of RWL in combat sports.

Effects of Rapid Weight Loss on Kidney Function in Combat Sport Athletes

Even though scientific literature shows numerous heath complications and performance decrements associated with rapid weight loss (RWL), its prevalence remains exceedingly high across various combat sports. The aim of this study was to thoroughly search the existing literature to explore the influence of RWL on kidney function in Olympic and non-Olympic combat sport athletes. PubMed and Web of Science were searched for the relevant studies. Only original articles published from 2005 onwards, written in English, that included healthy males and females who prompted ~5% weight loss within a week or less, were included in the study. Retrieved studies showed that creatinine, blood urea nitrogen and urine specific gravity values were significantly increased after RWL in the majority of the included studies. This observation indicates that RWL caused dehydration and subsequent acute kidney damage despite various degrees of weight lost during the RWL phase, which can lead to adverse events in other body systems. Alternative methods of weight reduction that prioritize athletes' health should be considered.