Bulimic Behaviors Among wrestlers

Bret Maurras

The sport of wrestling places demands for- a slim, lean body build. Wrestlers are known for their extreme weight cutting practices in order to obtain this lean build. By "cutting" to a lower weight class, the wrestler is believed to gain an advantage against a smaller opponent. Used by wrestlers preparing to weigh in for competition, weight-cutting practices typically include fluid restriction (dehydration), caloric restriction, fasting, and increased exercise. More extreme methods employ saunas, rubber or plastic workout suits, vomiting, and drugs such as diuretics and laxatives.

Weekly weight fluctuations frequently exceeding 2.5 kg occur during the 24 to 48 hours preceding the match and are often repeated 15 time in a season (Oppliger, 1993). Between the weigh-in and the competition, usually -five hours, the wrestler further engages in binge eating in an attempt to rehydrate. Weight-cutting and binge eating are not restricted to international or collegiate competition,.but are also practiced by young high school wrestlers who are still maturing. A growing concern among clinicians and researchers is what influence these weight-cutting and binging behaviors have on the potential for developing eating disorders.

Weight-Cutting Methods and Their Prevalence

In a study conducted by Steen & McKinney (1986), data was collected from forty-two college wrestlers representing two separate teams via diet recall, a food record, a written test, interviews/questionnaires, and anthropometry. The purpose of this study was to assess the nutritional and weight-control practices of these wrestlers before, during, and after the wrestling season.

Each wrestler was asked what methods he used to lose weight and what methods the coach recommended. Eighty-one percent of the wrestlers reduced food intake and 21% used food deprivation. A large percentage used dehydration techniques, including saunas (51%), wrestling in a heated room (74%), fluid restriction (58%), and wearing a rubber or plastic suit while exercising (42%). In addition, wrestlers on one team used laxatives (5%), and vomiting (11%) to lose weight. Only a very few used conventional methods such as running (9%) or exercise (19%). Eighteen percent of the wrestlers stated that the coach did not provide recommendations on how to lose weight. Twenty-eight percent reported that the coach recommended gradual dieting, 15 % that the coach advised "proper" dieting. However, information on how to diet effectively was not given. Instead the coaches gave only general advice, such as decreasing calories or eating in moderation. More than half of one team said their coach recommended dehydration the day before a match to lose any excess pounds.

Another study conducted by Oppliger et al (1993) examined weight loss practices, nutritional knowledge, and bulimic behaviors among 713 high school wrestlers in Wisconsin. The survey was composed of information on competitive performance, the extent of weight loss, information on weight loss methods, sources of information, items characterizing bulimic behaviors, and 21 questions examining nutritional knowledge. The results indicate that the more binging behaviors the wrestlers exhibited, the more likely they exhibited other extreme weight-cutting practices. Twelve wrestlers (1.7%) answered positively to questions consistent with all five DSM-III-R criteria for bulimia nervosa, a rate higher than the expected 1% for adolescent males. An additional 52 (7.3%) met four of the criteria. These 64 wrestlers were classified as having a high number (HIGH) of bulimic behaviors. Two hundred fifty-seven wrestlers (36%) met either two or three of the DSM-III-R criteria and were grouped as having a moderate number (MOD) of bulimic behaviors. The remaining 392 (55%) met one or none of the criteria and were classified as having a low number of buli.mic behaviors. DSM III-R criteria for bulimia nervosa include recurrent episodes of binge eating (rapid consumption (if a large amount of food in a discrete period of time). Criteria number two is a feeling of lack of control over eating behaviors during the eating binges. The third criteria includes .regularly engaging in eitherself-induced vomiting, use of laxatives or diuretics, strict dieting or, eating behaviors during the eating binges. The third criteria includes regularly engaging in either self-induced vomiting, use of laxatives or diuretics,, strict dieting or fasting, or vigorous exercise in order to prevent weight gain. The fourth criteria requires a minimum average of two binge eating episodes a week for at least 3 months. The final criteria requires persistent concern with body shape arid weight.

HIGH and MOD wrestlers included significantly more upperclassmen; 53% of the HIGH and 55% a+ the MOD, but only 36% of the LOW wrestlers, were juniors or seniors. The average wrestler lost 3.2 kg to compete, cycled 1.8 kg weekly, and fasted 20 hours prior to weigh in. Two thirds of the wrestlers used exercise and 40% gradual dieting three or more times per week. Almost half (48%) of the HIGH and MOD wrestlers frequently restricted food and 20% fasted frequently. However, of the LOW wrestlers, only 27% restricted food and 8% fasted frequently. Use of rubber or plastic suits, a violation of national wrestling rules, was reported by more than 25% of the wrestlers (33% of the HIGH arid MOD groups and 20% of the LOW group), and saunas were used by 16% of the wrestlers. Vomiting was reported by 13% of the HIGH, 9% of the MOD, and 1% of the LOW. Laxatives were used by 14% of the HIGH, 7% of the MOD, and 1% of the LOW.

When asked to rank the sources of information on weight Cutting, coaches received first or second rankings by 74% of the wrestlers, and fellow wrestlers received a similar ranking by 82% of the wrestlers. Former wrestlers received 59% of the top two rankings, fathers and mothers 48% and 42%, respectively, and physicians 31% of the top rankings.

Binging occurred more than two times per week in 92% of the HIGH wrestlers but also among 11% of the MOD wrestlers. Exercise, relaxation/sleep, and vomiting were the most common post-binging activities. Almost two thirds of the HIGH -irid 20% of the MOD felt a loss of control when binging, and 20% of the HIGH and 8% of the MOD were concerned about their binging. Twenty-seven percent of the HIGH and 22% of the MOD experienced mild or moderate depression. Unwanted thoughts of food occurred frequently or constantly among 65% a+ the HIGH but only 43% of the LOW wrestlers. A small number of wrestlers, especially those who feel depressed about binging and feel out of control (n=10 MOD and n=6 HIGH) are probably at risk +or exhibiting these behaviors out a+ season. Oppliger et al conclude that wrestlers exhibiting binging were more likely to exhibit other extreme weight-cutting practices.

Lack of Knowledge About Nutrition

Misconceptions and lack of knowledge about nutrition and dieting are often a primary reason why wrestlers fall into the practice of using inappropriate, unsafe weight-cutting techniques and diets which can eventually lead to eating disorders such as bulimia nervosa

In Steen & McKinney's study (1986), 18% of the wrestlers did not alter their diet for training, and most were not aware that nutrition plays a key role in conditioning. 'The Subjects tended to prefer foods that they believed were light and low in calories. Starchy carbohydrates were viewed as fattening and inappropriate for dieting. The subjects consistently preferred foods high in protein such as beef, chicken, or eggs. The subjects further had the misconception that excess protein leads to larger muscled and that protein is nonfattening because (they believed) what is not used for muscle or energy is excreted instead of being stared as fat. Only 8% of the wrestlers believed fluids are beneficial for training and performance. This low percentage reflects their use of dehydration methods to lose weight.

The results of Steen & McKinney's (1986) study also indicated that a high percentage of wrestlers did not meet two thirds of the RDA +or several nutrients during the competitive season. These include a 15% lower protein intake then recommended, 25% less vitamin C, thiamine, and total iron, and 50% less vitamin A than recommended. RDA deficits for vitamin B6, Zinc, and magnesium were present for more than half of the wrestlers. When supplements were excluded, the percentages which fell below two thirds of the RDA for many of the nutrients were even greater.

Preseason and post-season calorie intakes were generally adequate as compared to two thirds of the RDA. During thee season, however, 37% of the wrestlers were riot meeting their recommended calorie .allowance. This caloric deficiency is even more pronounced considering the RDA does riot account for activity level, especially the strenuous activity level of wrestling. Food and fluid intake were typically minimal and sometimes zero for the two days prior to a match, as the wrestlers concentrated on making weight.

A diet analysis indicated that the wrestlers consumed a diet that was higher in fat and lower in carbohydrates than recommended. It is believed that a low carbohydrate intake compounded by the effects of dehydration can harm performance. Steen & McKinney suggest a pre-event meal during the 5 hours between weigh in and competition consisting of high carbohydrates, non-greasy, and readily digested. Further, wrestlers, who are typically dehydrated, should keep protein intake minimal prior to a match. Instead the wrestlers in this study ate high-protein, high-fat foods such as steak, eggs, and protein bars before the event. Rankin et al (1996) found that weight loss by energy restriction (calorie reduction) significantly reduced anaerobic performance of wrestlers. Those on a high carbohydrate refeeding diet of 75% carbohydrates during the five hours after a weight loss period tended to recover their performance while -hose on a moderate carbohydrate diet of 47% did not recover.

During the five hours between weigh-in and the match, all of the wrestlers in the Steen & McKinney study binge ate in an attempt to rehydrate. Steen & Brownell's study (cited in Oppliger et al, 1993) found average caloric consumption, post-weighing, to be more than 1500 calories, and in some cases to exceed 3000 f restoring electrolyte balance and replenishing muscle glycogen concentration (which restores anaerobic power), a substantial amount of water weight may be gained. By match time, the wrestler can be several pounds above his weight classification because of this pre-match binging. The wrestlers further binged after their- matches.

A Model for Preventing Cutting

In 1989, the Wisconsin Interscholastic Athletic Association (WIAA) began a project to prevent weight-cutting behaviors. Known as the Wrestling Minimum Weight Project (WMWP), the project's goal is to reduce unhealthy weight loss practices in high school wrestlers. The project includes skin-fold measure estimates of body fatness to determine a minimum competitive weight for each wrestler, a limit on weekly weight loss, and a presentation of nutrition education information to help wrestlers to diet effectively (Oppliger et al, 1995).

Microcomputer Software developed for the WMWP uses skinfold measurements and the scale weight at time of testing to determine the percent body fat, minimal weight class, and the number of days until the wrestler can compete at that weight class. All of this data is provided to the school/coach who then sends the results to the WIAA. The minimum weight for an athlete is to be 7% body fat, and wrestlers are restricted to a maximum weight loss of three pounds per week. An appeal process is available which allows the wrestler to be re-tested or opt for retesting by hydrostatic weighing. Less than 1% appealed decisions in 1993, the start of the mandatory program. Nutritional education materials in the program are geared toward high school wrestler and coaches. The program focuses on the basics of nutrition, the relationship of nutrition to performance, and appropriate measure +or weight control (Oppliger et al, 1995).

Anecdotal feedback about the WMWP fram parents, teachers, and administrators has been very positive. Coaches, 60% of whom initially were opposed, are now in great favor of the project, with 95% approval . Many wrestlers who had quit returned because they no longer had to struggle with weight-cuttihg. Prior to the WMWP, participation in wrestling declined by 15%, but after the WMWP participation has increased by 6% (Oppliger et al, 1995).

In 1990, before implementation of the WMWP, 713 wrestlers fram 45 schools were surveyed to document the extent of unhealthy weight loss practices in Wisconsin. A follow-up survey conducted by Oppliger et al (1993) examined wrestles from the same 45 schools two years after the rule was mandated. Preliminary analysis has shown significant decreases in the amount of weight cycled weekly, the frequency of weight cutting episodes during the season, the total amount of weight lost to reach the competitive weight class and the length of the longest fast prior to a weight-in. Among the wrestlers, acceptance of the WMWP was 75% and almost 90% felt the body- at test was accurate (Oppliger, 1995).

Conclusions

The demands placed on wrestlers to meet the requirements for a lean, low weight body must be considered a risk factor for the development of an eating disorder. The wrestlers in -the cited studies are clearly meeting the criteria for bulimia nervosa. The majority are using recurrent inappropriate compensatory behaviors in order to prevent weight gain. Further, many are engaging in binge eating prior to their matches. This problem must be addressed at all levels. The national wrestling committees, coaches, and wrestlers must all admit that a problem does in fact exist. Education is not enough to remedy the problem. Rules set at the higher levels by the committees must also be changed in order for the problem to be more effectively solved.

References

Oppliger, Robert A., Harms, R.D., Herrmann, D.E., Streich, C.M., & Clark, R.R. (1995). The Wisconsin wrestling minimum weight project; a model for weight control among high school wrestlers. Medicine and Science in Sports and Exercise, 27, 1220-1224.

Oppliger, Robert A., Landry, G.L., Foster, S.W.,, & Lambrecht, A.C. (i993). Bulimic Behaviors Among Interscholastic Wrestlers: A Statewide Survey. Pediatrics, 91, 826-831.

Rarikin, Janet W., Ocel, J.V., & Craft, L.L. Effect of weight lss and refeding diet composition on anaerobic performance in wrestlers. Medicine and Science in sports and Exercise, 28, 1292-1299.

Steen, Suzanne & McKinney, Shortie. Nutrition assessment of college wrestlers. Physician and Sportsmedicine 14, 100-116.