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[EDITOR'S NOTES]

How to Prevent Death in Weight-Cutting Wrestlers

THE PHYSICIAN AND SPORTSMEDICINE - VOL 26 - NO. 2 - FEBRUARY 2021


One advantage of wrestling as a varsity sport in high school and college is its weight-class system. Little guys are as valuable as big guys. Ask a wrestler why he chose the sport and he is likely to tell you, "Because I'm too small to play football."

What wrestlers hate most is starving and dehydrating. They do this to reach the lowest possible weight that leaves them with sufficient strength to finish their next match. The result is one exhausted, underfed wrestler struggling on the mat with another exhausted, underfed wrestler.

Wrestlers cutting weight feel miserable. They can't concentrate, and they fall asleep in class. They have no energy left for activities besides wrestling and no friends besides other wrestlers because they are too grouchy. But none have died while dropping weight—until this season.

During a 5-week period this past fall, three varsity wrestlers at three different colleges died while starving and dehydrating themselves before a scheduled weigh-in for a match. This unprecedented series of deaths is being investigated by the National Collegiate Athletic Association (NCAA), USA Wrestling, the US Centers for Disease Control and Prevention, the US Food and Drug Administration, and each of the colleges involved. It behooves us to wait for all the facts to emerge before jumping to conclusions about what should be done. Nevertheless, I have a suggestion.

For most meets, high school wrestlers are required to weigh in 1 hour before the start of the meet. The time between weigh-in and match is important because this is when the wrestler attempts to regain his strength by eating and drinking as much as possible. From the wrestler's (and coach's) point of view, the more time, the better. An hour isn't much time for a wrestler to recover his strength after drastic weight loss.

For many years, college wrestlers weighed in 5 hours before a meet. In the past few years, however, colleges have tended to slide toward weighing in 24 hours beforehand. The down side to this is that the wrestler figures he can lose more weight because he has more time to recuperate—a full day. Thus, the door is open for wrestlers to cut weight more dramatically than ever before—increasing the risks, including that of death. The mechanism of death may differ from one individual to another, but the true cause is drastic, rapid weight loss.

Various measures to control weight cutting—such as banning the use of saunas, plastic sweat suits, diuretics, and self-induced vomiting—have been attempted, but are difficult to enforce. The determination of an individual's minimum allowable weight from body fat measurements has had some success, but is logistically complex.

There is a simpler way to discourage excessive weight loss. Why not schedule college weigh-ins the same as in high school: 1 hour before the meet? Weighing in 1 hour in advance encourages self-regulation: Wrestlers quickly learn that drastic weight loss leaves them too weak to win.

Cordially,
Richard H. Strauss, MD
Editor-in-Chief

Dr Strauss has worked with wrestling at the collegiate, high school, and international level for the past 20 years.

As this issue went to press, the NCAA announced that weigh-ins must be held no more than 2 hours before a meet.


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