Weight Cutting is Dangerous: Ask the girl who was rushed in for Emergency Surgery after following the advice of her ‘Weight Cut Nutritionist’.
If I binge watch a couple of seasons of Grey’s Anatomy, it does not make me a Doctor. If I go to a Car Show, it does not make me an expert on cars. If I spend the day swimming at the beach, it does not make me a lifeguard.
As ridiculous as these notions sound, a cruel reality is that this line of thinking exists everywhere in the field of Nutrition. They exist in the form of two-day certificates, short courses, and titles that contain the word Nutritionist preceded by some ambiguous terms such as Biohacking Neural Strengthening or something equally as ridiculous. Essentially, these courses make the participants believe (for a handsome fee) that they are qualified to advise people and athletes about their Nutrition.
I recently wrote an article about the experience I had in which a client of mine (a world champion in his sport and current coach to many talented fighters) rang me with a real concern for one of his athlete's health after that fighter had followed the advice from a grossly unqualified person who held the title of ‘weight cut specialist’. A qualification that is given after attending a three-day certification that requires no prerequisite knowledge of Nutrition Science, or any Science for that matter. Basically, any Joe Blow can complete the course that weekend and be advising athletes how to acutely lose 10% (or more) of their body weight the next.
When I started The Fight Dietitian (TFD), I had a goal to improve the practices that exist around making weight in Combat Sports. I wanted to achieve that through educating athletes, coaches, teams, gyms, organizations, and commissions but also by having high profile athletes, who athletes admire, champion this practice of making weight in a safe, scientific and sustainable manner.
This is why I feel the need to write another article about this topic. Today I received a phone call from an S&C coach, who is a good friend of mine, about an athlete who had been training at his facility for the past year. This athlete had just weighed in for a local MMA promotion and not even 24 hours later was sent to the hospital for emergency surgery.
This athlete had actually been a previous client of TFD, someone I had worked with for over 18 months. We had always had a good relationship, and as is the case with the majority of my clients, I was heavily invested in seeing them succeed in their endeavors.
Three weeks ago they were informed about the opportunity to make their amateur MMA debut. There was only one issue, their weight. As a Health Professional, my job is to look after my client's health, not advise them on how to aggressively reduce their body weight by any means necessary.
As part of our practice, we have developed a risk assessment that we use with all of our athletes who sign an agreement to fight. In this assessment, we examine their body composition, their state of metabolism, relevant blood work, and the time frame in which they have to make the weight. We also assess other factors such as experience level, previous weight history, and weigh-in format to arrive at a decision of the appropriateness of completing the weight descent.
Due to the fact that this was a short notice fight, an amateur debut, the athlete had limited experience in making weight within this weigh-in format, and the athlete's body composition was not ideal for the suggested time frame, our team strongly advised against taking the fight as there was not enough time to make the weight without risking the athlete's short and long term health.
Despite this assessment, the athlete decided to proceed with the fight. They also decided to get their Nutrition advice and help with their ‘weight cut’ from another individual. An individual with no tertiary qualifications, just some ambiguous terms in front of the word ‘Nutritionist’ as their title. After expressing our concerns with this, we professionally parted ways, and this started the process that would lead to the most painful and regretful ‘I told you so’ moment of my professional career.
The athlete proceeded with the fight, and under the guidance of their new ‘Nutritionist’ they successfully weighed in. However, within 24 hours of weigh-ins, they were being rushed in for emergency surgery to have skin grafts put on their legs to treat severe burns. According to this athlete's coach, this happened at the end of the ‘weight cut’ process.
Not only had this athlete started the dehydration process days before the official weigh-ins, they also spent 24 hours sitting in a sauna while wearing a sauna suit (not a practice I would advise to anyone, making weight or otherwise). They eventually made their contracted fight weight, but reportedly had three hours until they could officially weigh-in. The athlete was complaining of overheating and in an attempt to ‘cool’ the body down, the ‘Insert Ambiguous Terms Here’ Nutritionist advised them to go to a local Health Centre, run by a Naturopath to complete a cryotherapy session in a ‘cryo-chamber’.
The athlete was promptly welcomed in by the Naturopath (who also claims to be an Iridologist, I will let you figure out what that is) who neglected to ask them any questions regarding their medical well-being, discuss the risks of the practice, or discuss the terms of the waiver (that did not exist). As a matter of fact, after looking at both the Nutritionist’s and Naturopath’s social media accounts, it became obvious that they had worked together extensively in the past.
This is evident by one post in particular, where a promotion was run where participants would receive a discounted Cryotherapy session if they mentioned the Nutritionist’s business name. This makes me beg the question that there was an ulterior motive of financial gain as opposed to the athlete's best interest behind the decision to use this Cryotherapy.
Regardless, the athlete was put in a Cryo chamber for 6 minutes and left unattended. I am not familiar with what is considered best practice in this process but I am told the recommended time to be exposed in this chamber is just 3 minutes. After this, the athlete then went to the venue and officially weighed-in. That night they reported severe pain, and the next day they were having emergency surgery to remove skin from both of their legs.
If Cryotherapy is an unfamiliar term to you, it is basically marketed to athletes as an effective procedure for recovery. It involves the athlete standing in a chamber where a number of gases are cooled down to anywhere between -130 to -200 degrees celsius. Yes, you read that right, essentially, it is really really cold.
I am no expert in this practice, nor am I denying the potential recovery benefits of it. However, I would consider myself quite well-read in the literature surrounding making weight. Never have I read a piece of literature that suggests taking an individual who is fluid volume-depleted and in a state of (extreme) dehydration to a cryotherapy center to help them ‘cool’ off.
I am also no burns expert, however, one of the most basic teachings in First Aid is never to put ice on a burn due to it constricting the surrounding blood vessels and further worsening the injury. Additionally, as a rule in our practice, we actively discourage athletes from taking cold showers immediately after being in a hot bath or sauna. Instead, we move them to a ‘cooler’ room to slowly allow their body to reacclimate to room temperature.
The reason is that rapid exposure to a cold environment causes blood to rush from the extremities to the body's core to protect the vital organs. In fluid volume-depleted individuals this ‘shift’ can cause them to become light-headed and potentially pass out increasing the risks of head trauma while in a dehydrated state.
In an effort to understand why this would ever be suggested in the first place, and why the Naturopath (who at this stage was taking on the duty of care of this athlete) allowed this to happen, I went to Doctor Google and typed in ‘Cryotherapy and Dehydration’ only to find the below as the first result;
I would very much like to think that this person did not read this, or information similar to this, and then come to the conclusion that cryotherapy was a solution to help this athlete relieve their symptoms of (extreme) dehydration. I would also like to think that this is not the belief of the Naturopath working at the Cryotherapy Centre, but you know what, I am probably wrong. It is probably exactly what they thought, and that is the entire issue here.
Instead of consulting an experienced practitioner, a medical professional, or at least reading credible information, they referred to uncredible, unscientific, and non-evidence-based information to inform practice. Look at the result, a young, ambitious athlete with a world of potential that has been put to a huge standstill who now has to live with the trauma of this experience for the rest of their life.
As upsetting, disappointing, frustrating, and everything else that this situation is, the scariest part of it, is that it is not surprising. I would say that it surprises me, but if I am being honest, it doesn't, not in the slightest. It is actually exactly what I expect to happen.
It is exactly what I expect to happen when you let people complete a three-day course, complete a ‘weight cut specialist’ certificate, watch too much Youtube or even worse, indulge in too many Netflix documentaries, and then let them call themselves a ‘Nutritionist’ and be able to go and give people advice in a field that they should not be advising people in. This is what happens when clinical competence and critical thinking do not exist and are not enforced - people get hurt.
There is a reason Health Professionals have to spend years and years studying, and then even more time practicing in supervised conditions. Not only does it engrain certain principles into your brain but it also weeds out the people who are not capable of doing so. Who are not capable of keeping their clients/patients safe. These short courses, fake titles, and ambiguous certifications show complete disregard for this process, and the people who are doing them are likely people who should not be practicing at all.
If this field is ever going to advance, then we need to promote safe practices and promote the academics, researchers, and practitioners who dedicate their lives to ensuring that situations like this do not ever happen. We have already lost lives unnecessarily to this process in situations that were completely avoidable with the right guidance and advice. Is it going to take the loss of another person's son, daughter, brother, sister, husband, wife, partner, or friend to make us get serious about these pseudo qualifications?
If you are a weight category sport athlete, and you want to fill your social media with credible, scientific information, I have compiled a list of people who I consider the top experts in this field to follow. These are real experts, not people pawning of certifications for quick cash, they are top university lecturers, top practitioners, leading academics, and progressive researchers that I can personally vouch for their experience and expertise.
This is obviously a very testing time for this athlete, physically and mentally. As they will not be able to work through this time, her coach has created a GoFundMe page to help support them financially through this ordeal. If you are in a position to donate, it would be greatly appreciated. Follow the link here.
If you take anything from this experience, this story, and this ramble, please understand that this whole process is not a game. Nutrition, health, and making weight is not something you just decide to do because you watch a documentary, feel passionate about a particular way of eating, or have had a couple of amateur fights yourself.
This is a science, a risky science at that, and if you get it wrong there are consequences. As a Profession, and as a community we owe it to the people who participate in combat sports to provide them with evidence-based science and accurate information about making weight. This can only be done if we collectively take a stance to stamp out this pseudoscience and these pseudo titles that exist in this area. For the sake of all combat athletes’ health and safety, I hope this happens sooner rather than later.
Jordan Sullivan — Founder and Head Dietitian The Fight Dietitian
My list of academics, researchers, and practitioners who can provide great information in the area of Combat Sports Nutrition.
Dr. Reid Reale — UFC Performance Institute Shanghai
Dr. Lewis James — Loughborough University
Dr. Oliver Barley — Edith Cowan University
Dr. Matteo Capodaglio — CapoNutrition
Dr. Andy Galpin — California State University Fullerton
Dr. Gary Slater — The University of the Sunshine Coast
Amelie Rosseneu — Amelie Rosseneu Sports Dietitian
Danny Lennon — Sigma Nutrition
Jonathan Pain — Complete Human Performance
John Sassone — Combat Sports Dietitian
Joseph Matthews — Birmingham City University
Louise Bloor — British Judo
Ben Zhuang — Coach Ben Z
Tyler Minton — Tyler Minton Nutrition
Mike Shea — Hierachy Nutrition
John Connor — Irish Strength Institute
Dr. Sinead Roberts — Feed Fuel Perform
Here are some books that I also recommend reading that focus on nutrition for combat sports;
Making Weight and Everything Else by Amelie Rosseneu
Combat Sports Nutrition by Dr. Reid Reale
Performance Nutrition for Wrestlers by Clint Wattenberg
The Cut by Ben Zhuang
Sigma Weight Cutting System for Boxing and MMA by Danny Lennon