September 06, 2017
2 min read

AAP cautions youth athletes against unhealthy weight changes

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Youth athletes who participate in sports with weight classes or an emphasis on physique may be engaging in unhealthy strategies for weight loss and weight gain, according to a clinical report issued by the AAP Council on Sports Medicine and Fitness.

“Sometimes, children and teens in certain sports believe they need to achieve a particular body type to be successful,” Rebecca L. Carl, MD, MS, FAAP, from the Institute for Sports Medicine at the Ann & Robert H. Lurie Children’s Hospital, said in a press release. “Unless they have a healthy strategy to work toward their goals, however, they can end up defeating themselves and causing health problems.”

“Weight cutting,” or the process of fasting, restricting fluid intake and increasing sweat production for weight loss before a weigh-in, may encourage unhealthy weight loss techniques such as spitting, vomiting, steam baths, saunas and laxative or diuretic use. These dehydrating actions can lead to decreased psychomotor function, reaction time, accuracy and mental endurance, as well as temporary learning deficits, fatigue, mood swings and changes in cognitive state.

The AAP Council on Sports Medicine and Fitness warns child and teenage athletes about the dangers linked to unhealthy methods of gaining and losing weight for sports.

Additionally, athletes should not attempt to lose weight through dietary restriction, because they usually require a higher caloric intake than children who are not athletes. Unhealthy restriction habits range from not receiving enough calories to meet energy requirements to anorexia or bulimia nervosa, or both. For these youth athletes who desire to lose weight for their sport, pediatricians should suggest gradual weight loss with sensible methods for long-term change.

Weight gain may also be desired by athletes who participate in sports that require additional strength for functional or aesthetic purposes, such as football or bodybuilding. Athletes should avoid overeating or using dietary supplements because these approaches may result in increased fat accumulation rather than lean muscle mass. This is of particular importance, as Carl and colleagues suggest that adolescent boys who believe they are under- or overweight are almost four times more likely to use anabolic steroids to change body composition.

The researchers suggest that the child or adolescent’s stage of development, genetic factors, type of training, diet and motivation should be considered when attempting to influence weight gain and muscle development.

Carl and colleagues provided many recommendations for pediatricians who counsel youth athletes, including the following:

  • Obtain an understanding of healthy and unhealthy weight control methods;
  • Take the history of the patient to ascertain diet and physical activity patterns. Encourage placing nutritional needs for growth and development above athletic considerations. Acute weight loss through dehydration and the use of potentially harmful medications and supplements for weight control should be strongly discouraged;
  • Ensure that patients are avoiding weight control methods that may have adverse health effects, such as acute weight loss through dehydration and the use of potentially harmful medications and supplements;
  • Use the AAP Preparticipation Physical Examination monograph, which may be helpful for screening;
  • Engage the services of a registered dietitian nutritionist familiar with athletes to help with complex weight control issues, if these providers are available in their communities. Monitoring athletes with weight control issues every 1 to 3 months can aid the physician in detecting excessive weight loss;
  • Suggest a range of values for body fat percentage that is realistic and appropriate; and
  • Counsel athletes on beginning weight loss regimens early enough to permit gradual weight change before a season begins: Slow weight gain with strength training decreases gain of body fat; slow weight loss will decrease loss of muscle mass; recommend a well-balanced diet.

“Sports participation offers so many benefits for children and teens,” Carl said in the release. “Parents, coaches and pediatricians can help them enjoy whichever sports they choose while staying healthy and strong.” – by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures.