Pediatricians Warn About Rapid Weight Changes in Youth Athletes

Different sports tend to make us think of different physiques. Gymnasts tend to be petite and slim, for example, while football players bring to mind more robust frames. These preconceived notions about body types may encourage young athletes to slim down or bulk up, sometimes at a rapid pace.

“Sometimes, children and teens in certain sports believe they need to achieve a particular body type to be successful,” said Dr. Rebecca Carl, an attending physician in sports medicine and non-operative orthopedics at Lurie Children’s Hospital. “Unless they have a healthy strategy to work toward their goals, however, they can end up defeating themselves and causing health problems.”

To raise awareness about unhealthy methods of weight loss and gain, the American Academy of Pediatrics has issued a new clinical report that outlines the harms caused by methods such as fasting, excessive exercising and restricting fluids—or increasing caloric intake to bulk up—as well as ways to curb these practices.

“Our goal is to have kids engaged in physical activities and in sports they love, and to develop lifelong physical activity habits,” said Carl, lead author of the report. “We want kids participating in sports, but we’re just trying to point out the things that could make sports higher risk for kids.”

Youth athletes in sports such as gymnastics, figure skating and diving may believe they’ll be judged more favorably if they have a lean body build, the report states. Cross-country runners and cyclists may believe a lean physique will give them a “gravitational advantage,” Carl said. “For a growing athlete, it’s hard to say they should be losing weight. For most kids, losing weight may not be necessary or healthy.”

If an athlete is overweight or obese, they should work with their primary care physician and a registered dietitian nutritionist to gradually lose weight, Carl added. “Adults need to send the message to kids in adolescence that they can be really successful in your sport, but you don’t have to be underweight or at a very low weight.”

Athletes who participate in weight-class sports, like wrestling and martial arts, often participate in “weight cutting,” or losing weight rapidly through dehydration techniques, fasting, excessive exercising and restricting fluids. Most athletes attempt to regain weight by rehydrating between weigh-in and competition, the report states.

While athletes and coaches in weight-class sports may believe this process maximizes a competitor’s strength-to-weight ratio and gives an athlete a competitive advantage, it could impair an athlete’s performance.

“For most kids, losing weight may not be necessary or healthy.”

–Dr. Rebecca Carl


Unhealthy weight-loss methods, in which a child’s hydration and nutrition needs aren’t met, can cause reduced muscle strength, lower speed or less stamina in aerobic activities, according to the report. Decreased reaction time, alertness and accuracy can also result from unhealthy weight-loss practices.

Female athletes can develop what’s called the “female athlete triad,” which is characterized as low energy availability, menstrual dysfunction and low bone density. “People affected by female athlete triad have issues with bone density that persist” and can increase the risk of broken bones, Carl said. “It can cause issues with eating disorders, like anorexia and bulimia that have very severe health consequences.”

Warning youth athletes about health risks associated with unhealthy weight loss methods may not compel them stop, however. “They’re not as risk-averse as adults, but explaining that their performance may be impaired could be really helpful,” Carl said. “I think it’s important to talk to parents and athletes about their nutritional needs and the importance of placing growth and health above sports considerations.”

Athletes looking to gain weight for sports, such as football or rugby, can increase obesity-related risks while decreasing stamina and performance, according to the report. Rather than increasing caloric intake from food and dietary supplements, athletes trying to gain weight should combine increased caloric intake with strength training to encourage muscle growth rather than excess body fat.

“Kids can benefit from strength training at a young age if they learn the proper technique and are supervised by adults,” Carl said, adding it can help them gain lean muscle mass. “It used to be the idea that kids shouldn’t strength train because it could damage their growth plate. They can, but they shouldn’t do maximal lifts.”

Regardless of sport played, changes in a child’s weight and body composition – whether it’s weight loss or gain – should be gradual and based on a plan established with physicians, Carl said. “Parents should be concerned if they’re noticing rapid changes in weight in a child.”

All athletes should adhere to a well-balanced diet and any efforts to gain or lose weight should be started early enough to permit gradual weight change before a season begins, according to the report. Once a desired weight is reached, athletes should focus on maintaining constant weight. 

Follow Kristen Thometz on Twitter: @kristenthometz


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