Week 10- Weight loss

Which sports and events were identified as weight-category, aesthetic, or low-body-mass sports?

Examples shown:

- Martial arts

- Wrestling

- Gymnastics

- Horse racing

- Diving

- Rowing:

- Lightweight

- Coxswain

- Boxing

- Artistic swimming

- Sports/events where low body mass is often desired, e.g.:

- Track and field

- Endurance cycling

- Sailing

Lecturer explanation:

Different sports can reward lower body mass for different reasons, such as making a weight category or improving power-to-weight ratio.

What examples were shown of athletes failing to make weight?

Examples included:

- Scott Quigg and boxing's problem of failing to make weight

- Khamzat Chimaev missing weight for UFC 279 by 7.5 pounds

Lecturer explanation:

Failure to make weight can prevent an athlete from competing and illustrates the problems created by trying to lose too much body mass in a short period.

DIAGRAM ON SLIDE 3

What severe health outcomes of failed weight cuts were illustrated?

Examples shown:

- Uriah Hall was hospitalised overnight after a failed weight cut.

- MMA fighter Yang Jian Bing died in a case used to illustrate the dangers of weight cutting.

Lecturer explanation:

Extreme weight cutting, particularly severe dehydration, can have serious health consequences and can prevent competition.

DIAGRAMS ON SLIDES 4-5

Why do weight-category sports use weight divisions, and why do some athletes still cut weight?

Purpose of weight categories:

- Promote fairness

- Promote safety

- Match athletes of similar size

Potential competitive motive:

- An athlete may try to weigh in below their normal training body composition, then recover afterwards to gain a size or leverage advantage.

Two broad components:

- Chronic body-composition change

- Acute 'making weight' or weight-cutting practices

What practical challenges can make weight management difficult in weight-category sports?

- Weight categories can differ between competitions, e.g. World Championships versus Olympics.

- Catchweight fights may require athletes to meet halfway between divisions.

- Athletes may move rapidly between weight divisions.

- Competition or weight-class confirmation may occur at short notice.

Lecturer explanation:

Competition format, repeated weigh-ins and changing divisions can complicate long-term planning.

What common methods have traditionally been used to manipulate or make weight?

- Energy restriction and fasting

- Fluid restriction

- Passive sweat loss

- Active sweat loss

- Examples: rubber suits, saunas

- Vomiting

- Pharmacological agents

- Examples: laxatives, diuretics

Lecturer explanation:

Passive sweat loss means sweating without exercise, whereas active sweat loss involves physical activity. The lecturer distinguished commonly used methods from safe best practice.

DIAGRAM ON SLIDE 8

What methods of weight loss were most commonly reported in the historical wrestler data?

Approximate prevalence shown:

- Food restriction: ~80%

- Exercise: ~80%

- Fluid restriction: ~75%

Lecturer explanation:

Although the study is historical, the lecturer noted that these practices still occur.

DIAGRAM ON SLIDE 9

What additional weight-making methods were reported in the historical wrestler data?

Approximate prevalence shown:

- Fasting: ~59%

- Sauna: ~44%

- Rubber suits: ~24%

- Laxatives: ~11%

- Vomiting: ~10%

Lecturer explanation:

These are examples of traditional weight-cutting practices, not necessarily safe best practice.

DIAGRAM ON SLIDE 10

How can rapid weight loss affect sporting performance?

- There may be less impact in events dominated by high power output and absolute strength, e.g. weightlifting.

- Performance decline is more likely in sports relying heavily on aerobic and/or anaerobic energy metabolism.

- The frequency of weigh-ins matters.

- A post-weigh-in recovery period and nutrition interventions may partly offset performance losses.

- Any potential competitive advantage must be weighed against serious health implications.

Lecturer explanation:

Repeated high-intensity or endurance-type activity may be affected more than a very brief maximal-strength effort.

What psychological effects of rapid weight loss were listed?

- Poor performance

- Increased anger

- Increased tension

- Increased fatigue

- Reduced vigour

Lecturer explanation:

Athletes may become more irritable and fatigued as competition approaches, and these effects can influence decisions about weight class.

What potential health consequences of weight cutting or chronic restriction were listed?

- Decreased plasma volume from dehydration

- Impaired cognitive function

- Decreased metabolic rate

- Loss of lean muscle mass

- Impaired nutritional status

- Impaired bone health

- Poor relationship with food

Lecturer explanation:

The lecture emphasised both immediate risks, such as dehydration, and longer-term risks to muscle, bone and eating behaviour.

How did the lecture illustrate that weight-category sport policies are changing?

The lecture highlighted:

- Rowing's inclusion of 'beach sprints' at the Los Angeles 2028 Olympic Games.

- The broader context of lightweight rowing being removed from the Olympic programme.

Lecturer explanation:

The example was discussed in relation to athlete health and reducing pressure around weight-making practices.

DIAGRAM ON SLIDE 14

What is the purpose of the AIS Making Weight in Weight Category Sports best-practice resources?

They provide guidance for:

- Sporting organisations

- Athletes

- Coaches

- Practitioners

Purpose:

- Help determine whether a target weight category is appropriate

- Support safer weight-management decisions

- Encourage planning with a multidisciplinary support team

DIAGRAM ON SLIDE 17

What does the AIS Making Weight Decision Tree assess before an athlete attempts to make weight?

Initial steps include:

- Measure morning body mass and body composition under standardised conditions:

- Euhydrated

- Overnight fasted

- Rested

- Voided bladder and bowel

- Determine whether the athlete is heavier than the target weight division.

- Consider how many days remain before weigh-in.

- Consider body-fat level/body composition.

- Consider the recovery time between weigh-in and competition.

Lecturer explanation:

The decision tree can lead to the recommendation not to attempt the cut or not to compete if the target is inappropriate.

DIAGRAM ON SLIDE 18

What longer-term body-mass guidance is shown in the AIS Making Weight Decision Tree?

If sufficient time is available and excess fat mass is present:

- Consult a sports dietitian.

- Use dietary strategies that reduce fat mass while still supporting fuelling and recovery.

- Aim for no more than about 1% body-mass loss per week.

If the athlete is not above the target division:

- Maintain current body mass.

- Focus on pre-training fuelling and post-training recovery nutrition.

The decision tree also flags concern when body mass is substantially above competition weight.

DIAGRAM ON SLIDE 18

What short-term strategies are shown in the AIS Making Weight Decision Tree before weigh-in?

The visual shows staged acute strategies, to be trialled in advance:

48-96 h pre-weigh-in:

- Reduce consumption of bulking foods

- Low fibre: <10 g fibre/day until weigh-in

- Focus on very low-weight foods 24 h pre-weigh-in

48-72 h pre-weigh-in:

- Reduce dietary sodium

- <500 mg/day until weigh-in

24-36 h pre-weigh-in:

- Moderate fluid intake until weigh-in

- Scheduled training sessions may be used to promote further sweat losses

- Examples shown include extra clothing layers or sweat suits

0-24 h pre-weigh-in:

- Passive dehydration by hot bath/sauna should never exceed 1-2% BM

- Only considered with direct athlete supervision by the core multidisciplinary team

- Once weight is achieved, begin cooling strategies

Lecturer explanation:

The lecture presents these as specialist acute strategies that should be trialled, supervised and used only when appropriate.

DIAGRAM ON SLIDE 18

What does the AIS recommend athletes DO when making weight?

- Identify the preferred weight category with the support team:

- Coach

- Sports doctor

- Sports dietitian

- Psychologist

- Prioritise diet to support fuelling and recovery.

- Work with the support team to select appropriate weight-loss strategies.

- Document weight loss and strategies after every time weight is made.

Lecturer explanation:

The weight category and strategy should be agreed with the support team rather than chosen alone.

What does the AIS recommend athletes NOT do when making weight?

DON'T:

- Do it alone; seek professional guidance.

- Rely heavily on sweating, especially saunas, baths or other hot environments.

- Slide guidance: about 2-3% BM maximum.

- Fast or completely avoid food and fluid in the days before weigh-in.

- Restrict fluid unless absolutely necessary, and then only in the final 24 h.

- Allow waking body mass to rise above about 5-7% of competition weight.

Lecturer explanation:

The lecturer repeatedly discouraged heavy reliance on sweating, prolonged fasting and unnecessary fluid restriction.

What growth and body-composition measures should be considered when deciding on a weight class?

Growth:

- Height

- Weight

- Circumferences/girths

Body composition:

- Height

- Weight

- Circumferences/girths

- Skinfolds

Lecturer explanation:

Growth is especially important in younger athletes. The target weight class should be realistic without compromising normal growth or healthy body composition.

DIAGRAM ON SLIDE 21

What information can body-composition monitoring provide in the DXA example shown?

The DXA figure reports regional and whole-body measures including:

- Fat mass

- Lean + bone-mineral-content mass

- Total mass

- % fat

- T-scores

- Z-scores

Regions shown include:

- Left arm

- Right arm

- Trunk

- Left leg

- Right leg

- Subtotal

- Head

- Total

- Android region

- Gynoid region

Additional adipose indices shown:

- Total body % fat

- Fat mass/height²

- Android:gynoid ratio

- % fat trunk:% fat legs

- Trunk:limb fat mass ratio

- Estimated VAT mass

- Estimated VAT volume

- Estimated VAT area

Lean indices shown:

- Lean mass/height²

- Appendicular lean mass/height²

Lecturer explanation:

Skinfolds can monitor subcutaneous adipose tissue, while DXA provides more detailed estimates; repeat-testing conditions and hydration need to be standardised.

DIAGRAM ON SLIDE 22

What is the main goal of the cyclist body-composition case study?

The cyclist is:

- Looking to lose weight by reducing body fat

Lecturer explanation:

This differs from a combat-sport weight cut because the aim is performance-related body-fat reduction rather than meeting an official weight class.

DIAGRAM ON SLIDE 23

How can body-composition demands differ between road and track endurance cyclists?

The lecture contrasted:

- More muscular track endurance cyclists

- Leaner road cyclists/climbers

Lecturer explanation:

Some athletes may change body mass by around 8-9 kg when moving between cycling disciplines or events.

DIAGRAM ON SLIDE 24

How much energy does each macronutrient or alcohol provide per gram?

Energy density:

- Fat: 37 kJ/g

- Alcohol: 28 kJ/g

- Protein: 17 kJ/g

- Carbohydrate: 16 kJ/g

Key relationship:

Fat is substantially more energy-dense than carbohydrate or protein.

DIAGRAM ON SLIDE 27

What energy deficit examples were given for losing 1.0 kg versus 0.5 kg of fat per week?

To lose 1 kg fat/week:

- ~4,200 kJ/day deficit

- ~29,400 kJ/week deficit

To lose 0.5 kg fat/week:

- ~2,100 kJ/day deficit

- ~14,700 kJ/week deficit

Lecturer explanation:

The lecturer often favours the slower rate, around 0.5 kg/week, when appropriate; actual changes vary between individuals.

Which areas of the diet should be reviewed when trying to reduce adipose tissue?

Checklist:

- Meats

- Dairy

- Snacks

- Alcohol

- Fluids

- Added fats

Purpose:

Identify the major energy contributors that can be modified while preserving training fuel and nutritional quality.

Lecturer explanation:

Alcohol, added fats and less nutritious snack choices may be targets before unnecessarily removing whole food groups.

What 'positive nutrition' checklist was given for athletes who need structured eating?

- 3 meals and 2-3 snacks/day

- Aim to eat every 3 h

- 3 food groups per main meal

- Include a variety of all food groups daily

- Aim for about 20 different foods each day

- 1 serve lean protein

- 2 handfuls fruit

- 3 serves dairy or alternatives

- 4 serves high-fibre grains

- 5 different-coloured vegetables

- Healthy fats, e.g.:

- 30 g raw nuts

- ¼ avocado

- 1 tsp olive oil

Lecturer explanation:

The lecturer emphasised a positive, structured approach rather than focusing only on restriction.

What was the baseline macronutrient and energy intake in the 70 kg athlete example?

For a 70 kg athlete:

Carbohydrate:

- 6 g·kg⁻¹

- 420 g/day

- 6,720 kJ/day

Protein:

- 1.2 g·kg⁻¹

- 84 g/day

- 1,428 kJ/day

Fat:

- 1.0 g·kg⁻¹

- 70 g/day

- 2,590 kJ/day

Total:

- 10,738 kJ/day

DIAGRAM ON SLIDE 31

How was energy intake reduced in the 70 kg athlete example while preserving protein?

Carbohydrate:

- 6 → 5 g·kg⁻¹

- 420 → 350 g/day

- 6,720 → 5,600 kJ/day

Protein:

- Remained at 1.2 g·kg⁻¹

- 84 g/day

- 1,428 kJ/day

Fat:

- 1.0 → 0.7 g·kg⁻¹

- 70 → 49 g/day

- 2,590 → 1,813 kJ/day

Total energy:

- 10,738 → 8,841 kJ/day

Lecturer explanation:

The example reduces energy while still retaining carbohydrate for training and keeping protein intake unchanged.

DIAGRAM ON SLIDE 32

What simple food swaps or eliminations were used to illustrate reductions in energy intake?

Examples:

- 2 Tim Tams = 820 kJ

- 50 g packet chips = 1,005 kJ

- Snickers = 1,120 kJ

- Butter vs mustard = 434 vs 69 kJ

- Full-cream milk vs low-fat milk = 700 vs 458 kJ

- 40 g cheese = 680 kJ

- 1 Tbsp olive oil = 666 kJ

- 2 sausages vs lean steak = 1,710 vs 777 kJ

- McDonald's meal vs Subway = 4,897 vs 1,280 kJ

Lecturer explanation:

Small practical changes can reduce energy intake without automatically removing important training fuel.

What are the five stages in the boxer weight-management timeline?

1. Weeks prior

2. 1-4 days ahead of weigh-in

3. Night before event

4. Day of weigh-in

5. Post-weigh-in recovery

Lecturer explanation:

The case combines gradual long-term body-fat loss with shorter-term weigh-in planning and recovery.

DIAGRAM ON SLIDE 34

What is the recommended focus in the weeks before a boxer needs to make weight?

- Aim for slow, steady loss of body mass from adipose tissue.

- In the final 1-2 weeks, aim to be within about 2-3% of competition weight.

Lecturer explanation:

The preferred strategy is to arrive close to target well before the final weigh-in rather than relying on a large last-minute cut.

What may be considered 1-4 days before weigh-in in the boxer case study?

- Monitor body weight.

- If required, commence:

- A low-residue strategy

- Fluid restriction

- Sodium restriction

- These strategies should be trialled in training first.

Lecturer explanation:

Short-term manipulation should only be considered when needed and with professional oversight; the lecturer generally preferred not to restrict fluid.

What fluid and salt restriction guidelines were shown in the lecture example?

Fluid:

- Limit to about 1-1.5 L/day

- Include all sources:

- Training fluids

- Milk on cereal

- Foods that are liquid at room temperature, e.g. yoghurt

Salt:

- Choose low-salt alternatives, e.g.:

- Low-salt baked beans

- Tuna in spring water rather than brine

- No sports drink; cordial instead

- Do not add salt to foods

Lecturer explanation:

This was presented as a specialist weigh-in strategy rather than general hydration advice.

What is a low-residue diet and why might it be used before a weigh-in?

Low-residue diet:

- Usually used in a clinical setting

- Designed to reduce faecal content in the bowel

- Eliminates high-fibre foods and connective tissue

- Is nutritionally inadequate

- Reported individual body-mass reduction: ~300-700 g

- Used for about 2-3 days before competition

Lecturer explanation:

The weight change comes from reduced gut contents, not body-fat loss, so it is only a temporary strategy.

Which foods were listed as foods to avoid during the temporary low-residue diet?

Avoid:

- Whole-grain breads and cereals

- Choose lower-fibre alternatives such as Rice Bubbles, Cornflakes or Special K

- Brown rice and pasta

- Whole fruits and vegetables

- May be puréed but without skin

- Tough or coarse meat

- Seeds

- Nuts

- Legumes

- Peanut butter

- Coconut

- Marmalade

Lecturer explanation:

This differs from normal healthy-eating advice and is only part of a temporary low-residue strategy.

What should the boxer eat on the night before the event?

Choose:

- Low-fat

- Low-fibre

- High-carbohydrate meal

- Familiar foods only

Example:

- White rice

- Lean meat

- Salad / low-fibre vegetables such as:

- Zucchini

- Mushroom

Key point:

- Include carbohydrate

- Avoid trying new foods

Lecturer explanation:

The athlete should already know how the meal affects comfort and overnight body mass.

What are the key post-weigh-in recovery priorities before the boxer competes?

- Drink plenty of fluid with electrolytes if rehydration is needed.

- Breakfast should be:

- Low fat

- High carbohydrate

- Comfortable in the stomach

Example breakfast:

- Sustagen Sport

AND

- 1-2 cups cereal + milk

OR

- 2 slices toast

Eating-out options:

- Baked beans on toast

- Muesli + yoghurt

- Fruit toast

- Fresh fruit

- Juice

- Coffee

Then:

- Return to the normal morning-tea and lunch plan.

- Choose foods that feel comfortable and 'light'.

Lecturer explanation:

The aim is to rapidly restore fluid, electrolytes and carbohydrate without suddenly introducing a large amount of fibre after a low-residue phase.

What is energy availability (EA), and which physiological functions depend on it?

Energy availability is the energy remaining for essential physiology after exercise energy expenditure.

Processes shown as being affected by EA:

- Growth

- Movement/exercise

- Thermoregulation

- Cellular maintenance

- Reproduction

Health concerns when EA is inadequate:

- Impaired immune function

- Increased injury risk

- Delayed/disturbed menstrual function

- Hormonal-balance disturbances

- Nutrient deficiencies

What are the main causes of low energy availability (LEA)?

- Disordered eating / eating disorder

- Shown as the most prevalent cause

- Body-composition manipulation

- Energy intake failing to match high energy expenditure because of:

- Sudden increases in training or competition volume

- Appetite failing to track energy needs

- Restricted access to food

- Travel

- Training camps

- Boarding school, etc.

Lecturer explanation:

LEA can be intentional or unintentional and does not occur only in athletes with a diagnosed eating disorder.

What is Relative Energy Deficiency in Sport (REDs), according to the lecture?

REDs is underpinned by low energy availability.

Problems arise when dietary energy intake does not match the energy required for:

- Homeostasis

- Health

- Activities of daily living

- Growth

- Sporting activity

Psychophysiological consequences listed include:

- Impaired metabolic rate

- Disturbed menstrual function

- Low bone mineral density

- Impaired immune function

- Impaired protein synthesis

- Impaired cardiovascular health

- Impaired psychological health

REDs:

- Can occur across the spectrum of sex.

What health domains were shown in the REDs health-consequences diagram?

Domains shown around REDs:

- Gastrointestinal

- Immunological

- Menstrual function

- Bone health

- Endocrine

- Metabolic

- Haematological

- Growth and development

- Psychological

- Cardiovascular

The older Female Athlete Triad is shown within the broader REDs model.

Important relationship:

Psychological consequences may precede REDs or result from REDs.

DIAGRAM ON SLIDE 50

What health and performance consequences were linked to low energy availability in the 2023 REDs model?

Consequences shown:

- Impaired reproductive function

- Impaired bone health

- Impaired gastrointestinal function

- Impaired energy metabolism/regulation

- Impaired haematological function

- Urinary incontinence

- Impaired glucose and lipid metabolism

- Mental health issues

- Impaired neurocognitive function

- Sleep disturbances

- Impaired cardiovascular function

- Reduced skeletal muscle function

- Impaired growth and development

- Reduced immunity

Lecturer explanation:

Different professionals may detect different parts of the REDs picture, so multidisciplinary recognition is important.

DIAGRAM ON SLIDE 51

How are REDs severity and risk categorised in the colour-coded framework?

GREEN:

- None to very low severity/risk

- Clinical criteria:

- 0 primary indicators

- ≤1 secondary indicator

- No treatment required

- Full training and competition clearance

YELLOW:

- Mild severity/risk

- Examples of criteria:

- 0 primary + ≥2 secondary indicators

- 1 primary + ≤2 secondary indicators

- 2 primary + ≤1 secondary indicator

- Treatment, monitoring and regular follow-up

- Full training and competition

ORANGE:

- Moderate to high severity/risk

- Examples of criteria:

- 1 primary + ≥3 secondary indicators

- 2 primary + ≥2 secondary indicators

- 3 primary + ≤1 secondary indicator

- Treatment and close follow-up

- Some training/competition may need modification

RED:

- Very high/extreme severity/risk

- Examples of criteria:

- 3 primary + ≥2 secondary indicators

- ≥4 primary indicators

- Immediate treatment; hospitalisation may be required

- Major training/competition modification, often removal from training and competition

DIAGRAM ON SLIDE 52

What is the LEAF-Q used for in REDs/LEA screening?

LEAF-Q:

- Low Energy Availability in Females Questionnaire

- Cited as Melin et al. (2014)

- Used as a screening tool for female athletes

Lecturer explanation:

The questionnaire includes areas such as:

- Illness

- Injury

- Gastrointestinal symptoms

- Menstrual function

DIAGRAM ON SLIDE 53

What is the LEAM-Q used for?

LEAM-Q:

- Questionnaire for male athletes

- Cited as Melin et al. (2022)

Lecturer explanation:

Questions relating to sex drive were highlighted as potentially useful when investigating low energy availability in males.

DIAGRAM ON SLIDE 54

What measures were combined in the participant report card shown for LEA/bone-health screening?

The report card combined:

1. Caloric intake

- Average: 1,967 calories/day

- Recommended range: 2,506-3,000 calories

2. Energy expenditure

- Average: 1,072 calories/day

3. Calcium and vitamin D

- Average calcium: 1,501 mg

- Recommended calcium: 1,000 mg

- Average vitamin D: 1,127 IU

- Recommended vitamin D: 600 IU

4. Protein intake

- Average: 76 g/day

- Recommended range: 75-106 g protein/day

- 1.2-1.7 g protein/kg body mass

5. Energy availability

- Average: 17.99 kcal/kg fat-free mass/day

- Figure notes:

- EA >45 = optimal

- EA =30 = minimum for optimal reproductive and bone health

- EA =20 = moderate energy deficiency

- EA =10 = severe energy deficiency

6. Bone mineral density

- Total BMD: 1.278 g/cm²

- Z-score: 1.5

7. EAT score and LEAF-Q score

- EAT score: 3

- EAT <20 stated as normal

- LEAF-Q score of 8 or lower stated as normal

DIAGRAM ON SLIDE 55

Which REDs severe primary indicators were shown, and how are they scored?

Severe primary indicators:

- 2 points each

Examples shown:

- Primary amenorrhoea:

- No menarche by age 15

- Prolonged secondary amenorrhoea:

- 12 or more consecutive menstrual cycles absent

- Clinically low free or total testosterone in males

Important:

The slide states that this is not the complete list of indicators.

Which REDs primary indicators were shown, and how are they scored?

Primary indicators:

- 1 point each

Examples shown:

- Secondary amenorrhoea:

- Absence of 3-11 consecutive menstrual cycles

- Sub-clinically low free or total testosterone in males:

- Lowest quartile of laboratory reference tables

- Sub-clinically or clinically low total or free T3

- Bone stress injury (BSI) history:

- ≥1 high-risk BSI

OR

- ≥2 low-risk BSIs in the previous 2 years

OR

- >6 months off training because of BSI in the previous 2 years

- Adult BMD Z-score <−1 at:

- Hip

- Lumbar spine

- Neck of femur (NOF)

Important:

The slide states that this is not the complete list of indicators.

Which REDs secondary indicators were shown?

Secondary indicators:

- Oligomenorrhoea caused by FHA:

- >35 days between periods

- Maximum of 8 periods/year

- History of 1 low-risk BSI within the previous 2 years and <6 months absence from training due to BSI

- Elevated total cholesterol or LDL cholesterol above the reference range

- Clinically diagnosed depression and/or anxiety

- Counts as only 1 secondary indicator whether one or both are present

Lecturer explanation:

Secondary indicators contribute to overall REDs risk stratification and should be interpreted alongside primary indicators by qualified clinicians.

DIAGRAM ON SLIDE 57

What resource was identified to assist with disordered eating, LEA and REDs in high-performance sport?

The lecture showed:

- 'Disordered Eating in High Performance Sport' Position Statement

- Australian Institute of Sport

- National Eating Disorders Collaboration

Lecturer explanation:

The lecturer also referred to eating-disorder-in-sport education/workshops for athletes and families.

DIAGRAM ON SLIDE 58

What final principles were given for working with energy-restricted athletes?

- Use kilojoules effectively.

- Example: strategic timing of meals and recovery nutrition

- Prioritise nutrient-rich foods.

- Use positive nutrition education.

Lecturer explanation:

Safe weight-management work should use adequate lead time and supportive nutrition education rather than relying on extreme restriction.