Fight Medicine: Another Weight Cutting Tragedy

By Jon Gelber M.D. Dec 12, 2015
It has been two years since I last wrote about a weight cutting-related tragedy in mixed martial arts. Leandro Souza died in 2013 after he passed out while cutting weight for an MMA event in Brazil. Since then, the Ultimate Fighting Championship and other MMA organizations have seen some fighters pulled from cards due to weight cutting-related complications, including UFC 192 co-headliner Johny Hendricks, who was hospitalized for kidney stones. On Friday, a 21-year-old fighter died after reportedly trying to cut weight for a One Championship event in the Philippines.

I have said for many years now that the top three health-related problems facing MMA today are, in no particular order, performance-enhancing drugs, concussions and weight cutting. Fighters have been known to cut up to 20 pounds or more for a weigh-in merely a day or two before a fight. Weigh-ins have been a standard for combat sports for generations, but there’s a significant difference between a steady and controlled weight cut to even out discrepancies between fighters and losing weight at the last minute only to put it all back on as an advantage over your opponent. The crazy thing is, studies have shown that in boxing and MMA, the vast majority of the time, two fighters both cut weight to reach an agreed-upon weight class for the fight, only to then both put on weight the next day so that they are actually fighting at the equivalent of the next higher weight class.

Related » One Championship Flyweight Jianbing Yang Dies Following Weigh-ins

Why not just have both of them fight at that higher weight class and avoid all the pain and danger of cutting weight? I know the obvious business aspects of that answer; and of course, if a fighter receives a call several days ahead of a fight as a last-minute fill-in for the big show, he or she would be hard-pressed to turn the offer down. For many fighters, not making weight could make the difference between a chance in the UFC and not paying rent. As many news stories have recently pointed out, it’s not unheard of for fighters to dehydrate themselves to the point of needing intravenous fluids right after the weigh-in. I’ve even seen fighters show up to weigh-ins with a locked IV access already in their arm.

Some weight-loss methods can prove detrimental to a fighter’s health, including starvation, diet pills, diuretics and laxatives. The dangers of significant starvation are numerous and can lead to high levels of dangerous substances in the blood such as lactate and ketones. Many diet pills contain substances that supposedly increase your body’s metabolism, but in reality, your body will experience an increased heart rate and/or high blood pressure, possibly even to dangerous levels. In addition, laxatives can lead to dehydration from excessive water loss and not allow the body to absorb needed nutrients, and they place your body’s electrolyte balance out of whack. Furthermore, some of the diet pills and laxatives contain ingredients that are banned by national and international sports organizations and could result in a suspension and fine if detected.

What’s needed in the sport of MMA is an overall governing body. Unfortunately, the way the system runs now is that each state has its own commission that oversees contests. Even then, fighters can fight on Native American soil and not become subject to state regulations. Many of us in the medical and scientific communities are trying to find a solution to these issues. That’s why I founded the Mixed Martial Arts Research Society -- to bring more science to the sport. In addition, commissions are looking at ways to limit weight cutting and weight gain by re-weighing fighters before bouts or limiting the weight classes to which they can cut down. In NCAA wrestling, collegiate wrestlers are followed by athletic trainers to make sure they are only cutting to appropriate weight classes and not placing their bodies at undue risk. The weight classes they can cut to without reaching significant levels of dehydration are determined by hydration status. It can be measure by a number of instruments, including skin calipers, urine refractometers, water displacement and specially designed pods.

However, we cannot do it alone. We need the help of the MMA community to identify and solve problems as the sport grows. We also need to discourage the unsafe practices that are out there through education and proper training. There are some good resources available at the NCAA and USA Wrestling websites, as well as some of the state athletic commissions. In addition, some people have proposed the idea of limiting the weight classes at which fighters can compete. They would have to apply to fight at specific weight classes, just as they have to apply for state licenses when they fight. Let’s hope this is the last time we have to write about a weight cutting-related tragedy.

Jonathan D. Gelber, MD, MS is an orthopedic surgeon at Highline Orthopaedics in NYC and is the founder of the Mixed Martial Arts Research Society ( You can follow him on Twitter @FightMedicine or on
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