Personal trainers are frequently confronted by clients interested in using rapid weight loss (RWL) techniques to lose weight quickly for a sporting event (e.g., mixed martial arts, wrestling, boxing, weightlifting, etc.) or for esthetic reasons (an upcoming social event or obesity intervention) (3). However, there is no uniform definition to describe RWL in the current body of literature. RWL generally includes techniques used to improve weight loss results in a shorter period than what could be achieved by following a lower calorie diet and exercise. Unfortunately, many of these practices are not only unsafe, but could be potentially life threatening in some circumstances (7,11,12,16,43). For this reason, it is important that personal trainers be able to recognize individuals who may be putting their health in jeopardy and provide appropriate educational strategies and/or resources to help them safely and effectively lose weight and manage a healthy weight over time.
COMMON RAPID WEIGHT LOSS STRATEGIES
There are myriad weight loss strategies, many of which are propagated by the Internet, the media in the form of endorsements of specific supplement and exercise regimes by celebrities and athletes, and diet books and magazines. Table 1 lists several common RWL techniques. It should be noted that individuals may use a combination of the methods listed.
POTENTIAL NEGATIVE EFFECTS OF RAPID WEIGHT LOSS STRATEGIES
There are numerous physiological and psychological effects associated with RWL (Table 2). One potentially serious side effect is severe dehydration. Research indicates that even a 2% drop in water weight can lead to increased mental fatigue, sleepiness, nausea, vomiting, and apathy (10,19,38). Moreover, extreme dehydration may lead to an increased risk of heat-related illness, hospitalization, or even death. For instance, in 1997, 3 collegiate wrestlers died because of hyperthermia and dehydration caused by their precompetition weight-cutting methods (12). On a less severe note, dehydration and caloric restriction can impair exercise performance (1–5,8,33,34).
Extreme caloric restriction may lead to malnourishment, and over time, vitamin and mineral deficiencies (7). These nutrient deficiencies may result in any number of side effects such as dry or brittle hair and fingernails, muscle atrophy, fatigue, cramps, muscle weakness, depressed immune system, decreased energy metabolism, or dizziness (6,7,26,40). Severe caloric restriction may also lead to an increased reliance on stored muscle proteins as a fuel source during exercise (6,7,37) and a subsequent reduction in training gains when combined with a resistance-training program. In fact, a study by Garthe et al. (18) found young athletes (24 ± 3 years) randomized to either slow weight loss (0.7% body weight loss per week) or fast weight loss (1.4% body weight loss per week) along with 4 resistance-training sessions per week were better off losing weight slowly. The lean body mass increased significantly in the slow weight loss group, whereas it remained unchanged in the fast weight loss group. They noted that adults who want to gain lean body mass while also reducing fat mass should aim for a slower rate of weight loss at about 0.7% body weight per week (18).
Potential degradation of lean muscle tissue due to RWL may result in a decreased resting metabolic rate, which may be counterproductive when considering long-term weight management (6,19). However, a diet that contains more protein than the Recommended Dietary Allowance for protein may help to attenuate losses in lean body mass by helping maintain a positive nitrogen balance while on a reduced calorie diet (2,43). Additionally, incorporating 2–3 days of resistance training per week may also be beneficial for preserving lean muscle tissue, especially moderate to heavy (70–85% of the 1 repetition maximum) resistance training. It may be difficult for individuals to maintain these higher intensities because of the lower energy levels often associated with reduced caloric intake. Long-term caloric restriction may also lead to other chronic health issues and diseases, such as osteoporosis, muscle atrophy, lowered bone density, abnormal growth and development, anemia, heart damage, anorexia, and possibly death in extreme cases (7,42).
SITUATIONS THAT MAY WARRANT RAPID WEIGHT LOSS
Despite the many potential drawbacks stemming from the use of RWL, some of these techniques can be used both safely and effectively in certain situations; for instance, adults seeking to lose weight quickly to attenuate cardiovascular disease risk factors stemming from obesity, such as, hypertension, hypercholesterolemia, and diabetes (17,40). However, if an individual chooses to engage in such a practice, they should do so under the guidance and supervision of a registered/licensed dietitian or other qualified medical professional.
RECOGNITION AND STRATEGIES FOR PREVENTION
Recognizing the signs and symptoms associated with RWL techniques and providing clients with healthy alternative strategies are the keys to long-term success. Personal trainers should monitor and be aware of any rapid fluctuations in weight from session to session and week to week. In addition, trainers should be aware of any unusual behaviors that may indicate RWL techniques are being used and document them both for their own liability protection and for the client's records. Clients may simply be following poor advice regarding rapid weight loss tactics; however, in some instances, these behaviors may be indicative of deeper psychological issues such as eating disorders. Documentation can assist trainers in making informed decisions regarding appropriate intervention strategies such as referral to a mental health professional and registered dietitian. Because many RWL techniques aim to reduce body weight through water loss, recognition of the many signs and symptoms associated with dehydration is essential. These may include significant reductions in performance, increased resting heart rate, dried cracked lips, headaches, dizziness, dark/foul smelling urine, muscle cramping, and gastrointestinal distress. The use of extreme fluid restriction, diuretics, laxatives, excessive training (especially in layers of clothing or sweat suits), and spending extended periods of time exercising in extreme heat or sitting in a sauna should be avoided.
Early detection and recognition is critical for reducing the likelihood of negative psychological, physiological, and performance effects of RWL methods. Furthermore, education regarding the dangers of engaging in these practices is essential for maintaining optimal health, thereby preventing serious injury/death, and for long-term weight management success. Clients should be encouraged to maintain consistent hydration and healthy feeding behaviors and aim for steady and consistent weight loss of approximately 0.5–2 lbs/wk for long-term weight management.
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