Competitive Eating: How Safe Is It?

ranked No. 1 in the world by the International Federation of
Competitive Eating -- attributes his accomplishments to hard work, not
gluttony. But many doctors worry that competitive eating can have dangerous
consequences. And some dietitians worry that the sport sends the wrong message
at a time when obesity is growing to epidemic proportions.

Secrets of Competitive Eating

Chestnut, 23, a project engineer from San Jose, Calif., says his success
results from intensive training. "I slowly make my body adapt to my
goal," he says, comparing himself to a bodybuilder or a marathoner.

Chestnut trains about once a week, eating mass quantities of whatever food
he's expected to consume for the next eating contest. What kinds of foods? The
list includes hamburgers, hot wings, oysters, deep-fried asparagus, key lime
pie, chicken wings, cheesecake, and lobster. B

Chestnut also practices by drinking up to a gallon of milk in a single
sitting, which he says trains his stomach to expand.

Chestnut says he prepares carefully for practice and competition. In the
days before a competition, he stops eating solid foods and limits his diet to
protein supplements.

"Psychologically, I like to go in hungry," he says. "If I see on
the scale that I have dropped weight, I can easily imagine an enormous amount
of food inside me."

For a day or two after most competitions or practices, Chestnut admits that
he "doesn't feel so good." He goes back on the protein supplement diet
as his stomach empties out, he says.

At 6 feet 1 inch tall, the large-framed Chestnut weighs about 220 pounds,
though he came in at 207 before this year's hot dog contest. "I control my
calorie intake pretty rigorously," he says, and he also runs to keep his
weight down.

How does Chestnut win eating contests? Like most competitive eaters,
Chestnut drinks lots of water during the contest and dunks his food in water,
which he believes helps the food settle at the bottom of his stomach.B He
moves around as he eats, which also helps the food settle. And he also
attributes his success to good pacing.

Think competitive eating is just mindless gluttony? Don't tell Hall Hunt, a
25-year-old structural engineer currently ranked ninth in the world. Known for
his "academic approach" to eating, Hunt tells WebMD that he carefully
studies each food to maximize edibility. He studies food density to
"maximize the amount of food that can go down with each contraction of the
esophagus." And he studies which liquids are best at breaking down which
foods. (Want to cut through the grease on those cheese fries, for example? Try
lemonade.)B

To keep his weight manageable, Hunt practices mostly by loading up on
veggies. If he practiced only on high-calorie foods, he says, "I'd weigh
400 pounds." Actually, he weighs 175 pounds and is 6 feet 1 inch tall.

"My favorite things to do are eat, travel, and compete," Hunt says.
"This sport combines all of those things."

Are Eating Contests Dangerous?

Top competitive eaters may train intensively, but that all goes on behind
the scenes. What the average fan sees is a bunch of competitors getting egged
on as they stuff their faces with food. And that's why the growth of
competitive eating as a sport worries many dietitians.

"Knowing how many people don't have adequate nutrition, and how many
people abuse food and overeat constantly, seeing competitive eating celebrated
on TV disturbs me," nutritionist Milton Stokes tells WebMD.

Stokes, a spokesman for the American Dietetic Association, says competitive
eating can "send a message to spectators that going hog wild with food is
not a big deal."

Doctors also worry that competitive eating can be downright dangerous. For
example, binge eating could cause stomach perforations in people with
undiagnosed ulcers, says Shanthi Sitaraman, MD, PhD, a gastroenterologist at
Emory Universiy School of Medicine in Atlanta.

For those competitive eaters who train by gulping huge quantities of water,
water intoxication is also a concern. Water intoxication is a deadly syndrome
that results from dilution of electrolytes in the blood. But Sitaraman says
water intoxication is rarely a risk in people who are not already losing
electrolytes, for example through long-distance running.

If competitors are vomiting regularly, that could cause problems, Sitaraman
says. Protracted vomiting can increase the chances of aspiration, or food
getting into the lungs rather than the esophagus. This can lead to deadly
pneumonia. But competitive eaters say vomiting at competitions is rare.

Sitaraman was surprised when, doing a search of the medical literature of
the past several years, she found no reported complications from competitive
eating, short of a single case of a jaw fracture. "Maybe [competitive
eaters'] gastrointestinal tract has adapted and acclimatized to eat those
calories," she speculates.

What Does Competitive Eating Do to the Body?

Competitive eating is a little-studied phenomenon. So David Metz, MD, a
gastroenterologist at the University of Pennsylvania, was thrilled when
competitive eater Tim Janus offered himself as a guinea pig for study. Metz
hopes that by studying people who seem to never get full, he can have a better
understanding of the opposite phenomenon -- indigestion.

Metz studied how Janus's stomach handled huge amounts of food. In normal
individuals, he tells WebMD, a full stomach sends a message via the vagus nerve
to the brain, which then orders the stomach to contract and send food into the
small intestine. Competitive eaters somehow block that signal even as their
stomach stretches to enormous proportions. Otherwise, their digestion processes
appear normal, he says.

Metz suspects that competitive eaters may have some natural ability to
stretch their stomachs and may also be able to train the muscles in the stomach
wall. To know more, he says, he'll have to study an eater over the course of a
career. But Metz does know enough to be concerned about some potential
long-term effects of competitive eating. "If you don't get that stretched
feeling, that full feeling, and you don't tell your brain to switch off, then
you're at risk of obesity," he says.

Another serious risk, Metz says, is gastroparesis, or stomach paralysis. If
the stomach muscles are repeatedly overstretched, they may ultimately fail to
contract, and the stomach will lose its ability to empty itself. Usually
associated with diabetes, gastroparesis can cause chronic indigestion, nausea,
and vomiting. It has no effective cure, Metz says.

Metz is impressed with top eaters' discipline and natural abilities. But for
the general public, he has a message: "People shouldn't try this at
home."

By Richard Sine
Reviewed by Louise Chang
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