June 18, 2007
Overweight athletes are more apt to face on-field medical issues such as heat illness, asthma, sudden cardiac death, and musculoskeletal trauma, as well as cardiovascular problems and osteoarthritis when sports are over, according to a session presented at the 54th Annual Meeting of the American College of Sports Medicine (ACSM). Sports medicine physicians outlined management techniques for overweight athletes, noting optimal treatment for excess weight includes a combination of fitness, nutrition and behavioral therapy.
Overweight athletes are typically involved in sports where size and mass are important, such as football, says John P. Batson, M.D., chair of the session. This situation is most concerning when young athletes are overweight but do not continue athletics into adulthood, and are thus prone to problems associated with elevated weight, which tend to worsen as activity levels decline.
An athletic care network consisting of the team physician, coach, certified athletic trainer, parent (for younger athletes) and certain specialists if needed (i.e. registered dietician, strength and conditioning coach, endocrinologist, or cardiologist) is important to assess an "at-risk" or truly "overweight" athlete. Batson emphasizes the importance of identifying these factors, which put overweight athletes at increased health risk:
— Baseline medical history, especially issues such as hypertension, diabetes, elevated cholesterol, asthma, sleep apnea, and any orthopedic problems related to weight.
— Pre-season conditioning and any history of heat illness, since a lack of acclimatization and history of prior heat illness are risk factors (on top of obesity itself) for further heat-related problems.
— Use or possession of performance-enhancing supplements, especially in the younger population where side effects and long term usage risks are unknown.
— Use of stimulants, including excess caffeinated beverages, commonly used for weight loss and energy. Potential side effects include hypertension, palpitations, and arrhythmias.
— Use of agents such as creatine, steroid precursors, or steroids with the hope of losing fatty tissue and gaining muscle mass.
On the sideline, coaches and athletic trainers should be very aware of problems such as asthma/exercise induced asthma, heat illness, and sudden cardiac death as all of these issues have been associated with overweight athletes. Batson says there is a variety of intervention and prevention methods to address asthma and heat issues, and emergency plans are crucial for all management of all athletes, not just those overweight.
"Being an athlete does not necessarily equate to being healthy," says Batson. "Bigger isn’t necessarily better, even when it comes to the NFL. The increased size of athletes has been documented in youth football in recent years, so this is an important and ever-growing – literally – problem. Many recruiters and coaches are not necessarily looking for large overweight athletes. If they can’t run and have little skill, the athletes are often not helpful to the team. Hopefully this message will trickle down to families and encourage healthy weights from young ages into adulthood."