Introduction
For the sport medicine team, the overweight
athlete can present numerous challenges. First,
the type of athlete who wants or needs to lose
weight can vary dramatically, from a small
female participating in a lean build sport (gym-
nastics, track and field, figure skating) to a large
male participating in a strength or power sport
(weightlifting, heavy weight wrestling). Some of
these athletes may also participate in sports that
require ‘making weight,’ which adds a unique
challenge to any health professional guiding
them through the weight-loss process. These ath-
letes may not be ‘overfat or overweight’ accord-
ing to normal criteria, but may be considered
heavy for their sport or for the weight category in
which they must compete. To further complicate
the weight-loss process, some athletes partici-
pate in sports in which they are judged on both
performance and appearance. This can add pres-
sure to reduce body weight lower than optimal
for good health and performance. Second, the
weight-loss programme needs to provide ad-
equate energy so that exercise training can still
occur. The diet cannot be too restrictive in energy
without the athlete running the risk of injury, loss
of fat-free mass (FFM), poor performance, feel-
ings of deprivation, and eventual failure. Thus,
adequate time needs to be allotted for weight loss
to occur. Aerobic and strength training may also
need to be added if they are not already a part of
the athlete’s normal training programme.
Finally, the weight-loss programme needs to
provide a strong educational component. The
athlete needs to be taught good nutritional, exer-
cise and behavioural techniques for long-term
weight maintenance. Without an educational
component, the athlete is susceptible to the many
fad diets, diet products, and weight-loss drugs
that frequently hit the consumer market. With
the emphasis placed on physical appearance in
Western society, dieting can become obsessive.
The athlete is not immune to this pressure. In
fact, they are pressured on two fronts: their sport
and society. This pressure can lead to desperate
means of weight loss and an eventual eating
disorder.
This review will briefly outline the principles
and components of energy balance that need to
be considered before placing an athlete on a
weight-loss programme. Specific methods for
determining energy balance in an athlete will
also be reviewed. Finally, practical applications
and guidelines for determining the weight-loss
goal and approaches to gradual weight loss will
be given. For individuals working with athletes
in weight-category sports, the effects of rapid
weight loss on health and performance has been
addressed elsewhere (Steen & Brownell 1990;
Horswill 1992, 1993; Fogelholm 1994). Other
excellent reviews are available on the effect of
weight loss on sport performance (Wilmore
1992a), the techniques used in different sports
(Fogelholm 1994; Burke 1995), the effect of
weight loss on health and metabolism (Brownell
et al. 1987), and the role of dieting in eating disor-
ders (Wilmore 1991; Sundgot-Borgen 1993, 1994;