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Kill or Be Killed: How Eating Disorders Threaten Boxing

By Antonio Santiago-June 16, 2007

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"Kill or be Killed." The words still provoke a chilling echo in our hearts. They were the words written by Duk Koo Kim in his hotel room prior to his challenge of Ray Mancini for the WBA Lightweight Title in November of 1982. Kim, of course, passed away on November 18, five days after the bout. Many theories about Kim's death have come since, including the idea that he may have gotten injured further during rounds thirteen and fourteen an idea supported by studies that were later performed and led to championship fight rounds to be cut from 15 to 12 the idea that he was unproven and perhaps unworthy, because at 13-0, he was too inexperienced to fight a champion of the caliber of Mancini and had never fought outside South Korea, and many other theories.

The reality of it all was Kim had struggled with making weight for the fight, to be contested at 135 pounds or lighter, for weeks. He had been in Las Vegas, starving himself while exercising for days prior to the fight. When he stepped into the ring, he was severely dehydrated, and although the desert's heat had gone considerably down by the fight's day, Kim's body was lacking necessary nutrients as well as water and the oxygen that comes with it, and that lack of fluids combined with the lights positioned over the ring and the sweat Kim released during the fight made him much, much weaker and injury prone. Because of that, one can say, the inevitable happened. But was it really inevitable?

Many safety measures in boxing have been taken since. The rounds in championship bouts have been reduced to twelve, medical exams before fights have been imposed, mandatory, period related pre fight weight ins adopted and re evaluated, the use of headgear in professional boxing studied, and the presence of a certified medical doctor made a requisite in the vast majority of boxing venues worldwide. So what remains to be improved? It may not seem like much, but there certainly is room for boxer safety to be improved. One old saying is to watch out for the punch you can't see. Other sayings include the root of all problems is at home, and home is where the heart is. All three sayings can be used in boxing, because in boxing, a fighter is often his or her worse enemy, only they don't see it that way.

Naturally, in their quest to make weight before fights, fighters in general are suspected by some of becoming anorexic or bulimic in order to hit the mark on the scales. I know what you must be thinking right now: "Wait a minute, am I reading this correctly?" The truth is that those eating disorders have long been associated with other sports, mainly gymnastics and ice skating. One has to be, at least idealistically speaking, skinny in those sports in order to become a champion and win Olympic medals. But I remember one particular case of an athlete in gymnastics that hit very close to home back in the early 1990's. An Arizona teenager, that hoped she could attend the Barcelona Olympic Games in 1992, was told by her coach that she was fat and needed to lose weight. How fat was she? 100 pounds "fat." She quickly lost 40 pounds and got to what doctors refer to as the point of no return, a point in which the body is so weakened by the weight struggle that it can no longer fight opportunistic disease with the natural antibodies that serve us as protection. At the moment of that diagnose, patients are given an estimated short time to live. Sadly, that Olympic hopeful passed away before the Barcelona Olympics she had hoped to attend took place.

Who is to say that boxers do not develop these dangerous eating disorders? Most likely those who do, of course, do it unwillingly. The danger is still there, however. And boxing is already a dangerous sport as it is. Sure, boxers have nutritionists on their payroll, but who is also to say these are there only to keep appearances? Boxers, at least before fights, train in a very secretive, almost CIA evoking, way, because they do not want spies from the other boxer's side to find out their fight plan, and the other boxer to develop their own plan out of the fight plan they have. So we really don't know what goes on behind doors when fighters are training for major fights. Because of the consequences of Bulimia in particular, however, we can tell that there are many famous former fighters whose names I will not discuss and who very likely did suffer from that condition.

To understand the added dangers that Anorexia and Bulimia pose to a fighter, one has to deeply study the two diseases.

Anorexia Nervosa, as Anorexia is known within the medical world, is a serious, life threatening disease that can develop because of psychological, neurobiological or sociological reasons. Boxing being, in itself, a sports society of sorts, sociological reasons, such as the strain of being in one division, could play a part if any given fighter becomes anorexic. One could also attribute psychological reasons, specifically the fear of losing either a fight or a huge payday, to a boxer acquiring this dire illness. Because of the lack of essential body elements during Anorexia, the heart is deeply affected, and, as a consequence, so is the brain, that one most important of all areas that boxers need to protect.

In addition, as a consequence of the lack of calcium Anorexia produces, the bones weaken, which would leave boxers much more prone to injury and defeat during fights. Also, people who do have Anorexia, particularly the Binge-eating type, often over exercise, which in boxers can be roughly translated into the dangerous practice of over training, they misuse their food passages by inducing vomit to lose weight, which affects the esophagus, or may use laxatives, which make a normal intestine work harder, causing strain in the area. Because of Anorexia Nervosa's close relationship to endocrine disorders, it can also affect the human body's ability to produce natural insulin, which can lead to another major complication in the form of Diabetes. Endocrine disorders caused by anorexia can be even more harmful for female boxers, as menstrual periods could be stopped by this. Low blood pressure, Zinc levels and metabolism often result as a consequence of Anorexia Nervosa, as well as headaches, nerve deterioration which would slow a fighter's feet therefore making that individual more prone to a rival's punches, poor circulation and fluids around the ankle areas during the day are also attributed to this condition. Those are just a number of the many complications faced by an anorexic patient.

The other demon of the equation, Bulimia Nervosa, also better known as Bulimia, often involves periods in which a person loses control of their eating habits, therefore binge eating or, as we say in American English jargon, "pigging out," only stopping when something or someone else gets our attention. By that time, the individual's stomach has over expanded because of the uncontrolled food intake, an expansion which can also affect other nearby organs. A bulimic patient may use contraceptives to offset the craving for sugar or calorie ridden foods, and both men and women's hormones are also affected by this disease. Men's hormones, the testosterone, usually increase to a very high level when a man suffers Bulimia while women's estrogen levels become low.

It should be noted, for the benefit of women boxers or future women boxers reading this article, that 90 percent of the cases of diagnosed Bulimia involve women, so although everyone in boxing has to be careful not to develop Bulimia, more so women contestants, because the high percentage numbers of women patients are definitely against women. Bulimia's causes are very similar to those of Anorexia. The consequences could be as dire, if not more dangerous. People who use bulimia as a means to lose weight are exposed to heart attacks, brain strokes, malnutrition, dehydration, low plasma sodium levels, vitamin and mineral deficiencies, gastric rupture, salivary gland swelling, muscle atrophy, rupture of the esophagus or food and oxygen transporting cavity, peptic ulcers, high blood pressure, anemia, depression, infertility-which affects the ability to have children, Diabetes, Arthritis, chronic fatigue which would increase a boxer's chance to lose and to get badly injured during a fight, Polycistic Ovary Syndrome among women (which in turn may lead to infertility, Diabetes, heavy bleeding, endometrial and cervical cancer, sarcoma, potentially deadly low sugar reactions and obesity), miscarriage and other serious diseases.

Should boxers then incur in anorexic or bulimic acts to reduce their weight and gain another pay day? The obvious answer is a big no. The problem is, the pressure put on them to make weight could be overwhelming, and even heavyweights have had to deal with that pressure. It is well known that Muhammad Ali had to use thyroid pills in order to lose weight before his illogical fight with Larry Holmes. While that did not necessarily means Ali was an anorexic or bulimic, everyone who enjoys boxing has seen the sad result that his use of those pills contributed to. Ali's choice illustrates that anyone under the pressure of having to make weight before a fight can actually fall prey to these two diseases.

The key to avoid these two very dangerous conditions for a boxer, or anyone else for that matter, is to keep a diet regime that is well balanced against an exercise regime. That is, don't stop eating or start throwing up or taking laxatives after eating in order to make weight. A good exercise regimen by itself along with a diet low in fats but rich in nutrients the body needs so much to self preserve should allow one to come to a fight in good condition, weight, strength, and most importantly, health.

Another old saying is that many times, one is the only person who can defeat oneself. But boxing does not, clearly, have to be, like in Duk Koo Kim's fateful words, a kill or be killed sport. Just think about it, what's more sad to lose, a life or a payday?







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