Overweight Athlete: Fact or Fiction?
Satya S. Jonnalagadda, PhD, RD*, Robert Skinner, MS, RD, CSCS,
and Leah Moore, RD
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Address
*Department of Nutrition, Georgia State University, MSC 2A0880,
33 Gilmer Street, SE, Unit 2, Atlanta, GA 30303-3082, USA.
E-mail: sjonn@gsu.edu
Current Sports Medicine Reports 2004, 3:198–205
Current Science Inc. ISSN 1537-890x
Copyright © 2004 by Current Science Inc.
Maintaining appropriate body weight is important for
athletic performance. Body mass index (BMI) is commonly
used to classify an individual’s body weight. However, in the
case of athletes, who may have a high body weight due to
higher lean body mass, BMI may lead to misclassification
of the athlete as overweight or obese. Thus, both BMI
and body composition assessment should be conducted
before determining if an athlete is overweight or obese.
Body weight goals of athletes should be determined for
each athlete, based on the requirements of the sport, the
athlete’s body size and shape, and in consultation with the
athlete, coaches, and trainers. Safe weight loss goals should
be established on an individual basis. Athletes, coaches,
and trainers should work closely with individuals who have
training in nutrition (registered dietitians) to set appro-
priate weight goals and to develop weight management
protocols that promote healthy eating.
Introduction
Obesity is currently a major epidemic in the Western world
and is projected to be the leading cause of death in the
United States, surpassing tobacco, by the year 2005 [1,2].
Poor diet and physical inactivity, major players in the
obesity epidemic, account for 400,000 deaths (16.6% of
total deaths), compared with 300,000 deaths (14% of total
deaths) a decade ago [1,2].
Despite a national health objective to decrease the
prevalence of obesity in adults to less than 15% of the
population by 2010, overweight and obesity are continuing
to rise among adults and children. Age-adjusted prevalence
of obesity was 30.5% in 1999–2000 compared with 22.9%
in the National Health and Nutrition Examination Survey
(NHANES) III (1988–1994) [3,4]. The prevalence of over-
weight also increased during this period from 55.9% to
64.5%. These increases in the prevalence of overweight and
obesity have been observed to occur in all ethnic and age
groups, with little differences across the sexes. Additionally,
among children and adolescents aged 6 to 19 years, 15%
were found to be overweight and 10% of children between
the ages of 2 and 5 are now overweight [3–5].
Similar to the general population, body weights of
certain groups of athletes have also been creeping upward.
For example, on average collegiate football linemen
weighed 220 lbs in 1963, compared with 331 lbs in 2003
(Skinner R; Personal communication). These changes in
body weight are reflective not only of the changing require-
ments of the various sports, and the impact of body size on
performance, but also demands of other environmental
factors, such as increase in fast food consumption, larger
portion sizes, hectic schedules, and traveling away
for competitions. Heitmann and Garby [6] noted weight
differences within each sex group for the same body
height, which might be reflective of the genetic and
environmental factors determining athlete’s body weight.
In this article, we briefly review the issues related to
body weight of athletes and discuss appropriate weight
management strategies.
Body Mass Index Classification
The measurement most often used to classify body weight
and associated health risk is the body mass index (BMI),
which is a ratio of weight to height. The BMI describes
relative weight for height and is calculated as follows:
Weight ( kg ) -
BMI = ----------------------------------
2
[ Height ( m ) ]
or
Weight ( lbs ) × 703
BMI = -----------------------------------------------
2
[ Height ( in ) ]
Table 1 presents the BMI classification proposed by the
National Institutes of Health clinical guidelines for the
identification, evaluation, and treatment of overweight and
obesity in adults [7••]. For individuals under the age
of 20 years, overweight is defined as a BMI at or above
the 95th percentile of age-specific BMI growth charts [4].
The BMI has been observed to be highly correlated with
body fat, and is a useful parameter to assess risk of chronic
disease in the general public; however, it does not differ-
entiate between fat and muscle tissue, or body shape, and
could contribute to misclassification of certain groups of
individuals, such as athletes [8–10].
 Overweight Athlete: Fact or Fiction? • Jonnalagadda et al.
Table 1. BMI classification
BMI Classification
< 18.5 Underweight
18.5–24.9 Normal weight
25–29.9 Overweight
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30–34.9 Class I obesity
35–39.9 Class II obesity
≥ 40 Class III obesity
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BMI—body mass index.
Overweight and obesity constitute important public
health problems and are associated with numerous
health risks (Table 2) [7••]. Although BMI is an index
of weight for height, it does not quantify total body
adiposity. The existing BMI cutoffs (Table 1) should be
considered as a guide to allow for comparisons of differ-
ent groups and for determining relative risk of under- or
overnutrition and associated disease risk. BMI cutoffs
should be used as guidelines and further assessments
should be performed before categorizing individuals as
fat, especially athletes.
Body Mass Index Classification
of Athletes Body Weight
Using the BMI classifications, some athletes may be
wrongly classified as overweight and/or obese, whereas
in fact the excess weight may be due to increased muscle
mass rather than increased body fat mass. Therefore,
relying on the BMI to classify an athlete’s weight may be
inappropriate under certain conditions. Instead, a body
composition analysis maybe more beneficial in deter-
mining an athlete’s body weight status, given that
increased body fat is associated with risk of certain
chronic diseases as opposed to increased muscle mass
[11••,12,13,14••]. Furthermore, increased muscle mass,
that is, lean body mass, has performance-enhancing
effects, whereas increased body fat has a negative impact
on performance, except under certain conditions, such as
with Sumo wrestlers and football linemen, where block-
ing ability, rather than aerobic capacity and power, are
beneficial in achieving the goals of the sport. Thus, in
athletes, BMI could be useful as an initial assessment of
the athlete’s weight status, especially in sports in which
body image and aesthetics are important to performance,
such as gymnastics and figure skating. Athletes in these
sports, especially women, typically have BMIs in the
range of 20 to 22, which they consider to be overweight,
which is an unhealthy attitude [15]. Thus, determination
of BMI, along with body composition assessment, under
these circumstances can help dissuade unrealistic body
weight expectations and body weight classifications can
be discouraged.
199
Body Weight of Athletes
The body weight of athletes is a function of their genetics,
diet, lifestyle, training, and sport. The body weight of
athletes also reflects the structural, functional, training, and
performance requirements of their sport. Training efficiency
of athletes also determines their body weight and composi-
tion. Brownell et al. [16] suggest that there are three major
patterns for body weight and body fatness based on the
different sports. These include 1) sports based on skill rather
than physical fitness, such as golf, archery, bowling; athletes
in these sports may be overweight, which can have little
impact on their performance because it is mainly based on
their precision and skill of execution; 2) sports with specific
weight divisions for competition, such as weight lifting,
wrestling, and boxing; in these sports, overall body weight
is emphasized for performance as opposed to a distinction
between body fat and lean mass; and 3) sports in which low
body fatness is considered optimal for performance, such as
running, cycling, gymnastics, diving, and figure skating; in
these sports there is a strong positive association between
increased performance and increased lean mass. For some of
these sports, there are specific performance categories based
on body weight, but there are no sport-specific body fat and
lean body mass recommendations.
When discussing body weight of athletes it is important
to distinguish between muscle (lean) mass and fat mass,
because most athletes would benefit from greater lean
mass rather than body fat mass, with a few exceptions
(such as Sumo wrestlers and football players in certain
positions) [17,18]. An athlete’s body weight is defined
by his or her sport, position in the sport, dietary and
lifestyle practices, age, sex, and genetics. In certain weight-
specific sports, such as wrestling, athletes may have certain
body weight goals to meet the requirements for participa-
tion in the sport, and any body weight in excess of this goal
may result in classification of the athlete as overweight,
regardless of whether he is truly overweight, that is, excess
body fat and/or BMI greater than or equal to 25. Similarly,
among masters Olympic weight lifters, sex, height, and
body mass are important determinants of performance;
however, their relative contribution varies and is depen-
dent on the weight class [19]. Other groups of athletes,
who are typically considered overweight because of the
requirements of the sport and not necessarily due to excess
body fat, include football players (certain positions), judo
players, wrestlers, and weight lifters [20]. Another group of
athletes that are plagued with body weight issues are those
with disabilities, and their weight issues are related both to
the disability and genetic factors of these athletes. Harris
et al. [21] observed among US Special Olympic athletes,
the risk of being overweight was significantly higher
compared with athletes from other countries, with adult
athletes from the United States being 3.1 times more likely
to be overweight or obese compared with their counter-
parts from other countries [18,19].
 200 Nutrition
Table 2. Health risks of overweight and obesity
Insulin resistance
Metabolic syndrome
Diabetes
Heart disease
Stroke
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High blood pressure
Gallbladder disease
Osteoarthritis
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Sleep apnea and other breathing problems
Uterine, breast, colorectal, kidney, and gallbladder cancers
Weight divisions among certain sports, such as
wrestling and boxing, attempt to match athletes of similar
size and strength [22]. Typically, athletes competing in
these sports strive to compete in weight divisions that
are lower than their ideal weight and thus may consider
themselves as overweight and take part in quick weight-
loss regimens to qualify in a lower weight category. Weight
loss under these conditions is achieved by drastic means,
such as dehydration, food intake restrictions, increased
sweating through use of rubber suits, saunas, increased
exercise, and use of diuretics and laxatives. Typically,
in these sports, weigh-ins are held about 2 hours before
competition, which leaves little time for the athlete to
rehydrate and refuel. Therefore, for these weight class
sports it is important for both athletes and coaches to
define weight classes that are more realistic and appro-
priate for the athletes’ existing body weight status.
Weight loss should be achieved by safe, long-term weight
loss techniques rather than the aforementioned quick,
short-term techniques.
Athletic children with a low ratio of body fat to lean
body mass may exceed the recommended weight range
without having excess body fat. It is possible for these
children with low body fat to be misclassified as over-
weight when age-specific height and weigh reference data
are used. Richardson et al. [23] observed that based on
the National Center for Health Statistics weight for age
guidelines, 35% of girl and 37% of boy swimmers were
classified as overweight, whereas based on weight for
height, 22% of girls and 24% of boys were classified as
overweight. Based on BMI, 22% of girls and 27% of boys
were classified as overweight. However, the percent body
fat of these girls was 23% and for boys was 20%, and only
13% of girls and 29% of boys were classified as overweight
based on their body fat. Overall, based on weight for
age and body fat, 24% of girls and 13% of boys were
classified as overweight, but not over fat, whereas based on
weight for height and body fat, 11% of girls and 2% of
boys were classified as overweight but not over fat. Thus,
caution should be exercised when using height-weight
tables to interpret the status of these young athletes.
Misclassification of weight status of children participating
in competitive sports is a concern, because it can result in
preoccupation with body weight, restrictive food intake
behaviors, and eating disorders [16].
Body type of athletes may also sometimes lead to mis-
classification of athletes as overweight, especially among
athletes in aesthetic sports [15,16]. For example, size of
thighs and hips among female gymnasts and figure skaters
may be used to judge their body weight; however, in these
athletes who are typically underweight, energy restrictions
to achieve changes in body dimensions, especially of the
thighs and hips, can result in adverse consequences such
as increased risk of injury and nutritional deficiencies
[15,16]. Therefore, it is extremely important to understand
the body weight requirements of the sport and body
composition make up of the athletes, and the expectations
of the athletes and their coaches, in order to be able to
assist them in achieving the appropriate body weight
through safe techniques.
In addition to collegiate and competitive elite athletes,
body weight of varsity athletes and students participating in
school sports is also a concern given the rising epidemic
among school-aged children. Interestingly, Elkins et al. [24]
observed inner city black school-age boys who participated
in athletics and school-sponsored activities to be more
overweigh t t han boys who did n ot (31% vs 26 %;
P < 0.001), whereas among girls the participation in athlet-
ics was associated with a lower prevalence of overweight
(29% vs 36%; P < 0.001). Forty-three percent of football
players were overweight, experiencing a fivefold increase
in risk of being overweight, and the unadjusted relative
risk of obesity was twice that of non-football players.
In contrast, the risk of overweight and obesity was lower for
boys and girls who played basketball and participated in
track and field events. Girls’ participation in volleyball
and tennis was also not associated with a significantly
lower risk for overweight or obesity, whereas cheerleading
was. Self-selection of heavier players into football, which
requires knocking opponents down, may encourage boys to
maintain a higher BMI as a playing advantage. The risk of
overweight was observed to decrease with participation in
two or more sports among these adolescents, suggesting
that cross training may be important to decrease risk of
overweight and obesity among susceptible athletes.
Body Size, Body Weight, and
Body Composition of Athletes
Physique and body composition requirements differ from
sport to sport. For example, jockeys try to maintain low
body weights, whereas athletes in sports such as wrestling
may require higher body weight to attain target perform-
ance levels. Optimal body composition and body weight
is an important requirement for athletic performance.
Appropriate body composition is a concern of the wrestler
because competitors are matched by body weight and
size and athletes must “make weight” prior to each meet
[18]. The majority of wrestlers attempt to maximize their
 Overweight Athlete: Fact or Fiction? • Jonnalagadda et al.
amount of lean tissue and minimize body fat and total
body weight. Weight categories range from light (54 kg)
to super heavy (130 kg). Wrestlers typically have meso-
morphic characters, that is, very high muscularity, low
linearity, and low fat, with usually less than 10% body fat
(range 3%–13%). Wrestlers may try to bulk up to a higher
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weight class and could be strong per kg body weight.
During training and competition wrestlers are very lean
probably because of year-round training and/or their
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genetic make up. However, during the off-season their
percent body fat can range from 8% to 16%, suggesting
that a decrease in physical activity even among these highly
trained individuals can result in an increase in body weight
and a change in body composition [18].
On the other hand, Sumo wrestlers have extremely
large body size, because the most important factor for
winning in this sport is the wrestler’s body mass and the
velocity produced by his charge [25]. Therefore, higher
mass and velocity, through increased fat-free mass, is more
advantageous to the Sumo wrestler than just increased
body mass. Sumo wrestlers appear to be morbidly obese,
but studies suggest that they have a great amount of fat-free
mass, commonly considered as the upper limit for most
humans. Hattori et al. [25] observed Sumo wrestlers to
be heavier compared with untrained controls, with BMI
of 36.5 versus 21.5, and percent body fat of 26.2% versus
15.9% (P < 0.01). However, given their body size, these
wrestlers were observed to have higher fat-free mass (85 kg
vs 53 kg; P < 0.01). Similarly, Kinoshita et al. [26] observed
professional Sumo wrestlers to be young (22 y), tall
(179 cm), and quite heavy (118 kg), with a BMI of 36.6,
percent body fat of 29.6%, and fat-free mass of 81.9 kg.
Additionally, Saito et al. [20] observed Sumo wrestlers
of similar weight (111 kg) and BMI (35) compared with
sedentary controls, to have significantly lower percent
body fat (24.1% vs 31.4%; P < 0.01), lower total body
fat (28 kg vs 35 kg; P < 0.05) and higher fat-free body
mass (83 kg vs 76 kg; P < 0.01). Thus, although the Sumo
wrestlers were bigger than their untrained counterparts and
based on their BMI are considered morbidly obese, studies
show that they have higher fat-free mass. Thus, Sumo
wrestlers, despite their large stature, are more muscular
than their untrained counterparts. These athletes attempt
to gain weight by increasing their dietary intake in addition
to muscular training, because the development of muscle
mass is essential not only for their performance but
also for their promotion to a higher league in their sport.
However, in these individuals left ventricular end-diastolic
dimensions were observed to be greater than or equal to
60 mm (normal ≤ 54 mm) in 41% of these wrestlers, and
was significantly correlated with their height, weight, body
surface area, fat-free mass, and fat mass [26–28]. This is
suggestive of idiopathic dilated cardiomyopathy, and these
wrestlers, despite the benefits of their athletic training
and performance, need to pay greater attention to the
condition of their cardiovascular system secondary to their
201
body weight status [26–28]. In these highly trained, large
athletes the increase in left ventricular dimensions may
also be reflective of the adaptation of the athletes heart
to the large body size, and the long-term impact of this
adaptation is unknown at the present time. Additionally,
because of their increased body weight, these Sumo
wrestlers may be more prone to obesity-related diseases
(Table 2) during their postcompetition years, and weight-
related injuries compared with other athletic groups
and the general population, resulting in a life expectancy
10 years shorter than in the general population [20].
Furthermore, marked differences were observed in the
distribution of body fat, with it being concentrated in the
trunk in controls versus extremities in Sumo wrestlers,
increasing their risk of injury and associated health prob-
lems. Therefore, in order to prevent excessive weight gain,
weight classifications have been adopted to assist these
wrestlers in controlling their weight.
Another group of athletes who are often misclassified as
overweight are judo players. Whyte et al. [29] observed
male and female judo players to have BMI of 24.6 and 23.8,
respectively, which was not significantly different from
controls (24.1 and 22.4, respectively). However, percent
body fat of male (6.8%) and female (15.7%) judo players
was significantly lower than their control counterparts
(13.8% and 25.2%; P < 0.05) and fat-free mass was
significantly higher (69.9 kg and 52.2 kg vs 65.1 kg and
44.8 kg; P < 0.05). Similar to the Sumo wrestlers, left ventric-
ular wall thickness was significantly larger in the judo player
compared with sex-matched controls, even after normaliza-
tion of body size. This increase in wall thickness might be
associated with the highly resistive nature of the training
and the body endurance contribution of the sport, similar to
that observed in other power and strength trained athletes.
Likewise, Degoutte et al. [30] observed male judo players
to have a body weight of 75 kg, BMI of 24, percent body
fat of 16%, and fat-free mass of 63 kg. These individuals
had normal blood lipids, with total cholesterol (TC) of
171 mg/dL, triacylglycerol (TAG) of 76 mg/dL, low-density
lipoprotein cholesterol (LDL-C) of 110 mg/dL, and high-
density lipoprotein cholesterol (HDL-C) of 47 mg/dL.
In these athletes mean energy intake (13.4 MJ) equaled
energy expenditure (13.9 MJ), and protein, fat, and carbo-
hydrate contributed 15%, 33%, and 51% of total energy
intake. Similarly, Andreoli et al. [31] observed soccer, judo,
and water polo players with BMI of 23.4, 25.6, and 24.2
compared with BMI of 25.9 in controls. Likewise percent
body fat was 15%, 17.4%, and 18.1% versus 21.8%,
respectively. The higher percent body fat in the judo
and water polo athletes maybe attributed to the lower
aerobic activity of the judo athletes and the requirement
for buoyancy in water polo. All of these athletes had higher
body cell mass, indicative of higher oxygen exchange,
glucose-oxidizing work performing cells, compared with
controls. Thus, although misclassification of these athletes
as overweight is most likely to occur, their dietary intake
 202 Nutrition
and physiologic parameters are indicative of a protective
effect of their athletic participation regardless of their body
weight categorization.
Watts et al. [32] observed youth rock climbers to be
significantly smaller and lighter than athletic controls,
which might help minimize the work required for
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movement along the climbing route. In these climbers the
mean BMI was 18.6, which was not different from the
controls; however, significant differences were observed
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in percent body fat, with climbers having lower values
(7.8% vs 11.3%). These climbers appeared to be heavier
in lean body mass and lower in body fat mass, suggesting
that the BMI scores are inappropriate for screening subjects
with extreme reductions in body weight and body fat.
Likewise, Hassapidou et al. [33,34] observed BMI of Greek
basketball players to vary from 21.4 to 26.7; however,
their mean percent body fat was observed to be 10.7%.
Whereas Clark et al. [35] observed the BMI of female soccer
players to be 22.5, and their percent body fat was 16.2%,
well below the normal values in the general female popu-
lation, Moreno et al. [36] did not observe any significant
difference in the BMI of young soccer players compared
with their sedentary counterparts; however, percent body
fat was significantly lower in soccer players at 9, 11, 12,
and 14 years of age. These data further highlight the
importance of assessing body weight, BMI, and body fat of
athletes to determine their weight status.
Body Weight Changes
Body weight changes of athletes are determined by total
energy intake, dietary fat intake, level of physical activity,
competition, and training schedule, all of which are
important for successful control and maintenance of body
weight. Aging is characterized by gradual changes in body
composition, including increase in body fat and decrease
in fat-free mass, most likely due to sedentary lifestyles
and increased food intake [37,38]. Pihl and Jurimae [37]
examined the weight-change patterns of former male
athletes during the postcompetitive period. Athletes who
were physically inactive postcompetition gained on the
average 10.2 kg compared with athletes who maintained
regular physical activity (2.1 kg). Systolic blood pressure
(SBP) was significantly higher in those who gained over
10 kg compared with those who maintained their weight
(141 vs 125 mm Hg). Likewise, LDL-C and TAG concentra-
tions were significantly higher among the weight gainers
compared with weight maintainers (139 vs 122 mg/dL
and 143 vs 89 mg/dL), whereas HDL-C levels decreased
(44 vs 58 mg/dL). Compared with weight maintainers,
weight gainers had higher odds ratios for hypertension
(OR = 6.65, 95% CI 2.99–11.65), abdominal fat distribu-
tion (OR 10.51, 95% CI 6.11–16.24), elevated LDL-C
(OR 1.88, 95% CI 1.15–3.06), and TAG (OR 3.52, 95% CI
1.12–8.56). Likewise, Wiswell et al. [39] reported masters
athletes (runners) to experience significant increase in
body weight (74.5 kg vs 75.5 kg), BMI (23.8 vs 24.4), and
percent body fat (18.1% vs 19.1%) over 4.6 years, whereas
significant reductions were observed in VO2 peak capacity.
These results suggest that physical activity is essential for
the prevention of weight gain even among previously
active and competitive individuals.
With the increasing promotion of physical activity
for health, an increase in the number of older individuals
participating in regular physical activity for recreational and
competitive purposes has occurred. This has led to the estab-
lishment of a masters component to many of the popular
sports, along with national and international competitions.
Thus, it would be prudent to develop appropriate age-, sex-,
and sport-specific weight and body composition guidelines
and recommendations, and to monitor body weight and
performance levels of these individuals.
Body Weight Regulations and Management
The National Collegiate Athletic Association (NCAA) and
other governing bodies have instituted new rules that include
establishment of new weight classes and weight class certifi-
cation processes and reduce the time between weigh-in and
actual competition for athletes competing in weight-specific
sports such as wrestling [40]. Traditional dehydration tech-
niques, such as saunas and vapor-impermeable suits, were
also banned. Scott et al. [41] observed that these new rule
changes were effective in reducing rapid weight gain to only
0.66 kg during the 1999 NCAA championships. US wrestling
also instituted rules on weight management, banning rapid
weight loss practices. Freestyle and Greco-Roman wrestlers
were observed to gain an average of 3.4 kg, which represents
a 4.81% gain of body weight [22]. Wrestlers in the middle-
weight classes (103.5–167 lbs for cadets and 114.5–191.5 lbs
for juniors) gained more weight than wrestlers competing
in the lower (83.5–94.5 lbs for cadets and 98–105.5 lbs for
juniors) or higher weight classes (182.5–242 lbs for cadets
and 220–275 lbs for juniors). Over the course of their
careers, wrestlers achieved an average weight loss of 5.27 kg
and gained an average of 4.83 kg after completing the
wrestling season. To achieve loss, despite being banned,
these athletes commonly used running, saunas, exercising in
vapor-impermeable suits, swimming, cycling, and laxatives.
In order to control these various practices of “making-
weight,” minimum weight programs have been imple-
mented to regulate weight practices of these athletes and it is
important to emphasize body composition (lean body
mass) rather than body weight.
Athletes returning from an injury and from a break in
training may be at risk of experiencing increased body
weight and these individuals would need to be educated
about proper weight management techniques. Kaplan [42]
observed a high school football player who missed spring
practice due to shoulder injury to have gained a significant
amount of weight, to have a percent body fat of 36%, and
to be severely obese, with both height and weight above
 Overweight Athlete: Fact or Fiction? • Jonnalagadda et al. 203

Table 3. Working with athletes to achieve weight loss and maintain healthy weight
Initial assessment
Assess the need to lose weight and/or body fat
Measure weight, height, body fat, lean body mass
Obtain a history of weight patterns
Obtain history of previous weight loss attempts, purpose, and strategies
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Establish weight loss goals in the context of athlete’s history, sport requirements, and current weight and body composition
Establish realistic weight and fat loss goals
Weight loss no greater than 0.5–1 kg/wk and for body fat a maximum of 5 mm/wk
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Dietary and energy assessment

Collect information about eating patterns during training, competition, and off-season
Dietary history and food frequency checklist
Determine total energy and nutrient intake
Determine strategies used when eating away from home and traveling for competition, cooking skills, comfort or stress eating,
fluid and alcohol consumption, dietary supplements, and ergogenic aids usage
Determine resting metabolic rate and total energy expenditure (measured or predicted) for more accurate assessment
of energy needs
Men ≥ 19 y, the EER can be determined using the following equation
EER = 662 – 9.53 × age (y) + PA × [15.91 × weight (kg) + 539.6 × height (m)]*
Women ≥ 19 y, the EER can be determined using the following equation
EER = 354 – 6.91 × age (y) + PA × [9.36 × weight (kg) + 726 × height (m)]*
Dietary strategies for weight loss
Low-fat, moderately energy restricted diet to produce a weight loss of 0.5–2 lbs/wk
Subtract 250 cal/d = 0.5-lb weight loss/wk
Subtract 500 cal/d = 1-lb weight loss/wk
Subtract 750 cal/d = 1.5-lb weight loss/wk
Subtract 1000 cal/d = 2-lb weight loss/wk
Diets providing less than 1500 kcal/d should be avoided
Determine appropriate macronutrient distribution to prevent nutritional deficiencies
Carbohydrates: 4–10 g/kg body weight
Protein: 1.2–1.4 g/kg body weight for endurance athletes; 1.6–1.7g/kg body weight for strength athletes
Fat: 20%–30% total energy
Adequate protein intake at main meals and snacks should be ensured
Small, frequent meals and reduced portion sizes of foods consumed
Training and physical activity levels may need to be increased to increase energy expenditure and promote weight and fat loss
Follow-up and monitor weight changes on a weekly basis

EER—estimated energy requirements; PA—physical activity.

*Sedentary, PA = 1; Low active, PA = 1.11; Active, PA = 1.25; Very active, PA = 1.48. Subtract 10 kcal/d for men and 7 kcal/d for women for each
year above 30 y).
(Equations from the Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids
[macronutrients] [46].)

the 95th percentile for age (BMI = 41). This individual
had poor aerobic fitness, experienced exercised-induced
bronchospasms, and dyslipoproteinemia, which lead to
disqualification from participation in the sport due to
health risks associated with his body weight. However, by
disqualifying this athlete, he could potentially have been
put at increased risk of obesity-related disorders, because
physical inactivity can result in further weight gain. Thus,
when making decisions about an athlete’s body weight and
eligibility to participate in a sport based on his or her
body weight, it is important to thoroughly evaluate the
individual’s circumstances and intervene appropriately.
Certain overweight and obese athletes could be at
increased risk of musculoskeletal injury due to biomechan-
ical inefficiency or other factors. Football linemen may
believe that being heavier is better without regard for
whether the added tissue is fat or lean, and other athletes
may see it as a means to compete without having to
deal with their weight problem. High prevalence (14%)
of osteoarthritis of the joints, knees, and spine of football
players has been reported [43]. Shepard et al. [43] also
observed a high prevalence (13%) of osteoarthritis of the
hip among former football players, with higher odds of
osteoarthritis among former players compared with
controls. This could be attributed to the injuries experienced
during their competitive playing careers and also weight
status of the athletes. Obese athletes could also potentially
be at risk for dehydration, hyperthermia, and heat illnesses,
and therefore appropriate weight management is required.
Obese individuals have also been observed to have lower
fitness levels, with submaximal exercise requiring larger
peak VO2 (L/min) indicative of increased oxygen consump-
tion attributed to their larger body size [44]. Thus, during
their active athletic careers, and postcompetition, athletes
 204 Nutrition
should be continuously counseled about appropriate weight
management techniques.
Guidelines for Lowering
Body Weight and Body Fat
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Like the rest of the general population, athletes who
desire weight loss and body fat loss can do so by decreasing
energy intake, and increasing energy expenditure via aerobic
CX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8KKGKV0Ymy+78= on 03/18/2023
exercise [45•,46,47]. Safe weight loss goals (0.5–2 lbs/wk)
need to be established on an individual basis in consulta-
tion with the athlete, coaches, and trainers [45•,46,47].
Adequate dietary intake should be maintained and
nutritional deficiency due to elimination of specific foods
should be avoided. Athletes should ensure moderate
carbohydrate and protein intakes combined with low-fat
food choices. Dietary intake of athletes should include
food choices from all major food groups and adequate
fluid consumption. Table 3 provides guidelines for working
with athletes to achieve appropriate body weight and
body composition.
Conclusions
Body weight and body composition of athletes have a
significant impact on their athletic performance. Maintain-
ing appropriate weight status and body composition
among athletes is also important to prevent short- and
long-term health risks associated with under- or overnutri-
tion. Weight management should be an integral compo-
nent of athletes training schedule. Realistic weight goals
that are appropriate for the athlete’s body size, shape, and
sport should be set. Athletes, coaches, and trainers should
work closely with individuals who have training in nutri-
tion (registered dietitians) to set appropriate weight goals
and to develop weight-management protocols.
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