Competitive speed eaters risk long-term health consequences

While speed eaters have adapted their physiology to ingest enormous quantities of food in a short period, they are at risk of developing severe complications later in life, according to researchers at the Hospital of the University of Pennsylvania.

Investigators recommend that the International Federation of Competitive Eating prioritize follow-up of athletes and former athletes to fully assess the long-term risks of competitive speed eating. The study appears in the September issue of the American Journal of Roentgenology.

Dr. Marc S. Levine, chief of gastrointestinal imaging, and colleagues assessed a 29-year-old competitive male speed eater, ranked as one of the top 10 competitive speed eaters in the world. The subject stood at 5 feet, 10 inches and weighed 165 pounds. Researchers also assessed a 35-year-old, 6-foot-tall, 210-pound male control subject whom they described as having a hearty appetite.

Both subjects underwent water load tests and exhibited higher than normal capacities, but the competitive speed eater outperformed the control subject by a large enough margin that the tests were terminated early.

Investigators theorized that the competitive speed eater's physiology worked in one of two ways to handle its high capacity: either he could sequester larger volumes of ingested fluid in his stomach or he could empty his stomach more quickly than the control subject.

Solid-phase nuclear gastric emptying scanning revealed that the professional speed eater had emptied only 25% of the radioactive meal at two hours, whereas the control subject had emptied 75% (the normal rate at Penn at two hours is >50%).

While Levine and colleagues acknowledged the difficulty of extrapolating from a sample size of one, they suggested that competitive speed eaters have the ability to accommodate more food without feeling sated, rather than relying on rapid gastric emptying.

The eating "contest" came next. Subjects ate as many bun-less hot dogs as they could in 12 minutes while sitting semiupright on a fluoroscopy table. The control stopped eating after seven hot dogs, indicating an uncomfortable sensation of fullness.

The speed eater ultimately ate 36 hot dogs, two at a time, in 10 minutes, whereupon researchers, fearing gastric perforation, terminated the test over the subject's objections.

"It was truly remarkable how quickly he downed each pair of hot dogs without any noticeable letup during the test," the authors wrote.

Fluoroscopy revealed the competitor's stomach to be a massively distended, food-filled sac occupying most of the upper abdomen, with little or no gastric peristalsis and emptying of a small amount of barium into the duodenum.

Results confirm those of the water load test: that the speed eater's stomach is capable of expanding to accommodate the rapid ingestion of an enormous quantity of food. The speed eater indicated that he doesn't eat for several days after competitions, whereupon his stomach will become flat again.

The speed eater told investigators that he spent several years training for the sport, forcing himself to consume larger and larger amounts of food despite the sensation of fullness and satiety. Consequently, he is no longer capable of experiencing the usual sensation of fullness and satiety after meals.

So how does he stay slim and trim? He carefully monitors his food intake between competitions. He takes measured portions of food without refilling his plate despite the fact that he never feels full or sated.

"He therefore exercised extraordinary self-discipline and willpower to avoid becoming overweight in a setting ripe for gaining weight," the authors wrote.

Researchers speculated that aging speed eaters could lose their willpower to control eating, leading to chronic binge eating because they never feel sated. Such a scenario could lead morbid obesity.

Furthermore, their stomachs could lose the ability to shrink to their original size and become incapable of digesting or emptying solid food. They could then develop intractable nausea and vomiting, necessitating a partial or total gastrectomy to relieve their symptoms and restore their ability to eat.

Investigators called speed eating "a potentially self-destructive form of behavior" and called for further study of these athletes to determine the lifelong risks of speed eating.