Too many hot dogs take home top prize but lose peristalsis

Competitive speed eating is an activity that has grown in worldwide stature within the last several years. Researchers at the Hospital of the University of Pennsylvania, however, have sounded a clarion call for rigorous long-term study of competitors to gauge risks that may occur as these athletes age and stop competing.

"I'm not sure what the reaction will be of the International Federation of Competitive Eating," said lead author of a new study Dr. Marc Levine, admitting the difficulty of drawing conclusions from a sample size of one. "We certainly hope that the IFOCE will see this as an early warning sign and consider monitoring the long-term health of present and past competitors to get a better handle on the risks of this sport."

The IFOCE website states that safety is its first consideration, that eating matches should take place in a controlled environment and only among those 18 years or older. It also states that one should not try speed eating at home. Officials at the federation declined to comment.

Levine and colleagues assessed a 29-year-old competitive male speed eater, ranked internationally in the top 10, along with a 35-year-old male control subject whom they described as having a hearty appetite (AJR 2007;189:681-686).

First the speed eater outdrank the control and then he ate 36 hotdogs in 10 minutes, stopping only when researchers feared gastric perforation, while the control could muster only seven hot dogs. 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.

The speed eater said he spent years training, forcing himself to consume larger and larger amounts of food despite the sensation of fullness and satiety. Consequently, he now is incapable of experiencing the usual sensation of fullness and satiety after meals. So how does he maintain his 165-pound frame? He carefully monitors his food intake, measuring portions without refilling his plate despite the fact that he never feels full or sated.

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 to morbid obesity. Additionally, 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.

Ideally, investigators would like to do similar testing on a series of competitive speed eaters to determine if these preliminary observations are reproducible in a larger sample size. The prospects of that happening are slim. The logistics of arranging for even a single professional eater to come to Philadelphia were surprisingly complex, according to Levine, chief of gastrointestinal imaging at HUP.

Dr. Yong Ho Auh, chief of the division of abdominal imaging at Weill Cornell Medical College, said the research is interesting but too weak as scientific material. Nevertheless, with tongue in cheek, he forwarded the study to his son.

"My son is a speed eater," he said. "I always scold him not to eat fast. Maybe this will help him have more concern about his habit."