Competitive Eating: How Safe Is It?

As eating contests become more popular, some experts are concerned about the risks.

From the WebMD Archives

Eating contests used to be strictly county-fair stuff. Now, they're becoming a serious sport.

This summer, Joey Chestnut ingested a record 66 hot dogs in 12 minutes at the Super Bowl of competitive eating, the Nathan's Hot Dog Eating Contest. Sixty-six is just a number, until you make a comparison: How many hot dogs do you think you could down in 12 minutes? Maybe five? Six?

An estimated 50,000 people were in attendance at Coney Island to watch Chestnut stuff his face. Many more watched on ESPN, which began televising the competitions in 2004.

"When I started doing these contests, there were maybe fifty to a hundred people watching," Chestnut tells WebMD. Chestnut has only been competing for two years. "Now," he says, "there are tons of people, whether it's a small or big venue. People are asking me for autographs."

As the size of the audience for competitive eating has grown, so has the prize money. Chestnut won $10,000 along with his Yellow Belt at the Nathan's contest.

The level of competition has also been kicked up a notch. The Nathan's competition dates to 1916, but back in 2000 the record was a measly 25 dogs. This year, all 10 of the top finishers beat that mark.

Chestnut -- ranked No. 1 in the world by the International Federation of Competitive Eating -- attributes his accomplishments to hard work, not gluttony. But many doctors worry that competitive eating can have dangerous consequences. And some dietitians worry that the sport sends the wrong message at a time when obesity is growing to epidemic proportions.

Secrets of Competitive Eating

Chestnut, 23, a project engineer from San Jose, Calif., says his success results from intensive training. "I slowly make my body adapt to my goal," he says, comparing himself to a bodybuilder or a marathoner.

Chestnut trains about once a week, eating mass quantities of whatever food he's expected to consume for the next eating contest. What kinds of foods? The list includes hamburgers, hot wings, oysters, deep-fried asparagus, key lime pie, chicken wings, cheesecake, and lobster.

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Chestnut also practices by drinking up to a gallon of milk in a single sitting, which he says trains his stomach to expand.

Chestnut says he prepares carefully for practice and competition. In the days before a competition, he stops eating solid foods and limits his diet to protein supplements.

"Psychologically, I like to go in hungry," he says. "If I see on the scale that I have dropped weight, I can easily imagine an enormous amount of food inside me."

For a day or two after most competitions or practices, Chestnut admits that he "doesn't feel so good." He goes back on the protein supplement diet as his stomach empties out, he says.

At 6 feet 1 inch tall, the large-framed Chestnut weighs about 220 pounds, though he came in at 207 before this year's hot dog contest. "I control my calorie intake pretty rigorously," he says, and he also runs to keep his weight down.

How does Chestnut win eating contests? Like most competitive eaters, Chestnut drinks lots of water during the contest and dunks his food in water, which he believes helps the food settle at the bottom of his stomach. He moves around as he eats, which also helps the food settle. And he also attributes his success to good pacing.

Think competitive eating is just mindless gluttony? Don't tell Hall Hunt, a 25-year-old structural engineer currently ranked ninth in the world. Known for his "academic approach" to eating, Hunt tells WebMD that he carefully studies each food to maximize edibility. He studies food density to "maximize the amount of food that can go down with each contraction of the esophagus." And he studies which liquids are best at breaking down which foods. (Want to cut through the grease on those cheese fries, for example? Try lemonade.)

To keep his weight manageable, Hunt practices mostly by loading up on veggies. If he practiced only on high-calorie foods, he says, "I'd weigh 400 pounds." Actually, he weighs 175 pounds and is 6 feet 1 inch tall.

"My favorite things to do are eat, travel, and compete," Hunt says. "This sport combines all of those things."

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Are Eating Contests Dangerous?

Top competitive eaters may train intensively, but that all goes on behind the scenes. What the average fan sees is a bunch of competitors getting egged on as they stuff their faces with food. And that's why the growth of competitive eating as a sport worries many dietitians.

"Knowing how many people don't have adequate nutrition, and how many people abuse food and overeat constantly, seeing competitive eating celebrated on TV disturbs me," nutritionist Milton Stokes tells WebMD.

Stokes, a spokesman for the American Dietetic Association, says competitive eating can "send a message to spectators that going hog wild with food is not a big deal."

Doctors also worry that competitive eating can be downright dangerous. For example, binge eating could cause stomach perforations in people with undiagnosed ulcers, says Shanthi Sitaraman, MD, PhD, a gastroenterologist at Emory University School of Medicine in Atlanta.

For those competitive eaters who train by gulping huge quantities of water, water intoxication is also a concern. Water intoxication is a deadly syndrome that results from dilution of electrolytes in the blood. But Sitaraman says water intoxication is rarely a risk in people who are not already losing electrolytes, for example through long-distance running.

If competitors are vomiting regularly, that could cause problems, Sitaraman says. Protracted vomiting can increase the chances of aspiration, or food getting into the lungs rather than the esophagus. This can lead to deadly pneumonia. But competitive eaters say vomiting at competitions is rare.

Sitaraman was surprised when, doing a search of the medical literature of the past several years, she found no reported complications from competitive eating, short of a single case of a jaw fracture. "Maybe [competitive eaters'] gastrointestinal tract has adapted and acclimatized to eat those calories," she speculates.

What Does Competitive Eating Do to the Body?

Competitive eating is a little-studied phenomenon. So David Metz, MD, a gastroenterologist at the University of Pennsylvania, was thrilled when competitive eater Tim Janus offered himself as a guinea pig for study. Metz hopes that by studying people who seem to never get full, he can have a better understanding of the opposite phenomenon -- indigestion.

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Metz studied how Janus's stomach handled huge amounts of food. In normal individuals, he tells WebMD, a full stomach sends a message via the vagus nerve to the brain, which then orders the stomach to contract and send food into the small intestine. Competitive eaters somehow block that signal even as their stomach stretches to enormous proportions. Otherwise, their digestion processes appear normal, he says.

Metz suspects that competitive eaters may have some natural ability to stretch their stomachs and may also be able to train the muscles in the stomach wall. To know more, he says, he'll have to study an eater over the course of a career. But Metz does know enough to be concerned about some potential long-term effects of competitive eating. "If you don't get that stretched feeling, that full feeling, and you don't tell your brain to switch off, then you're at risk of obesity," he says.

Another serious risk, Metz says, is gastroparesis, or stomach paralysis. If the stomach muscles are repeatedly overstretched, they may ultimately fail to contract, and the stomach will lose its ability to empty itself. Usually associated with diabetes, gastroparesis can cause chronic indigestion, nausea, and vomiting. It has no effective cure, Metz says.

Metz is impressed with top eaters' discipline and natural abilities. But for the general public, he has a message: "People shouldn't try this at home."

WebMD Feature Reviewed by Louise Chang, MD on August 22, 2007

Sources

SOURCES: David Metz, MD, professor of medicine, division of gastroenterology, University of Pennsylvania. Joey Chestnut, San Jose, Calif. Hal Hunt, Jacksonville, Fla. Milton Stokes, nutritionist, Stamford, Conn.; spokesman, American Dietetic Association. Shanthi Sitaraman, MD, PhD, associate professor of medicine, Emory University School of Medicine.

© 2007 WebMD, Inc. All rights reserved.

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