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NJSACB considering weigh-in changes ahead of ABC meeting

Ahead of the Association of Boxing Commissions conference on August 1st, the NJSACB is taking comments from NJ medical professionals on potential improvements to weigh-in procedures. Iain Kidd and George Lockhart discuss some potential changes below.

A letter was sent by New Jersey State Athletic Control Board commissioner Larry Hazzard Sr. to NJSACB ringside physicians and NJ hospital.university based neurologists and neurosurgeons  for comment on proposals to potentially change the how weigh-ins are handled in mixed martial arts contests. Three of the proposals mentioned in the letter are same-day weigh-ins, as recently instituted for amateur and pro-am cards in Ohio, earlier weigh-ins, such as the 30 hour weigh-ins adopted by California, Kansas and recently Nevada for UFC 200, or even weigh-ins 72 hours before fight time, as is being investigated by the California State Athletic Commission. It should be noted that other proposals suggested by the consulted medical professionals will also be considered, and the options are by no means limited to the examples given.

NJSACB Counsel Nick Lembo said:

"The intent to the letter is to gather independent responses from agency medical staff and prominent NJ neuro related physicians. At that point, we'd like to bring these medical experts together at a symposium to form our agency's response to this issue at hand. At that point, we hope to have a proposal to present to the industry and will allow input and a comment period from the many established fight camps based in NJ and the surrounding metropolitan area. Our concern is that commissions do not seem to be working together to find a unified response to these issues: and a response that is based on detailed input from many medical experts. We see this as a medical issue first and foremost, not a governmental administrative matter."

New Jersey is typically, and rightly seen as the most competent athletic commission in the country, and this kind of wide ranging consultation ahead of any decision being made reinforces that. New Jersey is also a commission which has a history of setting standards which are adopted country-wide. Remember, the unified rules of MMA we use today were agreed upon and adopted at an NJSACB meeting.

For those who don't know, I'm currently writing a book on weight cutting with George Lockhart, who handles the cuts of Conor McGregor, Robbie Lawler and dozens of other elite athletes. As a result, I have spent a significant amount of time-hundreds of hours-studying the science behind weight cutting and hydration: everything from hormonal responses, like the renin-angiotensin-aldosterone system, to the roles of specific kidney enzymes.

I've read up on every biological system in the body that has an effect on, or is affected by weight cutting. I've examined scores of studies on every relevant topic; cell osmolarity, potassium-sodium balances, hypotonic v. isotonic rehydration protocols, temperature regulation, plasma osmolarity and dozens of other areas, all the way down to the effects of different hydration levels on brain ventricles and the associated change in pressure caused by cerebral spinal fluid.

The NJSACB call for information isn't solely about the timing of weigh ins, but as more commissions look into this issue you will likely see most people focus on that aspect. You'll see some people argue with vehemence that same day weigh-ins are the best way to counter dangerous weight cutting, and others will argue with the same vigor for earlier weigh ins. Both sides will be backed by the opinions of very educated men and women. Both sides will be correct in their own ways.

Having same day weigh-ins will cause the average fighter to cut significantly less weight. It may also lead to a shift in how weight cutting is viewed, which may lead to less weight cutting in general. That's laudable. The long term goal should absolutely to be to reduce the amount and severity of weight cutting in MMA.

My issue with this method, is that fighters who mess up during camp can't afford to turn up and say, "Hey, I'm 10% over the contracted limit, guess I can't fight. Now, I won't get paid, and I'll probably get fired. Oh well, that's fine." Instead, when a fighter comes in heavy, for whatever reason, they're going to cut weight. Then they're going to try to re-hydrate 10% of their body weight in 8 hours or so, and potentially go into the cage to receive traumatic brain injury while dehydrated. Chances are, it's only a matter of time until that ends in tragedy.

Any system adopted has to take the realities of the world into account, and can't operate under idealistic scenarios. Ideally, a doctor would rigorously check fighter hydration levels and ensure no dehydrated fighter competes. Do you trust every commission in the United States to get that right every time? A few will. Many won't. Plenty of commissions fail to rigorously check hydration levels before competing now. If same day weigh-ins are adopted and commissions and ringside physicians aren't perfect every time, it's only a matter of time before someone dies.

Let's imagine a scenario; it's UFC 210. A doctor informs the commission that a fighter is dehydrated after they weigh in. That fighter is in the main event of the evening. The fighter and promotion, which is bringing in tens of thousands of dollars that eventually determine how well-funded the athletic commission is, say that the fighter will be hydrated enough to compete by fight time.

One hour before the main event the doctor checks again, and the fighter is still around 3% dehydrated. Not ideal, but hey, that's how dehydrated some guys get after a good workout. That doctor, who is paid by the commission, can either call the main event off-costing the promotion tens of millions of dollars-or he can let the guy fight, because it'll probably be fine. How many commissions do you trust to call off that fight?

I can already hear the arguments, ‘That's the fighter's own fault. They're an adult, if they make that decision the consequences are on them!' That's true, but plenty of rules surrounding combat sports exist to protect fighters from themselves. Why can referees stop fights? Because sometimes fighters don't know when to give up. Sometimes fighters will risk brain damage by taking dozens of unanswered blows, and still complain when the fight is stopped. We've seen people try to fight with broken limbs, or try to compete when they can't even stand. Do you really think the potential risks of competing while dehydrated will be enough to convince those people not to cut weight and be pulled from the fight? If the option is to cut weight and fight dehydrated, or be pulled from the card and don't compete, most fighters will do the former.

Here's what top MMA nutritionist George Lockhart had to say about the possibility of same day weigh-ins:

"If we had same day weighs-in fighters will still cut weight. They don't know the actual effects the cut has physically, in terms of their brain and the extracellular and intracellular water. They don't know the ramifications it could have, not just for that fight, but over the course of their career. I've said this a million times: Fighters aren't worried about their health. If they were, they wouldn't be fighting. They're looking for an edge, and if they think cutting weight for same day weigh-ins will give them an edge, they'll still do it."

The other option, earlier weigh-ins, does nothing to encourage fighters not to cut weight. While rare, we do see fighters hospitalized due to weight cuts gone wrong. In smaller organizations, especially outside of the United States, we have even seen fighters die while cutting weight due to the use of powerful diuretics. Having weigh-ins earlier might even encourage some fighters to cut more weight, though in truth, the number of fighters who could cut an extra 10 or 15 lbs, even with more time to rehydrate, is relatively small.

Let me be clear, most fighters already compete at the lowest weight class they can.

What earlier cuts accomplish is helping to ensure fighters go into the cage fully hydrated. The truth is, that most fighters, coaches and camps know very little about the science behind re-hydrating. They don't know how glucose affects fluid absorption. They don't know when hypotonic solutions are preferable to isotonic solutions. They don't know how much sodium or potassium a fighter lost during their cut, or how much they have to reload. I'm talking about elite fighters and coaches from the top camps in MMA, here. If they don't know that, what chance does Joe Blow in the Local Cagefighting League have of reloading effectively?

Just now, top fighters tend to cut 10-15% of their body weight, and in extreme cases even more. For a middleweight, that's around 20-30 lbs in the space of a few days. That's a lot of fluid to reabsorb in 24 hours; 16 hours when you subtract time for sleeping. That's almost 2 lbs an hour, which is pretty close to the rate at which your body can effectively absorb the carbs, electrolytes and water you need when re-hydrating, as the rate at which your stomach can process fluids is around 1 liter (2.2lbs) per hour, according to some sources*.

In terms of becoming properly hydrated, you also have to ensure you are providing the body with the correct amounts of electrolytes at the correct time. For instance, slightly hypotonic solutions are significantly faster at rehydrating the body than isotonic solutions. Most fighters and camps are not well versed in this, and their re-hydration is far below 100% efficiency. To fully re-hydrate in those 16 hours, that fighter has to get his rehydration protocols spot on, and that generally just does not happen. Extra time between weigh-ins and fight time would allow fighters using imperfect re-hydration protocols to still compete safely.

Here's George's take on earlier weigh-ins:

"Most guys aren't educated on weight cutting. They don't even know what they don't know. So many guys aren't re-hydrating properly, and these are guys at the UFC level. Fighting while dehydrated makes them less able to defend themselves. It makes them weaker, slower and even affects their cognitive abilities. That's not even including the extra potential for brain damage.

The brain has a protective layer to help prevent things like swelling, and to control which substances can actually reach the brain, called the blood-brain barrier, and it takes time for electrolytes to get back through that barrier. From what I've read, it takes more time to re-hydrate the brain than the other cells in the body. We already know some fighters aren't fully hydrated in the rest of their body going into a fight, let alone areas which are slower to re-hydrate. A fighter will be a hell of a lot better off with the extra time. It reduces the risk of guys going in there not fully hydrated, and we should be doing everything we can to help reduce the possibility of long term brain injuries in the sport."

At a few points in the letter, the idea comes up that if a fighter eats healthily and trains properly year-round, there's no need to cut weight. Quotes like "...the practice of cutting extreme amounts of weight in short periods evinces a lack of professionalism in the athlete himself" appear, along with a quote from the 2006 press release announcing weight cutting procedures: "The new weigh-in procedure would not be necessary if championship caliber fighters conducted themselves like absolute professionals and stayed in competition shape year round and at or near their fighting weight."

In reality, the majority of mixed martial artists who are competing at championship level, do stay in shape year round. It's rare to find a championship level fighter above 10% body fat at any point, and the weight cutting tends not to be used to compensate for a poor diet. Fighters are cutting weight in an attempt to get a performance advantage, not because they're struggling to train like professionals between bouts.

Decisions have to be made with this fact clear in everyone's mind: Fighters usually cut weight to get an edge.

That's not to say there won't be a significant number of guys cutting weight because they screwed up their diet or cardio during camp, but as a general rule, that's not why most guys are cutting weight today.

The last point to consider is how dangerous it is for fighters to compete against opponents in higher weight classes. I've never competed in the octagon, and training isn't the same thing, so I defer to George Lockhart, who as well as handling the nutrition for half of the UFC's champions, is also a former professional fighter who competed in the preliminary round of The Ultimate Fighter.

"If a guy comes in with 15, 20 pounds on you, that's huge. When you're in there your arms are lead, you're tired, you clinch up and you will absolutely notice that 15 pounds. If he gets you down, that's an extra 15 pounds on you. That 15 pounds probably means that guy hits harder than you as well. People talk about Roy Nelson and say he should lose weight, but if he lost 40 pounds, that right hand of his might not be knocking guys out in one shot. Just look at the physics of force: F = ma. In most circumstances, that much extra mass is a significant advantage.

But, if you ask me what's more dangerous, a guy fighting dehydrated is much more dangerous than fighting a guy a weight class bigger than you. When you're dehydrated, not only is your brain more vulnerable to damage, but you move slower, your muscles don't trigger as well, even your cognition is affected. You can't think things through as well, you can't focus as well. If you go in there dehydrated, not only are you going to be less capable of beating the guy, you'll be less capable of defending yourself, as well. I'd rather block a punch from a 220 pound guy than take one in the face from a 200 pound guy because I wasn't thinking fast enough on my feet to avoid the shot."

Finally, I asked George what he would do to reduce the amount of weight cutting in the sport. His answer? More education.

"What's interesting is that every time a new rule about weight cutting comes in, guys educate themselves a little bit more, and start coming in a little lighter. When the IV ban came in, I saw a number of guys come in lighter. Since the UFC announced the 8% rule, even more guys are coming to me and asking questions and getting educated on the subject. Guys don't want to lose out on performance, so they're trying to figure out how they can still make weight with the new rules. Not all guys are changing how they do things, but some are.

If a guy cuts 30 lbs the week of the fight, is that dumb? Yeah, but fighters don't know that. They need to be educated on that, and they need to be educated on it by people who know what they're talking about and who have a real understanding of fighters' weight cuts. I've seen some commissions which think an extreme weight cut is 15 lbs. If you're a fighter and you hear that, you're probably not going to take that guy's warnings very seriously, because that's an easy cut for you.

That's one of the reasons I'm glad the New Jersey State Athletic Control Board is gathering information on the subject. Having that information will let them make informed policy decisions going forward, and I'm hopeful that every commissioner in the United States takes the opportunity to become well-educated on the subject.

I think the single biggest thing we could do is have a central, reliable source of information fighters can use. A fighter should be able to ask at any point, ‘What does it mean if my hands are tingling when I'm taking a hot bath?' and the commission, or some centralized website or resource should be able to give an educated, useful answer. They should be told what effect cutting weight has on their performance. There should be summaries of studies telling them, ‘Hey, even if you re-hydrate, your performance will still be 5-10% lower than normal if you cut a significant amount of weight.' All of that information should be easily and readily available, and it should come from a source fighters can trust, one which understands the realities of cutting weight.

I say this all of the time, but fighters only really care about performance. Show them how weight cutting hurts their performance, and you'll see attitudes change quick fast and in a hurry."

For my part, I agree with George that more education should be the cornerstone of any strategy designed to make weight cutting safer and less common. I also think there are a few practical steps which could be taken. While I support an official weigh-in 36-72 hours before the bout, I also support weigh-ins four days prior to the bout, and immediately before the bout, solely to gather hard data on fighter weight cutting habits and the effect regulations have on them. Just now, the data we have on what fighters weigh on fight night is lacking, as is data on fighter weight, pre-cut. Gathering those data points will help with making more informed decisions down the line.

Currently, different states have different medical requirements, both for licensure and around the weigh-ins and fights. I would advocate for a unified set of medical tests in order to gain a license, and for every commission to undertake hydration testing at three points - four days prior to the fight, at the time of weigh-ins, and a couple hours before the fight.

I would also like to see a defined and unified set of medical criteria around dehydration adopted by every jurisdiction to cancel a fight when a competitor shows symptoms including, but not limited to: vomiting, fainting or loss of consciousness, slurred speech, or the inability to properly move unaided. I'm sure the majority of medical professionals would seek to prevent a fighter from competing if they noticed these symptoms in the days leading up to the bout, but having them codified in the rules of every commission is a common sense step that also serves to highlight that dehydration to the point of causing those symptoms should be treated as a medical emergency.

To sum up, I'm loathe to support any change which potentially increases the chance of a fighter dying in the cage which rules out same-day weigh-ins for me. In an ideal world where fighters could be monitored and athletic commissions had infinite resources and capabilities to ensure no one was competing while dehydrated, same day weigh-ins would be a great way to discourage fighters from cutting weight. In the real world, it'll lead to some fighters still cutting weight and putting themselves in a potentially fatal situation as a result.

It was only months ago we saw Dhafir ‘Dada 5000' Harris fight with renal failure. If there's even a chance commissions don't catch that, I just can't justify relying on them to judge whether or not fighters are hydrated enough to compete after a same day weigh-in. To anyone involved in making this decision, please ask yourself whether you trust someone who can't recognize imminent renal failure to determine if a fighter is suffering from mild to moderate dehydration. Fighters' lives will be in the hands of people like that, and if same day weigh-ins are adopted, at least some of those lives will be at significantly greater risk.

The NJSACB is extremely influential, and any decision made here will likely encourage other commissions to go the same route. Unfortunately, many of those commissions do not share the NJSACB's exemplary standards. Let's hope that changes in the future.

*Advanced First Aid, CPR, and AED,  American College of Emergency Physicians.

Combat Sports Contestant Weigh-ins Survey Memo