Rapid Weight Loss in Combat Sports: Multidimensional Impacts on Performance and Health

Background: Rapid weight loss (RWL) represents one of the most widespread yetphysiologically and psychologically demanding practices in weight-category combat sports.Athletes in disciplines such as judo, wrestling, taekwondo, and mixed martial artsfrequently engage in acute weight-cutting strategies involving dehydration, caloricrestriction, and intensified training in order to qualify for competition. While these methodsare considered part of the competitive culture, mounting evidence suggests that they maycompromise cardiovascular function, metabolic stability, neuromuscular performance, andpsychological well-being. Within this scientific context, combat sports offer a uniqueopportunity to investigate how extreme and rapid physiological alterations interact acrossmultiple systems.Objectives: The overarching objective of this PhD thesis was to develop an integratedunderstanding of the acute and chronic consequences of RWL, examining its effects oncardiovascular physiology, metabolic responses, muscle damage, postural control,performance indicators, and psychological states. Beyond the contribution of individualarticles, the thesis aimed to unify findings from cross-sectional measurements, experimentalinterventions, biochemical analyses, and narrative or systematic reviews, offering amultidimensional perspective on how weight cutting affects athletes both in the short andlong term.Methods: The research program combined experimental studies on elite and sub-elitecombat athletes, longitudinal monitoring, field-based testing, laboratory assessments,biochemical and hormonal profiling, neuromuscular evaluations, stabilometric analyses, andthe use of innovative technologies such as EMG, Moxy sensors, and advanced kinematicsystems. The work was enriched by international mobility experiences and interdisciplinarycollaborations involving nutrition, metabolic health, psychological assessment, andperformance sciences.Results: Across the three years, the main findings reveal that RWL induces consistentalterations in cardiovascular parameters, including increased heart rate, transient reductionsin stroke volume, and fluctuations in cardiac biomarkers, suggesting acute myocardial stressduring weight cutting. Metabolically, athletes showed dysregulated glucose and lipidprofiles, increased oxidative stress, and hormonal shifts resembling early markers ofmetabolic syndrome, effects detected not only in active athletes but also in former elitecombat sport practitioners. Neuromuscular evaluations documented increased muscle4damage (CK, LDH), reductions in explosive power, and impairments in postural control,particularly in tasks requiring fine motor adjustments under fatigue. Psychologically, RWLwas associated with increased anxiety, irritability, and perceived fatigue, all of which maynegatively influence tactical decisions and performance execution.Implications: Taken together, these results highlight that RWL is not an isolatedphysiological stressor but a multisystem perturbation that affects cardiovascular, metabolic,muscular, neuromuscular, and psychological domains simultaneously. The integrativeevidence presented in this thesis underscores the need for revised weight-managementprotocols, education for athletes and coaches, and regulatory reforms to mitigate healthrisks.Future Perspectives: Future perspectives include developing sport-specific guidelines forsafe weight cutting, exploring individualized monitoring strategies, and implementinglongitudinal follow-up programs to assess long-term health outcomes. Ultimately, this workcontributes to reconciling performance optimization with athlete safety, promoting a modelof competitive excellence that does not compromise long-term well-being.