To compare prevalence and change scores of disordered eating (DE) in combat sport athletes by sex and explore the potential relationship between rapid weight loss (RWL) and DE scores. Prospective study based on 24 events (September 2022-2023). A body mass (BM) questionnaire was completed at ~1 day post-competition providing pre-competition BM data for -7 days, -24 h, and weigh-in. The Athletic Disordered Eating (ADE) online questionnaire was completed at ~7 and ~28 days post-competition, providing overall DE and four subscale scores (food and energy control, bingeing, body control, and body discontent). There were 122, 132, and 89 respondents for the BM (77 % male), and ADE questionnaires at 7 (79 % male), and 28 days (74 % male). A large proportion of males' (83 %) and females' (89 %) DE scores were moderate to very high; minimal (17 % vs. 11 %), moderate (36 % vs. 32 %), high (37 % vs. 36 %), and very high (11 % vs. 21 %). Comparing DE change scores in males and females indicated deterioration (5 % vs. 0 %), improvement (3 % vs. 25 %, p = 0.013), and no difference (92 % vs. 75 %). Body discontent change score showed a significant sex difference (p = 0.014), with females improving (42 % vs. 17 %, p = 0.035) and males deteriorating (35 % vs. 4 %, p = 0.008). Correlation analyses were significant for RWL -7 days and males' food control score (R = 0.22, p = 0.031). Moderate to very high DE indications were identified in 4 of every 5 combat sport competitors. A sex-specific change in body discontent is evident, and most competitors struggle with their food-body relationship post-competition, irrespective of RWL magnitude.

To explore the potential association between rapid weight changes and self-reported injury status (presence or absence of injury) 7 days following competitive events among male and female combat sports competitors. A 14-month study of 24 events. A weight management questionnaire was completed 1-day post-competition, and an injury questionnaire was completed 7 days post-competition. These online questionnaires provided data on body mass and injury status. Mixed effects logistic regression models were used to analyse the odds ratios of rapid weight change variables and their impact on athletes' self-reporting as injured or non-injured. There were 172 responses (155 athletes) to both questionnaires (37 females (24 %) and 118 males (76 %)); 88 athletes (51 %) reported no injury, and 84 (49 %) reported injury. Rapid weight loss 7 days (RWL -7 days) and 24 h (RWL -24 h) before weigh-ins was 4.9 % ± 3.4 % and 2.6 % ± 2.1 % for females, and 6.1 % ± 3.2 % and 3.0 % ± 1.9 % for males. Mixed effects logistic regression models returned the highest odds ratio for male RWL -24 h (odds ratio: 1.20, 95 % confidence interval: 1.00-1.43, p = 0.044). This indicates that for a 1 % increase in male RWL -24 h before official weigh-ins, the likelihood of reporting an injury increases by a factor of 1.2. Male RWL -24 h before weigh-ins is associated with reporting an injury at 7 days post-competition. Therefore, athletes and coaches should carefully consider and aim to limit pre-competition rapid weight loss to minimise the likelihood of injury.

This study investigates the rapid weight loss (RWL) and rapid weight gain (RWG) of contest winners and losers from Muay Thai (MT) and mixed martial arts (MMA) events. The relationship between rapid weight change variables of males and females, and competitive success is also examined. Data from a weight management questionnaire was collected one day post-competition from 185 participants across 24 fight events, resulting in 263 responses (MMA: n = 78, MT: n = 185). Official and secondary weigh-in data were provided by the Combat Sports Commission. The results show that in MT, contest winners compared to losers had significantly greater RWL–7 days (5.9 ± 2.6% vs. 4.6 ± 2.7%, p = 0.01), RWG (6.2 ± 2.9% vs. 4.7 ± 2.8%, p = 0.003), and RWG/RWL ratio (108% [86–132%] vs. 86% [60–119%], p = 0.038), while no significant differences were observed for MMA. Mixed logistic regression models that controlled for age showed that a 1% increase in female RWL–24 h ([OR = 1.57, R² = 0.105, p = 0.001]) was associated with a 1.6 times higher likelihood of winning compared to female athletes without this increase. We emphasise that associations do not imply causation, and it is possible that other factors which align with rapid weight change practices may impact the observed relationship. Nonetheless, MT contest winners show greater RWL, RWG, and RWG/RWL ratio than losers, and female rapid weight changes appear to be associated with competitive success in this cohort.

Combat sports athletes often undergo rapid body mass loss (BML), which presents health risks. Hydration testing has been proposed as a possible solution to reduce or eliminate rapid BML. However, combat sports athletes may exhibit distinct physiological characteristics due to repeated exposure to BML. Thus, traditional and emerging hydration biomarkers should be investigated to determine their potential suitability for field use in this cohort. This study examined whether BML can explain changes in serum and urine osmolality (SosmΔ, UosmΔ), tear osmolarity (TosmΔ), hematocrit (HctΔ), and urine‐specific gravity (USGΔ) after mild–moderate passive dehydration. Biomarker reliability was also assessed across two trials. Fifteen male and female combat sports athletes (age: 26.3 ± 5.3 years, body mass: 67.7 ± 9.9 kg) underwent a sauna protocol twice (5–28 days apart) aiming for 4% BML. The average BML in Trials 1 and 2 was 3.0 ± 0.7%. Regression analysis revealed that BML explained HctΔ (R² = 0.22, p = 0.009) but not SosmΔ (R² = 0.11, p = 0.079) or other biomarkers. Intraclass correlation coefficients (ICCs) were significant for all biomarkers except TosmΔ (ICC = 0.06, p = 0.37) and post‐Tosm (ICC = 0.04, p = 0.42); post‐Hct performed best (ICC = 0.82, p < 0.001). Contingency tables with post‐Sosm (295 mOsm/kg) and post‐USG (1.020) cutoffs revealed an 80% true negative rate (TNR) and a 62% true positive rate (TPR). Increasing the Sosm cutoff to 301 mOsm/kg decreased the TNR to 52% but increased the TPR to 83%. Although blood parameters were most sensitive to BML, they could only explain 11%–22% of biomarker variation. The typical USG cutoff misclassified 42% of athletes postdehydration, and reliability was generally poor‐moderate. Alternative strategies should be pursued to manage rapid BML in combat sports.

Background: Mixed martial arts (MMA) and Muay Thai (MT) are widely practiced combat sports, yet research on the full spectrum of competition-related health problems (HPs) remains limited, particularly for MT. Existing studies in both sports primarily focus on retrospective analyses of severe injuries, often estimating time lost from training or competition. This study describes the incidence of all competition HPs reported seven days after MMA and MT contests, and determines the number of days impacted by tracking athletes’ self-identified worst HPs until resolution. Methods: Data on competition HPs were collected using an online questionnaire completed seven days after each MMA and MT event (n = 26). The questionnaire included the Oslo Sports Trauma Research Centre Questionnaire on Health Problems 2 (OSTRC-H2). The Combat Sports Commission of Western Australia provided competition exposure time data. Incidence rates of HPs were calculated per 100 min of exposure (HPIR_ME). Competitors reporting HPs were followed up weekly using the OSTRC-H2 questionnaire until their worst HPs resolved. Results: Of the 175 competitors (238 responses) who completed the questionnaire (76% male; age: 27 ± 6 years), 81 competitors (92 responses) reported a total of 411 HPs (315 injuries, 96 illnesses). Among the 92 worst HPs, 26 were substantial, and 24 prevented training. The HPIR_ME was 20.1 (95% CI: 16.5–24.4) for MMA and 25 (95% CI: 22.3–28) for MT. Follow-up captured 78 (85%) of the worst HPs, with 175 responses collected over 14–70 days post-competition. The median days impacted by the worst HPs were 20 for MMA and 16 for MT. Conclusions: Among respondents, 39% reported at least one HP. On average, the worst HPs resolved in less than three weeks. These findings provide valuable insights into the frequency and impact of competition HPs,offering important information for promoters, athletes, coaches, and regulatory bodies to better understand and address the health challenges faced by combat sports athletes.

In mixed martial arts, punches commonly lead to a knockout (KO) or technical knockout (TKO), though factors influencing such punches are unclear. This study assessed how differences in height, reach, and combined difference (height + reach) influence fight-ending punches. We analysed 264 Ultimate Fighting Championship contests that concluded with a KO/TKO from hooks, straights, uppercuts, or overhand punches. Three multinomial logistic regression analyses assessed the influence of (a) reach, (b) height and (c) combined difference on likelihood of punch type, with overhand punches as the reference category. Pairwise comparisons for punch type were conducted, and probability differences were compared across the lower, middle, and highest point difference for reach (−20, 0, + 20 cm), height (−20, + 10, + 40 cm), and combined (−50, 0, + 50 cm). The punches with the highest frequency were hooks (51%) and straights (35%). For all models, the straight punch was more likely than the overhand (odds ratio: 1.06–1.10, p < 0.05). At 0 cm and 20 cm reach difference, the punch probability differences for straight and uppercut punches compared to uppercut and overhand was between 27–47% (p < 0.05). Similar findings were observed at +10 cm height difference, but at height +40 cm straights were 76% more likely than uppercuts and overhands (p < 0.05) for bouts that concluded with a KO/TKO. The combined model showed similar results to the reach model findings. These results can help inform coaches and fighters to prepare both offensive and defensive tactics by providing information on the most likely fight-ending punch depending on their specific matchups.