Decisional trade-offs towards doping and their association with moral attitudes and health risk perceptions: A mixed methods study.

The objective of the present research was to examine doping-related decisional trade-offs, and their relationship with health risk perceptions towards doping and moral attitudes in sport. A mixed methods sequential-explanatory design was used. In Study 1,249, Mixed Martial Arts (MMA) athletes from 16 countries completed anonymous online questionnaires on decisional trade-offs related to doping, health risk beliefs towards doping, moral attitudes in sport, and socio-demographic variables. The results showed that almost 1 in 10 athletes would trade their life for sporting success, independently of the moral implications of their choice. When mortal threat was absent, 31.5% of the athletes would trade morality for sporting success. Decisional trade-off choices differentiated scores in moral attitudes, such as acceptance of cheating and keeping winning in proportion. In Study 2, 11 British competitive MMA athletes were interviewed about decisional trade-offs involving moral violations or mortal threats. Thematic analysis corroborated the Study 1 findings, with most athletes dismissing the doping choice involving a mortal threat but endorsing the one where the mortal threat was absent. Anti-doping education in MMA athletes should target the decision-making process underlying doping, with an emphasis on moral values and the adverse health risk effects of doping.

Medical care in unlicensed combat sports: A need for standardised regulatory frameworks.

OBJECTIVES: To explore the provision of medical care at 'unlicensed', full-contact amateur and lower-level professional combat sports competitions in England. DESIGN: Qualitative, mixed methods. METHODS: Observations totalling 200h of fieldwork shadowing medical professionals at 27 individual combat sports events, alongside formal, semi-structured interviews with 25 medical professionals, 7 referees and 9 promoters/event staff. RESULTS: Practices and standards vary widely. Event organisers and promoters often have very little understanding of how different types of medical practitioners operate. They rarely, if ever, check that the staff they are hiring are qualified, sometimes resulting in unqualified staff being used to provide medical cover at events. Venues are often poorly equipped to accommodate basic medical procedures. Patient confidentiality is very often compromised. Medical professionals often have limited autonomy within the combat sports milieu and may find themselves marginalised, with their judgements overruled by non-medical staff during competitive events. Some practitioners are cognisant of the dangers such working environments pose to their professional reputations and livelihoods, but remain working within combat sports regardless. CONCLUSIONS: Despite pockets of good practice, the lack of standardised rules for medical care provision creates substantial risks to athletes, to practitioners and the standing of the profession. The development and implementation of standardised, enforceable regulatory frameworks for full-contact combat sports in England is urgently needed.

High Prevalence and Magnitude of Rapid Weight Loss in Mixed Martial Arts Athletes.

The practice of rapid weight loss (RWL) in mixed martial arts (MMA) is an increasing concern but data remain scarce. The aim of this study was to investigate the prevalence, magnitude, methods, and influencers of RWL in professional and amateur MMA athletes. MMA athletes (N = 314; 287 men and 27 women) across nine weight categories (strawweight to heavyweight), completed a validated questionnaire adapted for this sport. Sex-specific data were analyzed, and subgroup comparisons were made between athletes competing at professional and amateur levels. Most athletes purposefully reduced body weight for competition (men: 97.2%; women: 100%). The magnitude of RWL in 1 week prior to weigh-in was significantly greater for professional athletes compared with those competing at amateur level (men: 5.9% vs. 4.2%; women: 5.0% vs. 2.1% of body weight; p < .05). In the 24 hr preceding weigh-in, the magnitude of RWL was greater at professional than amateur level in men (3.7% vs. 2.5% of body weight; p < .05). Most athletes "always" or "sometimes" used water loading (72.9%), restricting fluid intake (71.3%), and sweat suits (55.4%) for RWL. Coaches were cited as the primary source of influence on RWL practices (men: 29.3%; women: 48.1%). There is a high reported prevalence of RWL in MMA, at professional and amateur levels. Our findings, constituting the largest inquiry to date, call for urgent action from MMA organizations to safeguard the health and well-being of athletes competing in this sport.