Posted by: Chris Maloney | July 4, 2011

We Can’t All Be Kobayashi: The Perils of Competitive Eating.

The image of competitive eater, Takeru Kobayas...

Image via Wikipedia

It’s that time of the year again, when competitive eaters compete in stuffing their faces with foodTakeru Kobayashi, former champion, always impressed me because he was putting a lot of food into a very small area.  Sure, if you’re a giant to begin with you might have a big stomach, but a little guy with a little stomach has to swell up like a tick. 

As a medically minded person, the whole process made me wonder about, well, getting rid of all that food.  At the speed they’re eating, the hot dogs or whatever is going down in enormous quantities.  It’s going down, as well, as enormous chunks.  Somehow I don’t think they are waiting to pass those chunks the normal way. 

Given the closed nature of competitive eating (see the SF story on the ninety events set up for this next year) we’re unlikely to see into the post-game locker rooms anytime soon (thank goodness). 

But laypeople have tried such feats of gluttony at home.  I’ll translate the horrific results from the second report below (you can skip the first, I just wanted to show it wasn’t an isolated situation).  A 22 year old bulemic was admitted with diarrhea, abdominal pain and vomiting.  She had eaten so much food she had completely blocked her abdominal aorta, causing a tourniquet effect on both her legs.  They removed 11 liters of material from her stomach (what is the hot dog equivalent).  She appeared better, but she went into shock and began clotting all thoughout her body (the lower extremities were deprived of oxygen for too long).  She died. 

Given the tremendous stakes of competitive eating, how long will it be until we see our first death from overeating?  Is it really a good idea to make a sport out of bulimia?  Fascinating, yes, but on par with watching those horrific home videos where people injure themselves.  Not a profession. 

nt J Eat Disord. 2006 Mar;39(2):166-9.

Massive gastric dilatation after a single binge in an anorectic woman.

Barada KA, Azar CR, Al-Kutoubi AO, Harb RS, Hazimeh YM, Abbas JS, Khani MK, Al-Amin HA.

SourceDepartment of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.


OBJECTIVE: Massive gastric dilatation is a very serious condition that is extremely rare in patients with no history of gastrointestinal disease. Several cases have been reported in patients with eating disorders, particularly after a binge. We report here the case of a young woman who developed severe gastric dilatation after a single binge.

METHODS: A computed tomographic (CT) scan of the abdomen was done and a psychiatric evaluation was performed.

RESULTS: The diagnosis of acute gastric dilatation was confirmed and superior mesenteric artery syndrome was excluded. The patient responded to nasogastric drainage and bowel rest. She was also found to have situational anxiety and depressive symptoms as well as a nonspecified eating disorder.

CONCLUSION: This case illustrates the serious sequel of even a single binge in any patient with abnormal dietary habits, and demonstrates the useful role of the CT scan in the diagnosis.


Int J Eat Disord. 2006 Nov;39(7):602-5.

Fatal outcome from extreme acute gastric dilation after an eating binge.

Gyurkovics E, Tihanyi B, Szijarto A, Kaliszky P, Temesi V, Hedvig SA, Kupcsulik P.

Source1st Department of Surgery, Semmelweis University, Budapest, Hungary.


OBJECTIVE: A 22-year-old woman is presented with acute gastric dilation after an eating binge, who died of complications of acute reperfusion syndrome.

METHOD: A young patient was admitted in our clinic with critical condition without any significant previous medical history. Her initial complaints–diarrhea, vomiting and abdominal pain–began after an enormous food intake. There was no history of medications or toxic substances. Physical examination showed a normally-developed, well-nourished female in severe distress with an extremely distended abdomen. Femoral pulses were absent. The US and CT scan showed a dilated stomach, extended into the pelvis, dislocating the intestinal organs and compressed the aorta and mesenteric veins.

RESULTS: Urgent laparotomy was performed. An enormously distended stomach was encountered without volvulus, obstruction or adhesions. About 11 liters of gastric content was removed gastrotomy and nasogastric tube. Following the gastric decompression, the mesenteric and femoral pulses reappeared. During the operation, the cardio-respiratory status was stabilized, but in the following 24 hours irreversible shock developed, possibly due to the reperfusion of the retroperitoneal organs and the lower extremities. In the postoperative period disseminated intravascular coagulopathy developed. In an uncontrollable state of diffuse bleeding, 36 hours post-operation, the patient died. In retrospective investigation, the family confessed that previous psychological treatments which aimed at her bulimic attacks.

CONCLUSION: Acute gastric dilatation is very uncommon and is of various etiologies, two of these being anorexia nervosa and bulimia. Several cases documenting complications of gastric dilatation were published; however, such severe complications, involving gastric infarction and compression of the aorta with ischemic injury of the bowels and lower extremities, are rare.

(c) 2006 by Wiley Periodicals, Inc.



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