BBN hear directly from the chief medical officer at GB Boxing on the dangers of extreme weight-cutting in prizefighting, and reveals which world champion from England did it just right:
I am the chief medical officer at GB Boxing, and that entails looking after the boxers' welfare, from injury management right the way through to making sure that they've got the right vaccinations and sleep strategies when they go abroad.
I don't prescribe how they lose the weight, I've obviously worked with plenty of fighters while they've been losing weight.
The weight cutting is really done by a combination of the coach and the nutritionist, rather than me. The decision to pull someone out because they're not making weight would be made by the head coach.
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It depends how long out from the fight you are.
The best way of making weight is to cut down your fat whilst maintaining your lean mass and muscle.
The trouble with starving yourself too hard is that you just lose muscle.
The best way is to do a long weight drop so that you are maintaining your lean body mass and have got the minimal amount of fat that you can comfortably live with and are not carrying any extra weight that is no good to you. Fat is no good to you in a fight.
You can usually lose the rest of the weight to make weight through fluid. Any rapid weight loss is always going to be fluid loss. If a fighter needs to lose a lot in the last few days before their weigh in then the only way of doing that is to dehydrate themselves, which is not what we would recommend.
We would allow a two per cent dehydration - that's considered safe. We would get people to dry out two per cent of their body weight and then put that back on again once they have made weight.
But greater percentages than that, we wouldn't recommend because it's just dangerous.
Fighters dehydrate because they've failed to make weight properly. It's a failure of planning.
Even if they lose 20 pounds then they will be very, very dry.
So, one: there's the danger of losing the weight, because you get very dry, lose a lot of electrolytes, put yourself at risk of heart arrhythmia, heart attacks and death, and then when you re-hydrate you disturb your electrolyte balance - that's the salts that are in your blood that are required for running your heart nice and smoothly.
Often when you put the weight back on the fluid doesn't distribute itself normally within the body to start with, and it can go in the wrong places.
It means you are almost certainly going to under-perform, so then you've got the danger of being hit hard and losing the fight.
So while it may sound attractive to lose 20 pounds before a fight and put it back on again, it just doesn't make any sense from a safety or performance point of view.
For none of those reasons would you want to lose 20 pounds before a fight. If you're doing it you have to be desperate to make the weight and you haven't planned your weight-making properly.
You lose a lot of that size advantage because of the weight-making that you have to do.
If you starve yourself beforehand you're almost certainly going to lose muscle mass rather than fat unless you do it from a very long time out.
If you do it from a very long time out then you can walk around at that weight anyway. Someone like Carl Froch walked around just a couple of kilos above his fighting weight all the time. He could make weight easily and didn't waste time, energy or effort on losing weight.
He just spent his time training and I think a lot of Carl's resistance in the ring, his ability to take big shots, was due to the fact that he made weight easily. I think that is theoretically a factor.
(Seizures, blindness) they are probably due to a fighter’s blood pressure being so low because he is so dehydrated. It's just so dangerous. That's why you get MMA fighters dropping dead at the weigh in, because of this really irresponsible weight cutting.
I have got no evidence of long-term effects, but the long term-effects can come from the fights. They can come from taking too many punches.
Your body regulates its temperature by sweating, so you're losing weight but also electrolytes because sweat isn't pure water. If you're not drinking, either - which you won't be because you're trying to cut weight - then you don't replace those electrolytes. Those electrolytes are very, very important for the nerves that make your heart beat regularly to work properly. They start misfiring, you start getting heart arrhythmia and then you get to the weigh in and drop dead.
You can usually calculate what weight a person can make by calculating their body fat and calculating how much body fat they've got on them and what they can do to lose it. The problem is that you can't dry out fat. Fat has got no water in it. Butter has no water in it, and fat has got no water in it. So the more fat you are carrying, the less able you are to dry out.
The good thing about losing fat is that you make weight better and you're able to dry out more easily than if you're carrying weight.
Nevertheless, the best way to make weight is to lose fat over a long period of time and then just dip down a little bit at the end by losing water.
Losing 20 pounds just a few days before you fight - it's just Russian roulette. It really is dangerous.
I think it's the responsibility of the whole team to make sure the weight cut has been done sensibly and the onus usually falls on the coach, not the medical team.
It's the coaches and nutritionists that guide the weight cut, certainly not the medics. Weight cutting is unpleasant and tedious but you are much healthier at the end of the day if you can go into a fight eating a full meal and eating what you like than you are not drinking at all and sucking on ice cubes three days out and eating half a jelly bean once a day.
If you think that's a good way of preparing for a major fight then you're just crackers.
We have strict guidelines on the rate of weight loss over a period of time and also the amount of fluid that we will sanction people losing at the end to make weight (two per cent).
The fighters know that and they know where they are on the weight cut at all times.
We just won't let someone get on the plane if they aren't on course to make the weight properly.
The really big weight cutting started in wrestling, and because many of the MMA fighters have experience in wrestling it made its way into boxing from there.
The further away that the weigh in is from the fight, the bigger chance that fighters have of putting the weight on again without being too ill.
So if you have the weigh-in the day of the fight then they just aren't going to get themselves into the ring. If you have it 36, or 48 or 72 hours before the fight then you have a much better chance of recovering from the severe re-hydration and fighting at a heavier weight, which gives you an advantage.
But that encourages you to cut weight really, really hard and the authorities are partly responsible for putting the weigh-ins a long way out.
What they would say is that they do that to give people a chance to recover, but by putting them a long way out you are encouraging them to dry out incredibly hard, which for me is possibly lethal.
If you take it to the extreme and weigh people as they walk to the ring, then you would be crazy to try and dry yourself out because you would enter the ring in terrible condition.
If you weighed in a month before the fight - and I'm just exaggerating for effect - then you would clearly starve yourself down to as light as you could.
The compromise is somewhere between those two, and that's how we've come to weighing in the day before, or two days before. But it's so marginal then that you're encouraging people to cut weight too hard.
We have seen decent fighters, nice people, dropping dead because they're cutting weight too hard. It's crackers.
These are fit, young men who are doing their best to earn a living in a very, very difficult, punishing way, and the last thing you want to do is encourage them to kill themselves by not drinking anything.
There's a lot of this catchweight stuff going on and it's starting to get very, very lax. Catchweights are just dangerous, because if you get a big guy going in and cutting hard but still not making it, and then fighting much heavier than the allotted weight, you're asking for trouble.
There have been people beaten up quite badly at catchweight competitions.
Combat sports are tough sports, and you don't need to make them any tougher to do this crazy weight-making.
It's not cheating if that's what the rules are. If the rules are that you can do that then you need to look at the rules.
I understand that people want to get their fights on, however you have got to think about the fighters at the end of the day.
Fighting men want to fight. The fighters will do anything to fight.
You've got to protect them from themselves, in a way, you can't just allow anything to go otherwise we will start seeing terrible injuries and deaths in the ring, and the sport will get banned because the public will be revolted by it.
The rule should be that if you miss the weight you don't fight, and you get a fine.
One way around it is to weigh fighters in for a second time on the day of the fight. You've got to take away the advantage of being able to drop your weight hugely with massive dehydration.
You can move the weigh in to closer to the fight, but that means the promoters might have to cancel the fight when everybody is there, and that's the issue with weighing in on the day of the fight.
You could have the weigh in two days before, but before you step in the ring we'll weigh you and if you're three or five per cent above the weight you weighed in at then you lose the fight, you lose the purse and you get fined.
That reduces the temptation to lose tons of weight before the fight.
Because you lose water and feel terrible and want to fight fit, you end up putting it all back on again.
When you’re dry your body secretes anti-diuretic hormone, so actually the fluids you take in when you rehydrate you retain because you don't pee it out.
So what happens is you actually have a rebound, where you end up heavier than before.
People may think that's great because you're even heavier, but it's just fluid, it's not muscle or anything. What actually happens is the fighter feels really poor because they're over-hydrated.
If you dehydrate hard and start drinking again, you retain all that weight.
Say you were an 80kg fighter and you walked around at 100kg, and lost 20kg for a fight - which would be a near-death experience anyway - there's no way you could dehydrate like that and then step through the ropes at just five per cent above what you weighed in at, which would be about 84kg. You would definitely be up to 100kg, if not 105.
So there wouldn't be a massive advantage for the fighter if you weighed them again on the way to a ring, because they would just feel like death.
So what? All it means is that they are fighting the same people but not killing themselves to make the weight. If they aren't doing that then they would just be fighting more comfortably.
Why hasn't this happened yet?
Professional fighting is about the money, and what promoters don't want is the fighters being stopped from fighting as they walk into the stadium.
You don't want a last-minute weigh in where your guy is six per cent over instead of four per cent, and you don't have a fight, and people have paid a lot of money for tickets and television companies and advertisers who lose out.
They don't want anything that will stop the fight on the day.
The only other way of doing it is to weigh the fighters as they cut the weight, where they have to hit pre-determined weights in the run up to the fight to ensure that their weight is coming down in a genuine fashion.
The thing about crashing weight is that you can't do it often, it can only be done once. You don't have time to recover and do it again.
So to hit the weight markers by dehydrating every time would be very, very difficult.
I would suggest that you weigh them on a regular basis for eight weeks of a camp coming up to a fight and you have a pre-determined weight-making strategy.
If they fall a certain percentage outside of that then they should forfeit the purse, the title and everything else.
That would be enforced by the sanctioning bodies, whether it's the British Boxing Board of Control in the UK, or the WBA or WBO for major international fights.
They can say what their weight-making strategy is and they can enforce that.
I'm sure there's very good reasons why the changes haven't been put in place so far.
But as a doctor who cares about the fight game passionately and cares about the fighters, I don't want to see these brave, talented young men dying because of a mad strategy to make weight.