Hot Dog Champ Joey Chestnut and the Risks of Competitive Eating

Rachel Pomerance

Babe Ruth. Michael Jordan. Joe Montana. And now ... Joey Chestnut?

The world champion competitive eater broke a new record yesterday - claiming, for the seventh year in a row, the prized "mustard belt" at Nathan's hot dog eating contest on Coney Island. After gorging on 69 dogs in 10 minutes, Chestnut raised his fist, and food-splattered chin, in a show of exhausted victory, his cheeks still swollen with hot dogs and a crumb caught in his eyelashes.

On winning the so-called "Super Bowl" of competitive eating, Chestnut tells U.S. News: "It's more than a contest. It's a Fourth of July staple, and it's in New York City. It's bigger than any eating contest."

As the annual Independence Day competition soars in popularity, Chestnut, it seems, has entered the pantheon of legendary American athletes. He arrived at the contest like royalty - hoisted in a chariot-like box emblazoned with the Nathan's logo. Whether competitive eating is a sport is unclear - though ESPN has been broadcasting the July Fourth tradition for nearly a decade - but it's surely an art, and Chestnut is its maestro.

The science of such gastrointestinal feats, however, is another matter. While Chestnut may seem like a superman, boasting a physiology or willpower that trumps the average digestive system, his competitive eating may put him at risk for a number of maladies.

"I really worry that it's playing with fire a little bit," says Marc Levine, chief of gastrointestinal radiology at the University of Pennsylvania Perelman School of Medicine. "You're playing with your GI tract here. You're using it in ways that it's not intended."

Levine led what appears to be the only research study on competitive eating, concluding in a 2007 report, "Competitive Speed Eating: Truth and Consequences," that the activity puts participants at risk of morbid obesity; chronic nausea and vomiting; gastroparesis, in which stomach wall muscles fail to properly empty the stomach; and the need for gastrectomy, or surgical removal of the stomach.

[Read: Weight-Loss Surgery: A Cure for the Morbidly Obese?]

Using hot dogs for consumption, one normal eater as the control subject and one speed eater, researchers found that as the competitive eater consumed the dogs (two at a time), his previously slim stomach ballooned in response. "For 35 years, I've watched people's stomachs, and I have never seen anything like this," Levine says. "When we stopped, it looked like he was carrying near full-term pregnancy."

After the competitor downed three dozen dogs, Levine and his colleagues cut off the effort over ethical concerns - the possibility that he could, literally, bust his gut. Levine recalls looking over at his colleague and saying, "What if his stomach keeps distending? What if we perforate his stomach?"

[Read: Guts and Glory: Mary Roach Tackles Digestion.]

By habitually eating past the point of fullness, the competitor had effectively switched off the sensation of satiety and trained his stomach muscles to loosen, Levine explains. Although the study examined just one competitive eater, he says "the findings were so spectacular and seemingly definitive that it's hard to believe that this is not the case for most speed eaters." Levine stresses that his conclusions are speculatory, but he says such conditioning can harm the digestive system, which relies on contracting muscles to propel food along and out of the body.

But Chestnut doesn't seem concerned about the potential health risks. "Right now, everything's working well," he says. "I go to a doctor, get my bloodwork done."

Asked about the safety of the sport, Richard Shea, president of Major League Eating, which sponsors the Nathan's event, said he could not comment. "I'm not a medical scientist," he says. "We make sure that there are EMTs at all events."

But the pattern of starving and gorging practiced by competitive eaters looks a lot like binge eating, says Marjorie Lang, a Mahattan-based registered dietitian and spokesperson for the Academy of Nutrition and Dietetics. As a result, competitive eaters up their chances of becoming obese and developing diabetes, high blood pressure, acid reflux and irritable bowel syndrome, she says.

[Read: Top Recommended Health Products: Stomach and GI.]

Potty humor, of course, is not lacking in the world of eating contests. And Pepto-Bismol has capitalized on the opportunity, having served as a sponsor of Chestnut and competitive eating events.

However, "it's not something to take lightly," Lang says. "It's not a fun process to go through ... Most people do wind up vomiting. They just don't show that on the TV."

Don Moses Lerman, who was on the competitive eating circuit from 2000 to 2006, compares the eating throwdowns to indulging at a buffet. You feel full, but you're back to normal in a few hours, he says.

And yet, Lerman is grappling with a thyroid condition he says began toward the end of his speed-eating days. When he started out, he weighed 142 pounds and had a 32-inch waist; six years later, he weighed 270 with a waist size of 50. He dropped the weight, but it inched back. (Lerman does not attribute his weight woes to competitive eating.) Now at 250 pounds, he tries to eat carefully - a daily diet might consist of Chinese takeout and two apples, he says.

[See: Use These 8 Foods to Help You Lose Weight.]

And even though, at 64, he says, "I got to hang up my spoon," Lerman still competes on occasion. Why? "This is my talent," he says. "It may be a carnival sport, but it's a sport." And with that, of course, comes the glory of competition. "To win a trophy, it's a high you can't get from whiskey. It's unbelievable."

Meanwhile, these competitions may provide useful information about digestive health and "what the body can handle," says Eric Goldstein, a New York-based gastroenterologist. "Medical science develops because someone observes something out of the ordinary once or twice ... [these competitions] may mean something. I'm not sure what yet."

[Read: How to Have a Plant-Based BBQ.]