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Essays

Jockey Eating Disorders: Body, Eat Thyself, by Michael Ransom


Jockey Eating Disorders: Body, Eat Thyself

By Michael Ransom

Few things in this world are more beautiful than a well-toned athlete, fit, running in full stride, sinews rippling and contracting with each explosive thrust of the legs. One would be quite naïve to think that scores of horse racing fans flocked to stadiums just to admire this raw beauty of horses racing side by side, nosing ahead of one another to the finish line. Shouting fans beat the air with clenched fists, eventually erupting either in the exhilaration of victory or in the exasperation of defeat.

No, this is not only about the horses, even less about the jockeys: it’s about the Benjamins. It’s about a lucrative betting business that forces many horse racing officials, horse owners, and track owners to turn blind eyes to the crass injustices visited upon the bodies of those who ride atop the massive creatures. Sadly, much of it is self-inflicted to gain a competitive advantage.

Popular press heaps praises and accolades upon winning horses with funny names. But the names of the men who risk their lives, who straddle the backs of 1,000lb beasts, pull the reins, and urge them on to victory, are rarely even mentioned. And it is no surprise when one considers their boyish size and miniscule weight. Behind a jockey’s compulsive nutritional behavior is an obsession to either maintain or be under the standard weight, a standard that many argue borders on the fringe of anorexia.

In fact many of the methods jockeys use to shed unwanted pounds, especially prior to a race, mimic those of individuals treated for eating disorders like anorexia nervosa and bulimia nervosa. A jockey who exceeds the weight limit at the pre-race weigh in is disqualified from competition, and the months of training, dieting, starving, etc., are tossed out the window. So, they are extremely motivated to meet the standard by any means necessary.

Consequently, jockeys routinely starve themselves, abuse ipecac and other things that make them vomit, abuse laxatives and diuretics, and languish for hours in the “hot box” (sauna), each of which can have grave long and short term complications, including death, especially when they overlap. Mortality rate among jockeys is astonishingly high compared to the rest of the population.

Extra! Extra! Obituaries!

For decades the plight of these men and women has been kept hidden from the public eye, but a couple of recent cases, combined with a history of suspicious deaths, have warranted a deeper inquiry into what is killing these relatively young people. Coroners’ reports often reflect common causes like malnutrition, chemical poisoning, and, most commonly, dehydration and fatal electrolyte deficiencies.

In a 2005 article, the Washington Post reported the then recent tragic death of apprentice jockey Emmanuel Jose Sanchez, a promising young fellow, whose perpetual struggle with weight loss eventually claimed his life. Even the high point of his career, a race win at Colonial Downs approximately one month prior to his death, was tarnished by the extreme effects of dehydration. He was so “unsteady”, it was reported, “after crossing the finish line at Colonial Downs, he needed help guiding the horse into the winner’s circle“ (Scheinman, 2005).

What should have been the harbinger of death was simply shrugged off as, well, that thing that jockeys do. Reporting on the same incident, ESPN horse racing writer Bill Finely definitively states the cause of 22-year-old Sanchez’s untimely death: “Shortly after riding a horse named Bear on Tour in Friday’s fourth race at Colonial, Sanchez was found on the shower floor in the jockey’s room, where he had lapsed. He went into a coma and died shortly thereafter at an area hospital … Sanchez apparently died of dehydration, the result, no doubt, of spending hours in the sweat box and/or taking Lasix pills to take off water weight” (Finley, 2005). The term “sweat box” refers to a sauna, a small room heated to 230° F (110° C). These are commonly found on jockey training compounds.

It is important to note here that Lasix pills are a loop diuretic used to treat congestive heart failure: they prevent the body from absorbing too much salt, which passes out of the body in urine. Even if used in prescribed doses, this medication carries hefty warnings against dehydration [http://www.drugs.com/lasix.html].

A similar tragedy uncannily happened in 2005, this time claiming the life of a more accomplished jockey. The death of 31-year-old James “Chris” Herrell proved that the cumulative effect of routine jockey weight loss methods extends beyond the racetrack. He collapsed in his apartment shortly after sharing lunch with his fiancé, herself an aspiring jockey. When asked about the particulars of his death, she stated: “Herrell’s death most likely was directly connected to ‘pulling’ weight every day, heaving and throwing up and everything that goes with being a tall jockey” (McGee, 2005). She went on to confide: “Herrell sometimes threw up as many as 15 times a day” (2005). On top of the constant heaving, Herrell was also known to spend excessive time in the “hot box”, again a lethal combination for sure. As with Herrell, and many more jockeys than would admit, it is clear that eating disorders are not only common in the jockey world, but also have compromised health, performance ability, and, in many cases, survivability.

The skinny on jockey eating disorders

One look at many of these young men and women of the jockey persuasion and it becomes abundantly clear: they do not need to lose weight. Many appear gawky, fragile, weak, and grossly undernourished, and some, even when they are successful, can barely hang on long enough to celebrate the victory. Not surprisingly, “wasting” is a familiar term to every jockey: “Racing has a term for keeping weight down—wasting—old as the sport itself, with a legion of stories” (Pinsent, 2007).

Despite the common symptoms, jockeys obsessively abuse multiple—at times overlapping—methods of shedding extra pounds, the impetus, making weight. Health professionals consider many of these popular methods individually dangerous when abused, but as they are coupled with any combination of the others, they become exceedingly, if not exponentially, dangerous to the human body in both the long and short-term. Retired jockeys like Shane Sellers admit to lifelong struggles with eating disorders.

            Ostensibly, anorexia and bulimia appear identical in nature, as the two conditions abuse the same methods. Anorexics routinely starve themselves, while bulimics get caught in a vicious binge-purge cycle—this is the distinguishing characteristic—but the underlying cause is the same: unrealistic body image, expectations, and fear of weight gain. Caught in a perilous downward spiral, they obsess over getting fat or too heavy, as they become excessively thinner and still thinner.

Imagine a jockey’s plight when his/her unrealistic expectation is reinforced by an equally unrealistic industry-wide weight standard with an unconvincing justifying purpose. It is a mere tradition that goes back to the 1800s, when, it is hotly debated, poverty-stricken men and women were of considerably smaller stature. Though this debated topic is beyond the scope of the present article, it was necessary to show that for the jockey, eating disorders are about more than faulty self-image issues; they’re about whether or not he/she gets to race. It is this that distinguishes jockeys from the general population of people with eating disorders.

Faced with constant starvation, the possibility of serious injury, dehydration or even death, these brave, if not foolish, young men and women feebly stand, skin stretched over shaky limbs, smiling with decayed teeth, caused by frequent exposure to stomach acids. In the words of the hit Journey song: “Still They Ride” (Greatest Hits Live, 1998).  Jockeys like Emmanuel Jose Sanchez give their lives for the sport just to have an opportunity to ride. Something he once said to a colleague captures his passion: “He just said, ‘I want to work.’ He said, ‘I don’t want to be the best, I just want to ride’” (Scheinman, 2005). He did—then died.

Methods of the madness

Self-induced vomiting

            Jockeys commonly induce vomiting to keep food—if they eat—from being absorbed into their intestines, which, they believe, increases their body weight. This practice clearly has been going on for decades, though not acknowledged by horse racing officials, track owners, and horse owners and trainers.

Dulling the sting of this growing dilemma is the effort of some to glamorize the sport with motion pictures like Seabiscuit, which, go figure, attracted plenty of the horse racing industry’s support. The obvious intention was to promote the positive aspects of the sport, and there are many—but at what or whose expense? In a 2003 USA Today article ‘Seabiscuit’ alone can’t save scandal-plagued sport, Jon Saraceno contended that, “plenty remains wrong.” He elucidates: “For decades, jockeys have silently battled weight problems; the film [Seabiscuit] nods to that when jockey Johnny Pollard barely is able to sip a spoonful of soup. What it didn’t show is how jockeys ingest laxatives or induce vomiting to stay trim” (Saraceno, 2003). Horse racing industry leaders appear to be operating on the premise: what they refuse to identify, does not exist.

  Induced vomiting, or “flipping” as it is commonly referred, exists among jockeys and so do its consequences. By their own confession, and now documented by reporters, many racetracks—including Churchill Downs, the vaunted home of the Kentucky Derby—install “heaving bowls” to accommodate jockeys’ frequent flipping before each race. It is “Horse racing’s dirty little secret”, Neil Schmidt of The Cincinnati Enquirer contends. He recounts a scene from Jockey, the HBO documentary: “Shane Sellers paused outside the washroom stalls in the jockeys’ room of Churchill Downs racetrack. ‘I want you to understand, this is reality,’ he said … He then opened the last stall on the right. Inside sits what jockeys call a heaving bowl, a large square basin designed to catch the vomit many riders regularly discharge to make weight requirements” (Schmidt, 2004). Prior to this stunning documentary, owing to racetrack owners’ commitment to secrecy, these heaving bowls were clandestine features of jockey rooms all over America, but no more. Americans know; the secret is out, and the ball is in the industry’s court.

Rader Programs, a popular eating disorder treatment center, states that many with eating disorders—jockeys clearly fit in this category—use syrup of Ipecac to repeatedly induce vomiting. They obviously ignore the stern warnings on the bottle: it is recommended for emergency purposes only. The urge to purge drives them past the fact that it is a neuro-stimulant, which acts on the nervous system as well as the stomach to induce vomiting. Its repeated use can be deadly: “the misuse of Ipecac syrup can cause significant and severe medical complications and even result in death” (Rader Programs, 2007). Cardiac Arrythmias/Arrest, High blood pressure, seizures, irreparable damage to the heart, dehydration, blackouts, and death are some of the major symptoms associated with long-term Ipecac abuse.

Still, for many the one finger approach is the method of choice, and, over time, the reaction is so automatized that some jockeys boast no longer needing it to heave. The problem has existed far too long in the “Sport of Kings”. Still, many are chastised for carrying too much weight and encouraged to do whatever it takes to shed pounds. It is estimated that somewhere around “50 to 70 percent of jockeys” (Forde, 2002) routinely induce vomiting to make weight.

“Reality bites” the saying goes, and here it is no different. There are two potentially deadly effects of incessant vomiting: (1) esophageal erosion caused by constant exposure to corrosive stomach acid, and (2) dehydration and its consequent electrolyte imbalance due to excessive fluid loss. The latter of these is potentially the most dangerous and shares a commonality with each of the other objectionable jockey wasting methods. Effects on the body are unmistakable, as listed on the New York Times’ online Health Guide (2007):

  • Tooth erosion, cavities, and gum problems
  • Water retention, swelling, and abdominal bloating
  • Acute stomach distress
  • Fluid loss with low potassium levels (due to excessive vomiting or laxative use; can lead to extreme weakness, near paralysis, or lethal heart rhythms)
  • Irregular periods
  • Swallowing problems and esophagus damage
  • Rupture of the esophagus, or food pipe
  • Weakened rectal walls (rare, but serious condition that requires surgery)

These are considered short to mid-term effects, but many jockeys don’t survive long enough to face the long-term ones.

Laxative abuse

            Jockeys freely admit to abusing various natural and unnatural laxatives to help make weight before a race. It appears, however, this truly only serves for psychological catharsis, making them feel thin. Abusing laxatives to shed unwanted pound is a dangerous myth, according to the National Eating Disorders Association (NEDA), which only removes much needed water from the body: “In fact, by the time laxatives act on the large intestine, most foods and calories have already been absorbed by the small intestine. Although laxatives artificially stimulate the large intestine to empty, the “weight loss” caused by a laxative induced bowel movement contains little actual food, fat, or calories. Instead, laxative abuse causes the loss of water, minerals, electrolytes and indigestible fiber and wastes from the colon” (NEDA, 2006). What many jockeys don’t realize is that any resulting loss of water weight is put right back on as soon as he/she drinks any water. Below is an NEDA list of “health consequence of laxative abuse”:

  • Upset of electrolyte and mineral balances. Specific amounts of electrolytes are necessary for crucial body and organ functions, like the brain and heart. Upsetting the balance in the negative jeopardizes their function.
  • Severe dehydration. Common symptoms are, “tremors, weakness, blurry vision, fainting, kidney damage, and, in extreme cases, death.”
  • Laxative dependency. The colon actually acclimates to the stimulation and requires incremental increases in the amount of laxatives.
  • Internal organ damage. The colon and the liver are on the hit list.

In some advanced cases, the colon becomes immune to the lower doses, fueling the necessity for ever-increasing doses to encourage bowel movements—eventually this individual becomes totally dependent.

Diuretic & diet pill abuse

            Reports of jockeys abusing diuretics date back to 1973, shocking Dr. David Price, whose telling article appeared in the British Medical Journal spoke of an established “black market” for what jockeys were calling “pee pills.” (Price, 1973) Common practice was to ingest them approximately three hours prior to a race; the consequent, “violent diuresis” (Price) helped them to lose around 6 pounds, fitting reinforcement of the behavior.

But this was not all, as Price indicted: “The prospect of the side effects that may result from a high dose of frusemide [Lasix, the most popular diuretic; visit http://www.drugs.com/lasix.html]—hypotension, dehydration, and many others—in someone taking part in a very athletic sport, I find alarming. In this particular sport they are not only endangering their own lives, but the lives of fellow jockeys, horses, and possibly the general public” (Price, 1973). No longer a “black market”, the practice of using diuretics to quickly lose pounds is now hidden in plain sight, where the powers that be have chosen to turn a blind eye. It is simply one of the methods jockeys use to gain competitive advantage.

Jockeys commonly compete in several races a day, so it logically follows that fear of putting on unwanted pounds before the next race might encourage them to refrain from ingesting any water to replenish what had previously been lost in frequent urinations. Some have been known to drink a glass of water and then go purge it shortly thereafter. Hoping to circumvent any water weight regain, they routinely create even further deficit of their frail bodies’ most substantial constituent. It is no wonder that there have been rampant reports of jockeys unable to see straight after a race, or of them dizzily stumbling into jockeys’ rooms—it is no wonder that some have been discovered in comas or worse.

Rader Programs lists the following complications of diuretic abuse, many of them potentially deadly: “Kidney damage, Cardiac Arrythmias, Electrolyte imbalance, Heart palpitations, Dehydration, Fluid retention, Headaches, Potassium deficiency, and Dizziness” [http://www.raderprograms.com/diureticabuse.aspx].

Finding doctors to write scripts for diuretics has proven difficult, especially in the wake of growing abuse awareness, so some jockeys have turned to the next best thing: diet pills. Easily obtained over the counter, these range anywhere from ephedrine, banned in the United States (FDA, 2004), but available online [http://www.buyvasoproephedrine.com/], to caffeine pills—addictive stimulants—to deadly fenfluramine. For the highly motivated individual, many of the banned substances can still be easily purchased over the Internet: “Phentermine/fenfluramine (Fen Phen)” (Online Pharmacy, 2007). Well-known “natural products” like chitosan extract have been either ineffective or cumbered with uncomfortable side effects, and many are neither studied nor regulated (Gong, 2005).

According to SFWED (Something Fishy Website on Eating Disorders), some of diet pills’ unwanted side effects are: “Diet pills, both over-the-counter and prescription, (as recommended, continuously, or in excess) can cause the following: nervousness, restlessness, insomnia, high blood pressure, fatigue and hyperactivity, heart arrhythmias and palpitations, congestive heart failure or heart attack, stroke, headaches, dry mouth, vomiting and diarrhea or constipation, intestinal disturbances, tightness in chest, tingling in extremities, excessive persperation, dizziness, disruption in menstrual cycle, change in sex drive, hair loss, blurred vision, fever and urinary tract problems. Overdoses can cause tremors, confusion, hallucinations, shallow breathing, renal [liver] failure, heart attack and convulsions” (SFWED, 2008).

In case these are not convincing enough, one deleterious complication from frequent use of Fen Phen, dominating the 1990’s diet craze, has surfaced recently with increased diagnoses of people with PAH (Pulmonary Arterial Hypertension [Lemonic, 1997]) or PPH (Primary Pulmonary Hypertension), “a rare blood vessel disorder in which the pressure in the pulmonary artery (the blood vessel between the heart and lungs) rises above normal leading to heart enlargement and failure” ( PAH Lawsuits, 2008). Stricken both with the passion to race, and the need to make weight, jockeys are lining up to take these risks—clearly something must be done to counteract the growing trends.

Macabre lists of possible side effects, coupled with any combinations of extreme weight loss methods, swirl into a lethal concoction threatening the lives of jockeys worldwide, and they do not exist within a vacuum. What affects them affects those around them of necessity. Add the impact of dehydration to this, and it is a wonder that jockeys can even stand up, let alone concentrate enough to ride their horses to victory. It is a feat just to finish the race.

Hot box

            In its proper use, the sauna can provide temporary relief from aches, pains, and relieve daily stress. Jockeys rarely—practically never—use it for its intended purpose, which is extremely detrimental. While many professionals support the benefits of sitting inside the hot box, within established limits, they are also quick to voice concerns over addictively abusing it as a weight loss measure.

“What are the health risks of steam and sauna baths? (healthlibrary.com, 2007),” is a pertinent question posed by the Health Library website. Seriously, can the sauna pose a health risk? The answer again sites the dangers posed by excessive dehydration and consequent electrolyte imbalance: “Steam and sauna baths lead to dehydration. The heat makes you sweat a lot and in the process important salts are lost. Sodium, potassium, magnesium, calcium, zinc and iron are literally sweated out … The more serious and direct consequence is that sweating causes the blood volume to decrease, blood pressure to fall and circulation of body tissues to decline. The blood circulation is impaired and consequently oxygen supply to vital body tissues also reduces. Dizziness, nausea and weakness are common symptoms” (2007).

Physicians independently studied a strikingly similar phenomenon in a most peculiar place; they probed into why people practicing a particular religious ritual were dying—in this case a 37-year-old Australian, Caucasian male—it required worshipers to purify themselves by sitting in what is known as a “sweat lodge”, similar to a sauna but only able to accommodate one person. “Sweat lodge syndrome,” as those conducting the study aptly named it, is signified by, “prolonged exposure to elevated temperatures in a relatively uncontrolled environment, failure to ensure adequate hydration, failure to appreciate the significance of loss of consciousness, use of ineffective alternative methods of treatment, and delay in seeking appropriate medical care …” (Byard & Riches, 2005). In many cases, jockeys exhibit all of these behaviors during their racing careers, making them more than susceptible to heat related complications as per the study.  

Since they are willing to make weight by any means necessary, it stands to reason that jockeys are not want to seek “appropriate medical care” for fear of their desperate practices coming to light, which sometimes include abuse of amphetamines—stimulants—for energy and/or alcohol to cope with stressful demands. Consequently, many tracks are now screening for these chemicals, threatening those who use them with fines and suspension.

Okay, so “dizziness, nausea, and weakness,” and severe dehydration do not mix well with the jockey’s massive responsibility of controlling a 1000-pound animal running at optimal speed in close proximity to others doing the same. But by far the deadliest complications stem from prolonged dehydration and corollary electrolyte imbalance.

Dehydration: throwing the jockey out with the water

            As has been sufficiently noted, the most common symptom of all of the abuses and eating disorders elucidated above is dehydration. Many commonly shrug it off as mere leg cramps, or an annoyingly persistent thirst sensation, but many, whether through ignorance or denial, don’t realize that these are merely the body’s initial cries for attention—once the cramps start and the mouth dries, dehydration has already set in. It’s a rugged, possibly deadly, road from here, so it pays to take heed.

            Dehydration is surprisingly common among athletes, surprising considering the increase in public awareness thanks to the sports drink industry; but it logically occurs more so among jockeys. Director of the Gatorade Sports Science Institute Bob Murray’s take on athlete dehydration was quoted in a 2005 Boston College independent newspaper article: “Dehydration at rest and during exercise is very common among athletes of all ages … the sheer volume of fluid required makes it difficult, but not impossible, for athletes to keep up” (Heffernan, 2005). If dehydration happens to athletes at rest, e.g., on the bench, even in cold conditions, then one can only surmise how prevalently it racks the bodies of the men and women who consistently induce vomiting, take diuretics or diet pills, and sit in saunas for protracted periods of time; and this is before they even mount up for a race, or “come off the bench.” The exertion of riding and controlling the horse causes them to sweat, dangerously sinking them further into fluid and electrolyte deficit.

            Dehydration is common among athletes and jockeys especially: this has been indisputably demonstrated within the professional health community. The next logical question is, “what is dehydration?” Ah, Mayo Clinic comes to the rescue here with a simple, yet apropos definition: “Dehydration occurs when you lose more fluid than you take in and your body doesn’t have enough water and other fluids to carry out its normal functions. If lost fluid remains unreplenished, you may suffer serious consequences” (Mayo Clinic, 2008). Since, “water is the most abundant and essential component or macronutrient in the human body” (Juan, W. & Basiotis, 2004), comprising somewhere in the range of 60% of total body weight, 65-75% of muscle, and 50% of body fat weight (Juan & Basiotis, 2004), it is absolutely essential, especially for athletes, to maintain proper levels of fluid in the body to ensure the proper body function necessitated by physical exertion. More simply though, the body needs water to survive, since blood volume is mostly water and a majority of the body’s water is found in the cells.

            Some of the symptoms (not a comprehensive list) of severe dehydration are:

·         Extreme thirst

·         Irritability and confusion

·         Very dry mouth, skin and mucous membranes

·         Lack of sweat and little urination

·         Sunken eyes

·         Low blood pressure

·         Rapid heartbeat

·         Fever

·         Delirium and/or unconsciousness

(Mayo Clinic, 2008)

Who turned off the lytes?

            As a final consideration, something just as crucial as water to body function is lost during dehydration: electrolytes. From the brain’s neural circuitry to the electrical impulses that trigger respiration and the heartbeat, the body needs a healthy electrical system to operate. Electrolytes such as “sodium, calcium, potassium, chlorine, phosphate and magnesium” (National Library of Medicine, 2008), encourage a body’s healthy “blood chemistry, muscle action and other processes.” So they can be found in all of the body’s fluids, and are excreted both in sweat during physical exertion, as part of a natural cooling system, and in urine, as part of a natural cleaning system.

            Obviously, jockeys and electrolytes, particularly sodium and potassium, are not good friends—for the same reasons they and water are not! Sitting for hours in the sauna triggers excessive sweating; induced vomiting and laxative induced diarrhea divulge copious amounts of liquid from the body in each setting; diuretics cause the body to decrease sodium absorption, which triggers frequent urination to expel the excess: the result is sever depletion of everything the body needs not only to function, but also to survive. Still the jockey sees this as rewarding since it is an easy way to shed five to ten pounds before a race; perhaps they do not realize that they are shedding body parts, too.

In the absence of crucial body fluids and electrolytes, the body begins to break its own organs down—where some of the highest concentrations of these chemicals reside—to compensate. Clearly, the heart, brain, kidneys, liver, pancreas, etc., are not exempt. The problem is that any individual, no matter how powerful his/her mental fortitude, no matter how indomitable his/her will, cannot survive without these organs intact and functioning properly. Something has to give, usually the heart!

Severe depletion of sodium (hyponatrimia), and/or potassium (hypokalemia) may trigger similar symptoms. The former leads to things like “nausea, headache, confusion, lethargy, decreased consciousness or coma” (Mayo Clinic, 2007), while the latter causes “weakness, fatigue, muscle cramps, constipation and abnormal heart rhythms (arrhythmias)” (Mayo Clinic, 2007). Combinations of these threaten the lives of both athletes and jockeys.

 

Making no excuse, jockeys know the dangers they embrace, and still they forge ahead, past the pain, beyond their bodies’ languished cries. Stricken, not with blindness, but with the conscious refusal to see, they ignore professional advice, though often at the urging of track owners, who provide heaving bowls and “hot boxes” in jockey rooms. They feel incessantly prodded by a dubiously enforced industry-wide weight restriction. One cannot help but question what possible benefit can come from it? And why the powers that be continue to live in denial while young men and women are dying.

The glamorous world of horse racing depicted in the movies simply is not real, and actors used to portray jockeys clearly exceed the 115 to 118-pound limit. This is the “Sport of Kings,” which historically featured horses pulling chariots with hefty men in tote; there is no doubt that horses have handled the strain of carrying or pulling weight. It’s almost as if they were designed for it. Detractors have provided little scientific evidence to support the horse racing industry’s intransigent enforcement of such low weight restrictions for jockeys.

In the passionate words of Shane Sellers, retired jockey, who fights to raise the minimum weight restrictions, “We’re dying here” (Proctor, 2004).

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