In just about every sport, coaches are confronted with athletes who want to gain or lose weight. These can prove to be sensitive issues, however, when you take into account the unsafe approaches used by some athletes to achieve either goal.

Some athletes participate in sports for which weight gain or loss is accepted and perceived as an advantage (for example, football, wrestling and gymnastics). While this may be true in specific cases, it is vitally important that coaches, parents — and especially the athletes — base their decisions on the correct information and take the appropriate actions.

To gain weight, many athletes will turn to the poorly regulated and potentially dangerous supplement industry and/or perilous androgenic-anabolic agents for answers.

To lose weight, some athletes resort to extremely dangerous procedures that serve only to dehydrate them or lead to any one of a litany of eating disorders.

The consequences of these and other perilous practices, in fact, has hastened the American Academy of Pediatrics (AAP) to revise its policy statement on “Healthy Weight-Control Practices in Young Athletes.”

Here are some highlights from the AAP’s recommendations:

n Primary care physicians should know of healthy weight-gain/weight-loss methods. They also should have a firm understanding of minimal recommended weight, normal growth curves, body composition measurements, and the ability and willingness to educate athletes, parents, coaches, athletic trainers, school administrators, and state and national organizations, when appropriate.

n Physical examinations of young athletes should include a comprehensive history of the following variables: weight gain/loss, eating disorder(s), hydration practices, heat illness, and other factors that may influence weight control or heat illness.

n Physicians should be able to recognize early signs and symptoms of eating disorders and obtain appropriate medical, psychological and nutritional consultation for young athletes with these symptoms.

n Nutritional needs for growth and development must be placed above athletic considerations. Fluid or food deprivation never should be allowed. There is no substitute for a healthy diet consisting of a variety of foods from all four food groups with enough energy (calories) to support growth and daily physical activities. Daily caloric intake for most athletes should consist of a minimum of 2,000 calories. Athletes need to consume enough fluids to stay properly hydrated. Physicians should engage the services of a registered dietician familiar with the special needs of athletes to assist with weight-control issues.

n In sports for which weigh-ins are required (for example, wrestling), athletes’ weight and body composition should be assessed once or twice per year. The most important assessment is the one obtained before the beginning of the sport season. This should include a determination of body fat and minimal allowable weight when the athlete is adequately hydrated. (For information on weight classification criteria for both high school and collegiate wrestlers, see www.nwcaonline.com.) Weigh-ins for competition should be performed immediately before competition. Additionally, athletes should be permitted to compete in championship tournaments only in the weight class they have competed for most of the events that year.

n A program for the purpose of gaining or losing weight should (1) be started early to permit a gradual weight gain or loss over a realistic time period, (2) permit a change of 1.5 percent or less of one’s body weight per week, (3) permit the loss of weight to be fat loss and the weight gain to be muscle mass, (4) be coupled with an appropriate strength and conditioning program, and (5) incorporate a well-balanced diet with adequate energy (calories), carbohydrates, protein and fat. After athletes obtain their desired weight, they should be encouraged to maintain a constant weight and avoid fluctuations in weight. A weight-loss plan for athletics purposes never should be instituted before ninth grade. And females should consume enough calories and nutrients to meet their energy requirements and maintain normal menses.

n Any athlete who loses a significant amount of fluid during sports participation should weigh in before and after practices and competitions. Each pound of weight loss should be replaced with one pint of fluid containing carbohydrates and electrolytes before the next practice or competition.

n Weight loss accomplished by over-exercising, wearing rubber suits (or “garbage” bags), steam baths/saunas, prolonged fasting, fluid reduction, vomiting, or the use of laxatives and/or diuretic supplements must be prohibited at all ages.

n Athletes who need to gain weight should consult their physician for resources on healthy weight gain and referral to a registered dietician. They should be discouraged from gaining excessive weight, which may impair performance, increase the likelihood of heat illness, and increase the risk of developing complications from obesity.

n Young athletes should be involved in a total athletics program that includes acquisition of athletics skills and improvement in speed, flexibility, strength and physical conditioning while maintaining good nutrition and hydration practices. This should be done under the supervision of a coach who stresses a positive attitude, character building, teamwork and safety.

It is vitally important for coaches and athletic trainers to not only stay abreast of current information on safe, healthy weight-management practices and protocols, but to disseminate this information to their athletes on a regular basis.

Ken Mannie is the head strength and conditioning coach at Michigan State University. To obtain a copy of the AAP’s policy statement, see www.aap.org.