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Hot dog hysteria: Inside the body of a speed eater

If you find competitive eating contests hard to stomach, imagine what it's like being the stomach of a competitive eater.
/ Source: TODAY

If you find competitive eating contests hard to stomach, imagine what it's like being the stomach of a competitive eater.

Professional speed eaters like Joey Chesnut, Matt Stonie, Takeru Kobayashi, nicknamed "the tsunami," or Molly Schuyler are not like us. They have suppressed gag reflexes and can control their esophagus muscles. While they aren't usually overweight, they have larger than normal stomachs, which have been slowly stretched out over time until becoming "a big, open soggy bag," according to David Metz, professor of medicine at the Hospital at the University of Pennsylvania.

Metz and colleagues studied speed eater Tim Janus for a study published in the American Journal of Roentgenology in 2007.

Inside the body of a speed eater.TODAY

Other than the Pennsylvania study, not much is known about what it takes to be a successful speed eater. Metz believes it's a combination of training and genetics.

Leading up to a competition, some speed eaters drink massive amounts of water or gorge on cabbage to expand their stomachs, without adding too many calories, says Metz.

Chestnut fasts before a competition. "I’ll make sure my stomach is loose by drinking liquid — but empty, no solid food. I’m pretty much a cleanse beforehand making sure I can take in a massive amount of food tomorrow," he said on TODAY in 2015.

Hot dogs are stacked up before the start of Nathan's annual hot dog eating contest in Coney Island.BRENDAN MCDERMID / Reuters

During the actual contest, the competitors dip their hot dogs and buns in water to increase lubrication, making it easier for the dogs to go down. After the eaters hurriedly chew the food, it moves to their esophagus just as it would with a normal eater. In a speed eater's esophagus, the muscles most likely become paralyzed, suppressing the gag reflex so they don't vomit the food back up.

From there, the food heads to the stomach, which is where speed eaters show the most difference from regular folks.

“The speed eaters have this unbelievable and uncanny ability to uncouple the muscle fibers so [the stomach] becomes a big open soggy bag,” Metz says. While most of us would feel full and our stomachs would distend, causing discomfort and sending a signal that says “enough,” speed eaters do not have the satiety reflex. Many report never feeling full, at least during the competition.

While the top half of the stomach expands and fills up like a storage tank, the lower half of the stomach grinds up the food into a smooth paste called chyme. If the chyme flows too fast into the small bowel, people experience "dumping syndrome," causing cramping, diarrhea, and abdominal pain. With the vast quantities of food and speed at which they eat it, it seems logical that some speeders would experience dumping, but they don’t. The chyme moves slowly into the small bowel, sometimes taking a few days to completely filter through.

“I think of these guys as the predator of the savanna. They don’t eat often; when they eat, they want to eat as much as (they) possibly can. They evolved to have these big stomachs,” says Metz.

While their blood sugar spikes much like anyone else, the speed eater maintains normal pancreatic function, delivering proper amounts of insulin to keep the blood sugar under control.

Over the next few days, the food continues to move from the stomach to the small bowel and through the lower intestine. Non-speed eaters would experience diarrhea trying to process this much food, but Metz says competitive eaters don’t.

Following an event, they don’t eat and when they resume eating, they eat sparingly.

Maybe the pro speed eaters feel OK in the short term, but the Pennsylvania researchers called competitive eating a "potentially self-destructive form of behavior." In 2011, the American Medical Association came out against speed eating, saying it "sets an unhealthy example for spectators" and that participants risk choking, stomach rupture and vomiting.

Hungry now?

This updated story was originally published in 2015