The Enhanced Games puts spotlight on weight loss drugs in swimming
Doping made the swimmer James Magnussen too heavy to swim fast. Honest Sport investigates the weight loss drugs Magnussen's Olympic teammates once tested positive for.
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When the former Olympic Australian swimmer James Magnussen was in training for a 50m Freestyle world record attempt, filmed during an hour-long Enhanced Games documentary, one moment was particularly poignant.
Magnussen, who won an individual silver medal at London 2012, was in the midst of a systematic 20-week doping programme when he realised his performance was suffering.
This protocol centred around the administration of synthetic testosterone to build up his muscle mass while a cocktail of unapproved, unregulated, but albeit prescribed growth hormone stimulating peptides were used for recovery.
In one scene, Magnussen is captured engaging in a blood doping technique, perhaps ozone therapy, to boost his red blood cell count and consequently endurance.
“We tried a few different things,” said the swimmer. “The base of it was testosterone and then peptides. We used BPC-157, CJC-1295, Ipamorelin and Thymosin.”
However, the drugs which gave Magnussen new strength, and speed of recovery, also slowed him down.
At 252lbs, the 6ft5 Magnussen was now too heavy for any credible attempt at the record held by the Brazilian Cesar Cielo since 2009, who inadvertently failed a drug test during his career.
The oversized Magnussen, who retired in 2018, fell two seconds short of Cielo’s record which stands at 20.91s.
Magnussen was literally sinking in the water.
“In all honesty, I got too big. It didn't translate well into the water that last probably two months, because I was just too big for a swimmer," said Magnussen.
Contrary to the marketing message of the Enhanced Games, which promises unparalleled performances achieved through doping, the Australian learnt the hard way that elite sport is already near perfectly optimised for high performance - irrespective of the use of prohibited substances.
The outdated muscular physiques of both Magnussen and the East German swimmers of the past, once plied with anabolic steroids from childhood, have now been surpassed in their effectiveness by those with leaner, less muscular frames.
Magnussen, who employed several desperate ‘tricks’ to improve his buoyancy, now promises to showcase a ‘leaner’, ‘meaner’, ‘faster’ physique at the Enhanced Games which will be held in Las Vegas next year. The leaner Enhanced Games swimmer Kristian Gkolomeev was indeed able to ‘break’ the world record in training.
Magnussen’s coach Brett Hawke described the problems faced by his added weight.
“I have been frustrated that we have been down here and, I am trying to elevate him [in the water]. So, we have tried a number of different tricks. We have had to make some adjustments,” said Hawke.
While the Australian swimmer did not disclose the secrets of the adopted ‘tricks’, weight management in swimming has long been a serious issue in the sport, as demonstrated by the traumatic experiences of many young swimmers.
Honest Sport now reports that there is a significant body of evidence that weight loss drugs, known as ‘water pills’, are being abused in professional swimming as they have been in weight-focussed sports such as gymnastics and boxing.
“This is unfortunately the most common use of diuretics; gymnasts trying to lose weight through water elimination, primarily in the thighs and buttocks,” the International Gymnastics Federation has warned previously.
‘Water pills’, otherwise known as diuretics, are a class of medications that increase both the production and excretion of urine. The drugs, such as furosemide and hydrochlorothiazide, help the body shed excess water and salts.
The medications are legitimately used to treat blood pressure and have consequently been at the centre of many inadvertent doping scandals at the highest level of swimming.
At the 2012 London Olympics, James Magnussen’s 4x100m medley relay mate Brenton Rickard, who was an alternate, tested positive for the diuretic furosemide.
A year later, another of Magnussen’s countrymates on the same London 2012 swim team, Kylie Palmer, also tested positive for the drug. And in 2011, the 50m freestyle world record holder Cesar Cielo, who was trained by Magnussen’s coach Brett Hawke prior to 2008, along with three of his Brazilian teammates, tested positive for furosemide at the same event.
In America, on the other hand, diuretics cases have tended to involve another diuretic - hydrochlorothiazide.
Twelve days after Michael Phelps won a record 8 gold medals at the Beijing 2008 Olympics, his training partner at the University of Michigan Emily Brunemann tested positive for hydrochlorothiazide. Between 2017 and 2018, two members of the same Team USA junior swim squad, Grace Ariola and Matthew Willenbring, also tested positive for the same drug.
More recently, the Tokyo 2020 Olympic champion Bella Sims failed a drug test for hydrochlorothiazide while training under Anthony Nesty, the Team USA head coach at Paris 2024. Nesty’s swim group at the University of Florida also includes the swimming superstars Katie Ledecky and Caeleb Dressel, who holds the fastest 50m Freestyle time in recent years.
All of the swimmers were cleared of any intent to cheat with defences ranging from contaminated supplements to mistakenly confusing a relative’s medication for laxatives, as was the case for Brunemann.
However, diuretics use in professional sport, and specifically swimming, has a dark side.
At the time of the East German state doping regime, Olympic athletes worldwide used diuretics prior to international competitions, when they knew they would be tested, to flush the traces of anabolic steroids from their system.
The technique was effective, and athletes were able to take anabolic steroids just two weeks prior to competition.
When three Chinese swimmers tested positive for hydrochlorothiazide in 2016 an anonymous source told The Times that they were concerned the swimmers were using ‘water pills’ as a masking agent.
“That all these swimmers test positive for the same masking agent, which cleans out their system ahead of testing, indicates a systematic network of doping athletes. There is a deep problem and there are rogues working in the sport,” said the source.
However, in modern day swimming, diuretics are unlikely used for this purpose.
A current official at a World Anti-Doping Agency-accredited laboratory has told Honest Sport, in confidence, that diuretics are instead used for their weight-loss properties.
“Most diuretics are readily detectable and, hence, nowadays not very useful anymore as masking agents,” said the official. “But they certainly still are effective in quickly reducing body weight.”
It is an opinion also shared by the former doping chemist Victor Conte who worked with the American Olympic swimmer Amy Van Dyken in his career.
“[It’s] not a real smart strategy,” said Conte.
In the past, diuretics would increase the speed at which the detectable by-products of anabolic steroids, known as metabolites, were excreted from the body by increasing the rate of urine flow. In 2012, however, a new long-term steroid metabolite test was developed which could detect anabolic steroids in urine months after administration irrespective of the use of diuretics.
Doping techniques have since changed and athletes take smaller doses of synthetic versions of natural compounds, such as testosterone and human growth hormone, which cannot be detected using standard steroid analysis. Human growth hormone, for example, can only be detected in blood samples.
The weight loss properties of diuretics, on the other hand, have preserved the drugs’ place as a doping agent in sport. Previously, the prevalence of diuretic use was largely confined, at least publicly, to weight sensitive sports such as boxing and gymnastics.
A recent doping case involving a swimming doctor and the story of a brave young American athlete, whose experiences have some parallels to those of young swimmers at the world’s best swim clubs, suggest that is no longer the case.
In 2019, the American runner Mary Cain revealed to the New York Times that she had been subjected to ‘emotional’ and ‘physical’ abuse in relation to her weight by the Nike coach Alberto Salazar, who was banned for doping for four years. Cain was subjected to ‘weigh-ins’ in front of her teammates as Salazar allegedly kept a maniacal focus on her weight.
“Alberto was constantly trying to get me to lose weight. He created an arbitrary number of 114lbs and he would usually weigh me in front of my teammates and publicly shame me if I wasn't hitting weight,” said Cain.
That same year, the Australian swim coach Dean Boxall was accused of ‘fat shaming’ and subjecting swimmers to public weigh-ins at St Peters Western Club (SPW). SPW is home to the Australian Olympic champion Ariarne Titmus and Shayna Jack, who inadvertently failed a drug test for the anabolic agent ligandrol in 2019.
“Dad, I can’t please this guy (Boxall). Every time I walk in, it’s about my weight”, said one young swimmer.
SPW and Boxall denied the allegations, but similar claims were made against a former SPW coach, Michael Palfrey, by the Australian Olympic swimmer Maddie Groves.
"I would basically go and hide in the bathrooms, or go and hide, like, in another part of the pool area so that I wouldn't have to do it [weigh-ins] or they wouldn't be able to find me," said Groves.
Earlier this year, the top British coach Jon Rudd was also accused of similar conduct at the Plymouth Leander Swimming Club, which was home to Ruta Meilutyte when she won the 100m breaststroke at London 2012 as a 15-year-old.
Where these stories differ drastically is Cain’s weight loss pressures ended with Salazar, who coached Sir Mo Farah to four Olympic gold medals, allegedly encouraging her to use prohibited diuretics to lose weight. There is no evidence of diuretic use at the two aforementioned swim clubs.
“He wanted to give me birth control pills and diuretics to lose weight, many of which are banned in athletics,” said Cain who did not succumb to Salazar’s purported demands.
Another of the group’s runners, Kara Goucher, was also given a legal thyroid drug by Salazar, without prescription, for weight loss purposes rather than to treat any legitimate thyroid condition.
Cain is now a council member at the Sport & Rights Alliance safeguarding centre which safeguards athletes against such welfare issues.
In 2006, 44% of sampled young swimmers, between the ages of 11 and 19 years old, demonstrated abnormal eating behaviours which can include the use of diuretics, according to academics at the University of Rio de Janeiro.
“Disordered eating (DE), a component of the female athlete triad, refers to a group of abnormal eating behaviors such as restrictive eating, fasting, frequently skipping meals, the use of diet pills, laxatives, diuretics, or enemas, overeating, binge eating, and purging,” read the study.
Cain’s story, in relation to diuretics, and the experiences of many young swimmers remain a brutal reminder of the toxic pressures of elite sport.
Next year, when James Magnussen subjects himself to self-enforced weight loss during an attempt to break the freestyle world record at the Enhanced Games, he will have the benefit of competing in an unregulated ‘sport’ free of drug testing.
For many young swimmers who are subjected to forced weight loss, unlike Magnussen, they must rely on the regulated sports world to stop bad actors from operating freely.
Last month, the International Testing Agency announced that it has suspended the Bolivian doctor Dr Matheus Das Neves Borgo for six years for administering the Olympic swimmer María José Ribera with furosemide, the same diuretic she tested positive for at the Paris 2024 Olympics.
“The doctor asked a supplement manufacturing laboratory to include the prohibited substance furosemide to made-to order supplements used by swimmer María José Ribera, who then tested positive for furosemide,” reads the ITA’s press release about the case.
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