Obesity in a high school football player.

When a physician disqualifies an athlete based on theoretical deleterious effects, he is doing so based on the perception that the risk of participation is sufficient to override the athlete's desire to participate (4). If sports participation is very important to the athlete, the sports physician should determine what interventions might reduce the risk of participation. Rather than look for reasons for disqualification, the team physician should look for ways for the athlete to participate more safely and reduce the risk of injury. (If the risk of participation is too high, the athlete should be disqualified.) In this case an aggressive shoulder rehabilitation program and prompt follow-up of his asthma and anemia would have been helpful to this athlete's participation in football. In general, team physicians should weigh all the potential risks and benefits in each case and involve the athlete and the family when these difficult playability issues arise. The team physician should be mindful of potential conflicts of interests and should be careful to avoid imposing his or her own values on the athlete. In this case, the disqualification of this athlete based on obesity was not in his best interest. Whether the potential conflicts in decision making played a role in the decision in this case will never be known. Weighing the facts as presented, I believe the athlete's interests would have been better served by allowing him to play after completing a shoulder rehabilitation program.