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Some say it’s a waste of food, others say it’s dangerous, but it continues to rise in popularity. A major speed eating event took place in Toronto just this past weekend with some of the world’s top eaters racing to down heaps of poutine. But at what cost?

Many critics of eating contests are concerned that consuming dozens of hot dogs or a 5 pound steak can lead to lasting damage.

Gastroenterologist, Dr. David Armstrong says, there are very few recorded cases of permanent damage caused by speed eating, but little research has been done on the topic.

One study compared a top ranked speed eater with an average eater. The speed eater’s stomach could expand to a much greater size but it emptied food more slowly. Armstrong says speed eaters train their bodies to push beyond the discomfort of fullness.

“To that extent it’s like any other sport which is where they learn how to adapt to the discomfort or pain that comes with going beyond the normal boundaries.”

There have been a few cases of death by choking at amateur eating competitions, but events sanctioned by ‘major league eating’ the body that oversees professional speed eating, have paramedics on standby and their competitors know their bodies inside and out.