The Enhanced Games are Sunday. Here's what to know about the controversial event

"I understand that there's a very large commercial opportunity for this company, but it is something I think borders on the lines of ethics," said Dr. Aaron Baggish, a professor of medicine at the University of Lausanne in Switzerland who worked with sports teams in Boston for 20 years.

The one-night competition will be held in custom-built arena at Resorts World Las Vegas with a four-lane 50-meter pool, a six-lane sprint track and a weightlifting stage.

What will happen at the Enhanced Games?

Over 40 athletes from across the globe will compete across three sports: swimming, track and weightlifting. There will also be a "strongman" deadlift showdown..

The four swimming events are 50-meter and 100-meter races in both freestyle and butterfly. The track and field races include the 100-meter sprint and the 100-meter and 110-meter hurdles. The weightlifting series will feature the clean and jerk as well as the snatch events.

The total prize pool for the games is $25 million, CEO Max Martin told Front Office Sports News. Each individual event has a total purse of $500,000, with a $250,000 prize awarded to first place. The company also said that if an athlete breaks a world record in either the 100-meter sprint or the 50-meter freestyle, they will be given an additional $1 million. Though, neither mark would be recognized by governing bodies, such as World Athletics, which requires drug testing.

Enhanced Games competitors are allowed to use performance-enhancing drugs that are banned in internationally recognized sporting events. According to the company, the drugs are FDA-approved and prescribed by doctors.

Enhanced did not break down what specific athletes used which drugs, but they announced on Wednesday in the lead-up to the event that 91% of the athletes competing used testosterone or testosterone esters, 79% used human growth hormone, and 62% used stimulants, such as adderall.

Baggish said the public should understand that "FDA approval does not equate with safe use when the drug is not used the way the FDA has approved it."

He added that there is a difference between someone being prescribed testosterone because they don't produce enough versus someone taking much larger doses for athletic achievement.

Research on high doses of drugs like testosterone, for example, have shown an increased risk of heart disease, Baggish said. He said the number of Enhanced athletes using testosterone is "very concerning."

"We have to be careful not to confuse short-term success with long term implications," Baggish said. "These athletes, I assume many of them, if not all of them, will go through the Enhanced Games without any visible problems whatsoever."

"But what happens to them three years from now, five years from now?" Baggish said.

For context, the International Olympic Committee follows strict guidelines on doping with the World Anti-Doping Agency list of prohibited substances. These include testosterone, human growth hormones, and stimulants such as adderall. There are a few strict exemptions.

Who's behind the games?

Enhanced Games was founded by Aron D'Souza, an Australian entrepreneur and lawyer who previously worked with Thiel to file litigation against Gawker Media. Martin, the CEO of Enhancement, took over for D'Souza in November.

In 2023, D'Souza announced the Enhanced Games, and last May at a launch event he divulged the details. At the event, he said the idea for the games came to him in 2022 "during a moment of reflection."

"I imagined a new kind of competition, one where science and sport and society could evolve together, where we stopped apologizing for progress and started to embrace it," D'Souza said.

His company is exploring athletic enhancement "openly, responsibly and ethically," he added.

The administration of the drugs was overseen by independent medical and scientific commissions, he said. D'Souza said the drugs would be administered with "fully personalized protocols and constant monitoring to ensure their safety and peak performance."

Baggish, the professor of medicine, said he was approached to join Enhanced Games as a doctor which he said he immediately turned down. He said the apparent medical oversight should not blind people to the dangers of performance-enhancement drugs.

"That's akin to me saying: If I'm a physician watching you smoke cigarettes, I can make smoking safe for you," Baggish said.

Representatives for Enhanced Games did not immediately respond to a request for comment on the criticism of the games. In a 2024 statement responding to the International Federation of Sports Medicine's concerns over the games, D'Souza said the competition's approach "aims to reduce the risks associated with unregulated practices and bring them under medical oversight."

"The Enhanced Games do not promote the indiscriminate use of restricted substances," D'Souza said. "Instead, we advocate for the safe, responsible and clinically supervised use of performance enhancements."

Which athletes are participating?

There are some big names competing at the games.

U.S. Olympic gold-medalist swimmers Cody Miller and Hunter Armstrong, a former world-record holder, along with British Olympic silver-medalist swimmer Ben Proud will compete. U.S. runner Fred Kerley, a three-time world champion and two-time Olympic medalist, will be a sprinter at the games. Kerley was banned from competing in globally recognized competition for two years after missing drug tests — a violation of anti-doping rules that does not necessarily mean an athlete is taking drugs — the Athletics Integrity Unity announced in March.

Armstrong and Kerley have said they are among the athletes who won't be using performance-enhancing drugs in the games.

Most of the participating athletes trained for the competition in Abu Dhabi as part of Enhanced's own study.

Former NFL player Emmanuel Acho and MLB Network broadcaster Abby Labar will be the anchors for the competition.

What do the experts say?

The games have been largely panned by outside medical experts and sports governing bodies. Multiple recent studies assess the harm surrounding the Enhanced Games.

Travis Tygart, the CEO of the U.S. Anti-Doping Agency, called the games a "dangerous clown show that puts profit over principle" in a statement. The International Olympic Committee said the games are a "betrayal of everything that we stand for." The World Anti-Doping Agency (WADA) last year urged U.S. authorities to stop the games.

The International Federation of Sports Medicine said in 2024 that they see the medical oversight as "insufficient" to support the athletes.

"There's simply no way to make the use of these drugs safe by medical monitoring in the short and long term," Baggish, the professor of medicine, said. "It's essentially a natural history experiment to see what happens."

Dr. Michael Joyner, a clinical anesthesiologist whose research focuses on physiology and human performance, said that there's a credible body of research showing the effects of doping across a wide spectrum of people, including a study linking the premature deaths of bodybuilders to the use of steroids, and archival data from East Germany in the 1960s.

"The question is: What is anybody trying to prove?" Joyner said. "It's been known for years that anabolic steroids work," he added, "I don't understand what's new here."