Bodybuilding and its risks

This past week, the bodybuilding community was struck with a devastating loss with the passing of world-class bodybuilder Cedric McMillan. Cedric was a military and family man and an inspiration to many in the world of fitness, inspiring all to become their best selves. Cedric McMillan brought one of the most complete bodybuilding packages to the stage, mixing sheer mass with classic aesthetic lines. His Arnold Classic 2017 performance was one of the best physiques to ever grace the bodybuilding stage and his victory speech afterwards will speak to all who hear it. With all his great attributes, it is hard not to find a fan of Cedric McMillan. 

Unfortunately, Cedric suffered a heart attack on April 12 at the age of 44. His death marks one of the many that have torn through the fitness community in the last couple of years. Particularly, heart failure seems to be the most prevalent cause of death among professional bodybuilders. There are many factors to consider that make the bodybuilding lifestyle inherently dangerous, but also recent factors surrounding COVID-19 may account for the abnormal spike across top level competitors. 

A major factor that contributes to the unhealthiness of the professional bodybuilding lifestyle is the sheer weight packed on the frames of most bodybuilders. Having large amounts of body mass can put undue strain on various organ systems over time. Although overly-muscled bodies may be the ideal for professional bodybuilding, it is not the ideal when it comes to health and longevity. The organ systems most damaged by bodybuilding tend to be the heart, liver, and kidneys, but with the recent bouts of cardiac arrest, the spotlight will be put on the cardiovascular system. The heart may become overburdened with the task of pumping blood through 240+ lbs. of a body on frames that were never meant to hold that much size. 

Considering that the anabolic steroids and human growth hormone that are utilized in bodybuilding can enlarge the cardiac muscles of the heart as well, the heart can become very susceptible to failure. Dallas McCarver, a young promising bodybuilder who passed away in 2017 at just 27 years old, was found to have a heart weighing over 800 grams which is nearly three times the mass of the average human heart. Individual genetic response to steroids and training can affect the rate of and overall growth of the heart, but accumulating 250+ lbs. of on-stage weight to even 300 lbs. and more in the off-season increases the burden of the heart drastically. 

A more recent cardiac burden that has arisen in the last few years is the emergence of COVID-19 and related dangers. We have all heard of the risk of myocarditis among those who have suffered from the virus. The effects of infection can affect the entire population, even trained athletes. Considering that bodybuilders spend a lot of time in the gym, undergoing muscular and cardiovascular stress nearly daily, it is safe to consider them athletes in some sense. There have been many cases of the virus causing long term effects to the many high-level bodybuilders who got COVID. 

Cedric McMillan himself was hospitalized after his run in with the virus. The risk of myocarditis is likely enhanced by the strain already put on the heart as well as the stress on all the organ systems, possibly reducing overall immune system function. There is also the risk of myocarditis due to vaccination that cannot be ignored if all factors for the spike in recent deaths are being considered. No one is certain of long-term effects of either COVID or vaccination for the virus, so it is important to keep an open mind when the bodybuilding community is trying to keep their athletes safe. 

The last factor and one of the biggest associated strictly with bodybuilding is anabolic steroids, performance enhancing drugs, and diuretics. Clearly, the average human body is not meant to build and maintain professional bodybuilder levels of muscle mass on its frame. The average person has nowhere near the endogenous hormonal support to sustain muscle development and maintenance on that scale. Not to say people cannot build large and impressive amounts of muscle naturally, but there is clear assistance needed to ever reach the size and conditioning needed to step on the Olympia stage. Anabolic steroids can disrupt the endocrine system with the introduction of exogenous hormones and long-term use can severely hinder the ability for the body’s natural processes to ever recover, hence why many retired bodybuilders are on some form of testosterone replacement therapy. 

Anabolic steroids themselves and how they act on the body is not usually the most dangerous practice in bodybuilding, but the mismanagement of steroid cycles can cause fairly severe damage to the kidneys in the case of oral steroids. Other drugs such as insulin or diuretics are wildly dangerous. The use of insulin is a high-risk practice used due to insulin’s inherent anabolic properties of preventing cell breakdown and aiding in protein synthesis, but its use can cause severe and even fatal hypoglycemia (low blood sugar) to bodybuilders who already tend to be very insulin sensitive individuals. The use of diuretics is common to achieve the grainy shrink-wrapped look that is desired when on stage. They are not typically used until the last weeks of prep for a competition. 

Diuretics dry out individuals of much of the water in their bodies, allowing the skin to press tight against the muscles, showing striations and conditioning beyond what can achieved through diet alone. With this immense dehydration and severe electrolyte imbalance, bodybuilders can pass away suddenly like the late, great Mohammed Benaziza did in 1992 just after competing. The most conditioned bodybuilder Andreas Munzer passed away in 1996 after total liver and kidney failure due to chronic diuretic use from which he achieved his iconic look.  

The recent tragic losses have opened the eyes of many fans of bodybuilding and particularly the athletes themselves. Many have advocated for more routine blood tests, which check for proper metabolic and hormonal function in people, as often as possible. Some have advocated for changing the emphasis on conditioning in the scoring criteria in order to prevent the use of diuretics, opting for more of a focus on size and shape. Some athletes have changed divisions, opting to go down to lower weight classes such as Keone Pearson who went from the 212 division back to classic physique after last year’s deaths of former Mr. Olympia, Shawn Rhoden, aged 46, and Keone’s former fellow classic physique and 212 competitor, George Peterson, aged 37. 

Many have also advocated for the downsizing of competitors when they are not competing and or are already retired, in order to alleviate the stress on their bodies. The bodybuilding and fitness community has taken these tragedies as an opportunity to advocate for healthier practices that will allow everyone to enjoy the sport and lifestyle that is bodybuilding in the long term.

In Memory of Cedric McMillan.