Steroids, Fake Tans, and Muscle: Inside the World of Bodybuilding

Roy A. Meals, MD

Jul 31

It is probably not entirely coincidental that synthetic testosterone became available in 1935 and that the Mr. America bodybuilding contest started in 1939, Mr. Universe in 1948, and Mr. Olympia in 1955.

Female bodybuilding contests trailed several decades behind male ones, and, as one might expect, audiences differed on what form a female winner should take—some resemblance to a Grecian goddess's physique or just hugely muscular. The best of both are rewarded, because today women bodybuilders can compete in five categories: Physique, Figure, Fitness, Bikini, and Wellness. Universally evaluated are poses in increments of 90-degree turns along with demonstrated poise throughout the judging. The fitness category also requires a dance routine that includes a push-up, high kick, straddle hold, and side split. Some categories call for high heels and jewelry, others for bare feet.

To prepare for a competition, male bodybuilders tell me, it takes about three months of disciplined work to go from routinely robust to awesome. They continue with their usual strenuous weight-lifting routine and begin intense endurance training and dieting to reduce their body fat, which masks their musculature. Their diet during the final month consists mostly of chicken breast, fish, broccoli, asparagus, and a little rice supplemented with nutrients and protein shakes, which in total might add up to 1,000 calories per day. The aim is to reduce body fat to 3–7 percent of the total body, which from a general health perspective is dangerously low. Several days before the competition they begin loading up on carbohydrates to add glycogen and bulk to their already bulging muscles. For the last 36 hours they restrict water and sodium intake, leaving themselves starved, dehydrated, and likely irritable, but now nothing but skin separates their muscles from each judge's scrutiny. Additionally, some bodybuilders indulge in a pre-performance belly-flattening enema. Because of the overall commitment required, most bodybuilders do not compete more than once or twice a year.

For the event itself, a natural tan will not hold up under the bright lights, and advice on the Internet includes, "When you think you're tan enough, do another two coats! Judges can and will hold a poor tan against you, so err on the side of caution and assume that more is better." To further take advantage of the bright lights to demonstrate muscle definition, bodybuilders shave with safety razors. Electric ones don't trim close enough.

For the women, the bikinis are small, sparkly, and require particular attention to detail. "Since you need to make sure you are 'secured' in your suits, make sure to bring some suit glue."

Although they looked trim and fit, their clothing completely disguised their lean physiques and awesomely developed musculature.

Male bodybuilders compete in three categories: Men's Physique, Classical Physique, and Men's Bodybuilding. The typical body shape/size by category is robust, plausible, and unbelievably freakish, respectively. As the muscles get larger from one category to the next, the outfits get smaller: board shorts to small briefs to even smaller "posing briefs." In Men's Physique, the contestants are judged from both front and back but without any blatant muscle flexing. For the Classic Physique and Bodybuilding categories, each contestant assumes eight different required poses. These include front and rear double biceps, front and rear lat (latissimus dorsi) spreads, side triceps, side chest, and front abs and thighs. Following the obligatory poses, contestants have an opportunity during the "pose down" to flex freely in an individualized, choreographed sequence of postures that they think maximally display their splendors. In case you think bodybuilding contests have passed you by, some of them have age categories to accommodate everyone, including masters (over 39 years old), grand masters (over 49), and even super ultra platinum masters (over 79).

For both men and women bodybuilders who, despite overtime in the gym, lack symmetry or who can't make a particular muscle stand out, assistance is available via Synthol injections or surgical implants. Just as the use of growth-enhancing medicinals such as steroids, growth hormone, and insulin are unregulated in most competitions, so are physical-bulk enhancers. Synthol, which is mostly oil with some local anesthetic and alcohol mixed in, is advertised as a posing oil with characteristics purportedly better than baby oil and olive oil. Some bodybuilders, however, use it as a "site enhancement oil" and inject it to "fluff" out an otherwise perfect physique. (Why else would it contain local anesthetic?)

To learn more about this performance art, I recently attended a bodybuilding competition—as a spectator. The International Natural Bodybuilding Association was the host. It takes great pride in being one of the bodybuilding organizations that pays more than lip service to prohibiting use of performance-enhancing drugs. The INBA randomly picks contestants for testing and routinely tests winners in each category.

I paid extra for a backstage pass to visit the prep rooms, which early on had standing room only and displayed vast expanses of "tanned" skin tightly stretched over bulging muscles, none freakishly large in accordance with the INBA's firm stance against performance-enhancing drugs. Contestants not satisfied with the sheen provided by their newly applied spray tan were applying posing oil to themselves and to the backs of fellow competitors. Some had brought their dumbbells along and were "pumping up" their muscles into full glory. Others were doing slow, controlled push-ups between strewn-about gym bags laden with supplements. I glanced into the women's ready room but immediately turned away in shock. Amazons! In bikinis and high heels! With eye shadow!

The audience nearly filled the 300-seat theater, and everyone I talked to was either a friend or family member of one of the competitors. Seven judges, male and female, all former bodybuilders, sat in the front row with clipboards in hand. Several rows back a professional photographer clicked away all day, providing images for the INBA's magazine, Ironman. A forest of trophies covered five or six tables at the back of the stage. For each category, the emcee introduced competitors by name, age, city, time in training, and day job. Many were personal trainers, but the clergy, police force, and business interests were also represented. In categories that had at least three competitors, the host awarded checks of $1,000, $500, and $300 to the top three winners. In addition, the trophy tables were gradually deforested over the day.

For part of the show (after the Amazon jolt, as I recall), I sat next to a woman whose husband was competing. They had flown into Los Angeles from Austin, Texas, the day before, were staying in a hotel for two nights, and then flying home. He won his category, which included seven or eight competitors, so naturally his wife excitedly photographed him holding up his giant $1,000 check. Some silent calculations convinced me, however, that by the time they got home, they would be ahead by only the trophy and maybe some brag rights at their gym—"their gym" because sometimes she also competes. Maybe his photo in Ironman would garner him a product endorsement, movie audition, or additional clients to train, but it had to be more than prize money that motivated him.

I had an even more depressive thought as the day progressed. After they had performed, showered off their tans, and donned warm-ups, some of the contestants came out and sat in the audience. Although they looked trim and fit, their clothing completely disguised their lean physiques and awesomely developed musculature. For instance, there was no evidence whatsoever that their abs looked like biscuits on a baking sheet and that their silhouettes when performing their front-lat spreads reminded one of a hulking B-52 bomber. Consider that the men rigidly diet for at least three months to reduce their body fat to 5 percent of their overall weight. (The American Council on Exercise says that "fit" and "athletic" men have about 16 percent and 9 percent body fat, respectively. For women, the averages are several percentage points higher.) Then the contestants pump iron obsessively and especially spot-train muscles that aren't quite as grand as their others to gain "symmetry." After all of this they might win a trophy and a break-even weekend in Southern California.

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