Bodybuilding: understand the risks of the sport that takes the body to the extreme

Athlete and influencer Gabriel Ganley died, this Saturday (23), aged 22. The information was released by Integral Médica, a sports supplement company. According to CNN Brasil, he was found dead in his apartment in the capital of São Paulo.

Bodybuilding is a sport that involves sculpting bodies, mainly through muscle growth and fat loss. To be able to meet the evaluation criteria, such as volume, definition and proportions, athletes face a rigid routine of intense training and restrictive diet. However, some practices that go beyond healthy can pose health risks.

A study published this year in the European Heart Journal found that professional bodybuilders have a five times greater risk of sudden death compared to amateur athletes. To reach the conclusion, the work analyzed more than 20 thousand athletes who competed in International Federation of Bodybuilding & Fitness (IFBB) events between 2005 and 2020, with an average follow-up period of more than eight years.

For researchers, competitive bodybuilding can impose physical and psychological stress on professionals, through intense training, strict diets, dehydration techniques and the use of anabolic steroids. These factors, in the view of the study authors, can overload the cardiovascular system, increasing the risk of arrhythmias and cardiac structural changes over time.

"The bodybuilder's preparation involves months or years and the planning must be thorough and monitored by experts. However, supplements and the use of anabolic steroids come largely from the 'underground' world, from the known layman and, often, further expose the health of these athletes", says Clayton Macedo, director of the Brazilian Society of Endocrinology and Metabology (SBEM), to CNN Brasil.

Preparing a bodybuilder involves intense training and restricted nutrition
Preparing a bodybuilder athlete involves different steps. Bodybuilding training is generally divided into muscle groups, with varying cycles to gain strength and definition.

The diet must also be balanced and followed strictly, with an adequate and personalized amount of proteins, carbohydrates and fats. "Food has a specific and strategic role in training. There is the mass gain phase, which is bulking, where the athlete needs to have a caloric surplus, maximize protein synthesis and ensure recovery for muscle building", explains Macedo.

After bulking comes the phase of defining and reducing body fat, trying to preserve lean mass. This step is called cutting. "This requires the restriction, often severe, of some nutrients, manipulation of macronutrients and the risk of nutritional deficiencies, dehydration and even hormonal dysregulation. Therefore, adequate support from nutritionists, specialized and well-intentioned doctors is necessary, because, if not, the athlete enters into metabolic exhaustion and great physiological suffering", he states.

What are the risks associated with bodybuilding?
The health risks associated with bodybuilding are mainly related to calorie restrictions and the use of anabolic steroids - a practice prohibited by the Federal Council of Medicine (CFM) as of CFM Resolution No. 2,333/2023, which prohibits the prescription of androgenic hormones and anabolic steroids for aesthetic or sports performance.

"There are very specific indications for the use of steroids that are not recommended for professional bodybuilding. But we know that the use of anabolic steroids has become almost institutionalized and normalized, but that doesn't mean it will become legitimate", says Macedo.

According to Amanda Gonzales, doctor at the Exercise Cardiology Unit at Hospital Sírio-Libanês in São Paulo, an association between the use of anabolic substances and cardiovascular risk, such as increased blood pressure, formation of plaques in the coronary arteries, changes in vascular function and increased risk of thrombosis, is already well established by science.

"There is no 'safe dose' for the supplementary use of these substances, whether for aesthetic purposes or performance gains. What often happens is the unequivocal interpretation of tests by some health professionals, who prescribe them as 'hormonal replacement or modulation'", says the specialist to CNN Brasil.

The risk occurs because anabolic steroids alter the functioning of several subsystems in the body, increasing bad cholesterol (LDL), reducing good cholesterol (HDL) and favoring the thickening of the heart muscle. "These changes, in the medium and long term, increase the risk of heart attack, stroke and sudden death, even in apparently healthy young people", explains Carlos Rassi, cardiologist at Hospital Sírio-Libanês in Brasília, to CNN Brasil.

In relation to restrictive diets, cases in which there is a sudden cut of carbohydrates and fats, combined with intense exercise and long periods of fasting, can harm the functioning of the body in several areas, with consequences such as hypoglycemia, loss of lean mass, hormonal changes, mood problems, sleep changes and even a deficiency in the immune system, according to Rassi.

Another point of attention is cutting out water and salt, a practice carried out by many bodybuilders before competitions to appear "drier". "Intense dehydration, with the aim of eliminating fluids from the body, can lead to water and electrolyte disorders, increasing the risk of arrhythmias, thrombosis, as well as acute kidney changes and digestive problems", warns Gonzales.

Intense training, when not carried out with adequate rest and accompanied by a professional, can lead to relative energy deficiency syndrome or a state of overtraining. "In some cases, it can even lead to hypogonadism syndrome, which is the decrease in sexual hormones associated with exercise and excessive dietary care", says Macedo.

For this reason, experts emphasize: bodybuilding, to be a safe practice, must be carried out under the supervision of specialists from different medical areas, with constant adjustment of dietary needs, periodic and preventive exams and with attention to the use of anabolic steroids without medical indication.

Consumption of anabolic steroids without medical advice is harmful to health

Source: CNN