Professional bodybuilding is one of the most dangerous sports in the world, especially through usual excesses such as drug abuse. This now shows more than ever a shocking study.
“Hail to the King” (“Long live the king”), the band’s heavy metal anthem Avenged Sevenfoldbooms from the boxes in Greater Convention Center in Columbus, Ohio. It is March 4, 2017. 5,000 spectators fire Dallas McCarver and Cedric McMillan, who pose on stage for the title at the “Arnold Classics”. Huge muscles, veins like cables. In 2017, McCarver and McMillan are the kings of the bodybuilders. In 2022 both are dead – their hearts simply stopped beating.
According to a new study by the University of Padua/Italy, her death was not surprising. Sports doctors Daniel Neunhaeuserer and Marco Vecchiato have observed 20,286 male bodybuilders who started between 2005 and 2020 in competitions of the World Association IFBB. 121 died in the observation period, almost 40 percent of it due to sudden cardiac death, which was the most common cause of death.
Daniel Neunhaeuserer (left) and Marco Vecchiato (right), researcher at the University of Padua
Risk for sudden cardiac death increases many times
“In football or the marathon, we have one to two athletes per 100,000 years of athletes who suffer a sudden cardiac death”, explains Daniel Neunhaeuserer. An athlete year stands for an athlete who is active for a year. If you observe 100 athletes, for example, over two years, this result in 200 years of athletes. “In amateur bodybuilding we are at 20, even in the professional sector in 130 cases.”
According to the study, seven percent even died of the examined athletes who had participated in the highest “Mr. Olympia” competition because the most important organ stopped. “Here the sudden cardiac death can no longer be described as a rare event”, says Vecchiato.
The researchers got the idea for their study at the Fibo fitness fair in Cologne. They actually wanted to give a lecture on another topic there. But then they happened to take a look at the bodybuilder hall, where a muscle show was taking place-a staging of the extremes. The two doctors were fascinated and shocked at the same time. A sport with a large audience, hardly researched in sports science.
Excesses in the extreme the problem
Back at the University of Padua, they started to deal with bodybuilding in its extreme form. They researched athletes and their causes worldwide through publicly accessible sources. “On the one hand you can learn from these athletes. You know your body very carefully, have a healthy lifestyle, regularly do strength training and pay great attention to your diet”explains Neunhaeuserer. “It becomes problematic if you drive these principles into extremes.”
Then the benefits return to the contrary: a permanently very high protein intake burdens the kidneys. Diuretics, drilling medication, move the electrolyte balance and strain the circulation and heart. The crash diets that are common before competitions weaken the entire organism. The biggest problem, however, is: doping.
Anabolic steroids and other forbidden substances are often a matter of course in the scene. The consequences range from hormone disorders and organ damage to cardiac arrhythmias, renal failure and sudden cardiac death. Ninehaeuser: “We have autopic reports, toxicological reports that show that doping is a problem. We have also found clear statements from professional bodybuilders on social media.”
Bodybuilder Matthias Botthof in action
“Doping is part of it”
Matthias Botthof, once one of the most successful German bodybuilders, confirms: “Doping is part of professionalbodybuilding. I was aware of the risks, but I displaced them.” Only when he felt cardiac arrhythmias did he look for medical help. Today he is poured, but bodybuilding is still his life. He runs a gym in his hometown Gudensberg in Hesse. Cardio training on the ground floor, iron are held in the basement.
When asked whether he would do bodybuilding again so excessively, Botthof is silent. “Of course you often think back what you have done to your body in the hardcore bodybuilding time”he finally says. “When I hear that a bodybuilder died again, I am of course worried and then think: Fortunately you got out of the matter so well so far, and hopefully it stays that way.”
Ex-bodybuilder and studio owner Matthias Botthof (right)
Lifelong risks
This is not guaranteed, says Potsdam cardiologist Claudia Beckendorf: “If a heart is damaged by anabolic steroids, the changes are no longer reversible. Those affected have these risks for a lifetime – possibly up to sudden cardiac death.” Often an ultrasound is sufficient to distinguish the heart of a doped bodybuilder from that of a competitive athlete and to recognize the dangers: “Compared to a typical athlete’s heart, the hearts of bodybuilders who have taken anabolic steroids thicken themselves and beyond the norm: the heart muscle may then no longer be sufficiently supplied with oxygen.”
Beckendorf looks after many athletes at the Olympic base Potsdam. But bodybuilder? So far, only one has found their way into their practice. “He had changes to my heart and admitted to having taken anabolic steroids earlier”, she says. Beckendorf recommends regular medical screening to recognize risks at an early stage.
No interest in education?
The researchers are also committed to this in Padua. As the next step, they want to support the study with the help of medical data – if possible in cooperation with those affected. In order to minimize the risks of the heart and to displace the sudden cardiac death from bodybuilding, all parties would have to play along, including the organizers.
But that’s exactly what it seems to be a catch. The World Association IFBB does not seem to have any real interest in combining doping consistently. This would go hand in hand with the fact that less spectacular bodies are displayed on stage. The World Antidoping Agency Wada classified the association in 2022 due to a lack of tests and noticeably many positive cases. And according to the WADA, IFBB has so far not made any significant efforts to change something. The IFBB has not responded to several inquiries from the ARD doping editorial team.