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A paper I wrote on Eating disorders in bodybuilders

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Johan, here is the paper that I was talking about. By no means is it a complete discussion of the topics, I was only allowed so many pages.

Of course, there are many many articles that may dispute what i found, but I had a hard time finding any research done strictly with bodybuilders and their diets. This is especially true when it comes to the affects of high protein diets.


also, I am new to bodybuilding so my ideas about the eating behavior may be off. Feel free to correct me. The more I know the better!



A.Boss 2009


The Eating Behaviors of Bodybuilders and the Effects of Their Diet


The sport of bodybuilding requires a lot of self- discipline; this includes maintaining an intense work out schedule that constantly pushes the bodies’ boundaries as well as consuming an extremely disciplined diet. These practices may lead to the development of serious detrimental eating behaviors among bodybuilders. All bodybuilders (male or female) use particular eating methods in order to achieve their “ideal” competition weight and physique. These methods may include a “bulking phase”, a period of eating in which the bodybuilder will eat more food in an effort to put on more muscle mass and weight, as well as a “cutting phase” in which they will eat what is known as a “clean diet” or a diet that cuts out all junk foods (foods high in sugar and fat or empty calories) and contains a certain macro nutrient ratio. This paper is concerned with how these strict eating behaviors and exercise regimens affect the bodybuilder’s probability of developing an eating disorder as well as what possible negative effects the eating habits may have on the body (in particular how they affect the kidneys, blood chemistry and bones).

Bodybuilders are constantly fluctuating between bulking and cutting as their training seasons change (they typically begin cutting about 16-18 weeks prior to a competition). [the change in appearance from the cut competition physique to a less defined physique during the bulking phase combined with the constant strive to reach perfection may eventually affect how the bodybuilder perceives their body image and ultimately lead to an eating disorder.] It appears that eating disorders among bodybuilders may be more common than thought; the large online bodybuilding forum http://www.bodybuilding.com dedicates an entire thread to eating disorders so that its members can discuss the issues they have had with their eating habits. In fact, according to a scientific article by William M. (2005), 30% of competitive bodybuilders have fit the diagnostic criterion for bulimia nervosa. This same article suggests that it is not solely the preparation for competition that influences the obsessive eating and exercise habits/behaviors used to achieve the ideal body image. However, the pre-competition diet may in fact lead bodybuilders to develop a habit of binge eating. The implementation of strict dieting and avoidance of junk food may actually have something to do with the binge eating found in bodybuilders. William suggests that this is because when people are deprived of food they become obsessed about those foods which they cannot have (such as high calorie foods). This deprivation also leads to a decreased capability to feel internal cues and feelings of hunger and satiation. A study was conducted by Goldfield et al. (2006) to determine the prevalence of bulimia in bodybuilders. The study compared competitive male bodybuilders, recreational bodybuilders and men with bulimia nervosa (who were not bodybuilders) using a questionnaire, the Beck Depression Inventory and the Eating Disorder Inventory. The study found that the competitive bodybuilders had higher rates of binge eating, bulimia nervosa and they also used Anabolic Androgenic steroids more often than the other two groups enlisted in the study, suggesting a preoccupation with body image. Goldfield states that, male bodybuilders report more of the following psychological characteristics (independent of disordered eating): narcissism, hyper masculine beliefs and homophobia, ineffectiveness, and elevated scores on obsessionality, perfectioninism and anhedonia. This is perhaps an explanation for the prevalence of developing the disorder, particularly having the characteristics; obsessionality and perfectioninism. Regarding body image, Goldfield found that there were no group differences for the desire to obtain a more toned muscular body, which indicates that while male bodybuilders were already muscularly large they were still not satisfied with their appearance. This drive for a more satisfying appearance is consistent with the disorder muscle dysmoprhia, which is also sometime referred to as bigorexia (a reverse version of anorexia in which the person wishes to become bigger instead of smaller).

Eating disorders are not often associated with males and more studies have been done regarding their female counterparts. However, recently there have been more studies done with a focus on the male population. A study conducted by Roberto Olivardia et al. (2004) studied psychological traits and body image in 154 college men. The researchers were interested in how subjects perceived themselves (more muscular or less fat), and if depression had any correlation on muscle belittlement or fat exaggeration. They were also interested in if EDI scores would also be positively correlated with muscle belittlement and fat exaggeration. The subject’s self perception was measured using the Somatomorphic Matrix (which had men choose from a group of images of the male body they thought most women would chose as their ideal male physique.) The study found that the men thought that women would want lean muscular male bodies as their ideal, when, in fact, the women did not chose a lean muscular body as their ideal. They also found that men thought they were more muscular and slightly fatter than they actually were. What is important with regards to causation of muscle dysmorphia is that these men perceived themselves to be significantly less muscular than what they thought would be the ideal of females.

Depression as it related to body satisfaction and muscle belittlement was measured using the Beck Depression Inventory- Short Form. The results showed that depression was, as hypothesized, positively correlated with muscle belittlement but not positively correlated with fat exaggeration. They also found that six of the EDI scores were positively correlated with muscle belittlement, theses scores included: bulimia, body dissatisfaction, ineffectiveness, interpersonal distrust, drive for thinness and total EDI. [While this study did not focus on bodybuilders, it still exhibits the possible causes and dissatisfaction one might have with their appearance and how they may lead to the development of abnormal eating habits or with the development of muscle dysmorphia]. A similar study also conducted by Olivardia (2000), which used weight-lifters as subjects, found that those subjects with muscle dysmorphia, when compared to normal weightlifters, had more body dissatisfaction (50% reported spending more than three hours a day thinking about their muscularity) and had more extreme eating habits and attitudes (54% reported that they had “no” or “little” control over their dietary regimens). The author suggests that this preoccupation among men to have a muscular body could be caused by a sociocultural influence. Olivardia offers the ideas that the ideal body image shown by the media has changed and has become more muscular. For instance, GI Joe figures have grown steadily leaner and more muscular from the 1960’s to the present. The article mentions that these influences were mirrored in some of the comments of several of the subjects.

The self-esteem of bodybuilders seems to be a contributing factor in the development of abnormal eating behaviors, studies by Fisher (1997) and Heywood (1998) support this theory. A study conducted by Mekolichick (2002) reports that the mean self-esteem of members of the National Amateur Bodybuilding Association of the United States was significantly above all comparison groups. Mekolichick’s study was conducted using survey information collected from 190 male (72%) and female (28%) members of the National Amateur Bodybuilding Association of the United States. The author suggests that one possible cause of the contradicting findings is that her study focused solely on amateurs whereas previous research has focused on professional or elite bodybuilding competitors. It can therefore be suggested that the level of involvement in this particular sport may influence the self-esteem of a bodybuilder. As was stated previously, prior to a competition a competitor goes through a dieting phase known as cutting in order to reach their ideal physique. As Mekolichick discusses, professional bodybuilders may have lower self-esteem and lower feelings of self worth as they compare their appearance to the “ideal” physique which is only temporarily met during a competitive season compared to amateurs who may not suffer the same esteem issue.

It should be noted that not only do some male bodybuilders suffer from low-self esteem and increased risk for muscle dysmorphia, but some of their female counterparts may as well. Nilsson (2000) states that while 10% of male bodybuilders suffer, about 84% of female bodybuilders suffer (this number may possibly be affected by a disproportion of those who report having the issue because females are more likely to openly discuss having an eating disorder). A study conducted by Roussel and Griffet (2000) claimed that their analysis showed that the majority of the women in their study had low self-esteem before becoming a bodybuilder. Probert et al. (2007) conducted a study using 382 competitive male and female bodybuilders and found that “for women, bodybuilding had the capacity to play into, even amplify their sensitivities surrounding appearance and body image, their preoccupation with diet and weight control and a propensity towards eating disorders.” The study by Mekolichick, however their study found there were no significant differences in self-esteem among male and female subjects. Another study by Guthrie, Ferguson and Grimmett (1994) that focused on female bodybuilders found that they reported having positive body images which again gives credibility to the fact that there may be other contributing factors leading to the development of disorders. Further research must be done in this area to better determine what the causes of these serious disorders may be so that they will be better treated by professionals. There has been some progress in this research ares, Mayville et al. (2002) conducted a study which assisted them in the development of an assessment measure specific to muscle dysmorphia called the Muscle Satisfaction Scale (MASS). MASS is a 19-item self-report measure and will be of much assistance in conducting further research in the area of bodybuilders and their eating behaviors.

Because bodybuilders implement such extreme diets as part of their competition preparation, it seems relevant to discuss what influences their particular diets may have on the body. This portion of the paper will focus on the effects that high protein diets have on bone health, the kidneys, as well as a person’s blood chemistry.

Bodybuilders are typically told to consume around 1.5-2 grams of protein per pound of body weight a day. Sometimes this means consuming around 30 plus grams of protein in one sitting (assuming they ate 6 meals a day and weighed around 130lbs.). This amount far exceeds what is necessary and is, in fact, more than the 0.8 grams that is recommended for the average person or someone that does not work out. A study by Barzel and Massey (1998) focused on persons who consume the average American diet which consists of 42.2% meat, fish and poultry, 20.3% dairy, 4.2% egg, 9.8% vegetables, 4.1% legumes and 18% grains. The American diet is already very high in protein and low in alkali-rich foods such as vegetables and fruits. The study found that this type of diet generates a large amount of acids (sulfates and phosphates) which can adversely affect bones because “a diet high in acid-ash proteins causes excessive calcium loss because of its acidogenic [acid forming] content.” The authors conclude that the consumption of excessive protein can adversely affect bones “unless buffered by the consumption of alkali-rich foods”. This study can therefore (possibly) be extrapolated to the high protein rich diets consumed by bodybuilders. However, because no research currently exists that solely focuses on the affects of the bodybuilder’s diet on bone health, it therefore cannot be assumed that they do not already obtain the required amount of so-called “buffer” foods that have been suggested as being able to reverse the possible negative effects sometimes associated with the consumption of a diet high in protein.

A review by Martin, Armstrong and Rodriguez (2005) examined the effect of dietary protein intakes on renal function and discussed that data suggests there is no significant evidence that a high protein diet will have any negative effect in the kidney function of a healthy individual (or an athlete). It is not known whether a high amount of protein intake negatively affect the risk factor “for either the initiation or progression of renal disease”. Therefore, we cannot be sure that a bodybuilder consuming large amounts of protein on a regular basis and who may already be at risk for developing kidney disease would actually do so and have it be caused by his protein consumption.

In the month prior to a competition the most changes in the diet of a bodybuilder occur as they strive to reach their optimum physique. A study done by Hickson et al. (1990) followed a 27 year old male bodybuilder for about a month as he prepared to compete. The diet implemented by the subject allowed him to reach the placement of 3rd place as well as his goal weight with predictability and to lose fat. The subject’s blood was taken and showed, ‘abnormalities including hemoconcentration and alterations in cholesterol metabolism, which could have placed the subject at risk for thromboembolic phenomena because of increased blood viscosity” which the authors suggest could be related to the ergogenic drugs [external influences that enhance performance] that the bodybuilder self administered.

The author of this paper believes that in order to fully grasp the consequences that a bodybuilder’s diet may have on their perceived body image and its effects on the body, more research needs to be conducted, particularly research that involves population specific subjects (for instance using only bodybuilders) and is a long-term study. It may also be of interest to research what effects other aspects of their strict diet may have on the body, for example, the use of restricting ones water intake a few days prior to a competition. As can be seen in this paper, the sport of bodybuilding requires a great deal of discipline regarding diet regimens and the exercise practices, all of which may have an effect on the potential for developing muscle dysmorphia or another eating disorder, as well as the diet’s effects on the body.























Barzel, Uriel S. & Massey, Linda K. (1998) Excess Dietary Protein Can Adversely Affect Bone. The Journal of Nutrition, Vol. 128 No. 6 (June), 1051-1053

Fisher, L. A. (1997). Building One’s Self Up: Bodybuilding and the Construction of Identity Among Professional Female Bodybuilders. In P.L. Moore (Ed.), Building bodies. (pp. 135-164).

Goldfield, Gary S. PhD, Blouin, Arthur G. PhD, Woodside, Blake D. MD (2006) Body Image, Binge Eating, and Bulimia Nervosa in Male Bodybuilders. Canadian Journal of Psychiatry, Vol. 51, No 3 (March),160-168

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Mayville, Stephen B., Williamson, Donald A., White, Marney A., Netemeyer, Richard G., Drab, Danae L. (2002) Development of the Muscle Appearance Satisfaction Scale. Assesment. Vol. 9, No.4, 351-360

Nilsson, Simone (2000) The Heartbreak of Bigorexia. Insight on the News. Section Medicine, pp.33 (April)

Olivardia, Roberto, Harrison, Pope G. Jr., Borowieck, John J. III, & Cohane, Geoffrey H. (2004) Biceps and Body Image: The Relationship Between Muscularity and Self-Esteem, Depression, and Eating Disorder Symptoms. Psychology of Men & Masculinity. Vol.5 No.2, 112-120

Olivardia, Roberto, Harrison, Pope G. Jr, M.D., M.P.H. & Hudson, James I., M.D., S.M. (2000) Muscle Dysmorphia in Male Weightlifters: A Case-Control Study. American Journal of Psychiatry 157: 1292-1296 (August).

Probert, A., Palmer, F. & Leberman, S. (2007) The Fine Line: An Insight into ‘Risky’ practices of Male and Female Competitive Bodybuilders. Annals of Leisure Research, 9(3-4) 272-290.

Roussel, P., & Griffet, J. (2000). The Path Chosen by Female Bodybuilders: A Tentative Interpretation. Sociology of Sport Journal, 17, 130-150.

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