COMPETITIVE BODYBUILDING: HEALTH RISKS

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COMPETITIVE BODYBUILDING: HEALTH RISKS






 Male bodybuilders—especially those who compete at the professional level—face a notably high risk of sudden cardiac death, according to research published in the European Heart Journal on May 20, 2025. The study, led by Dr. Marco Vecchiato of the University of Padova, Italy, found that sudden cardiac death accounts for a disproportionate share of fatalities among male bodybuilders globally, with the highest risk observed in professionals.

Sudden cardiac death, which refers to an unexpected death caused by heart malfunction, is rare among young and seemingly healthy individuals. Yet, it frequently stems from underlying cardiac conditions. This new research highlights the unique health risks of competitive bodybuilding and underscores the need for increased awareness, preventive measures, and policy changes within the sport.

For the study, Dr. Vecchiato and colleagues compiled a list of 20,286 male bodybuilders who had participated in at least one International Fitness and Bodybuilding Federation event between 2005 and 2020. They tracked reported deaths by searching media reports, social media, bodybuilding forums, and blogs in five languages, cross-referencing and verifying the information with the help of two clinicians to establish causes of death where possible.

The team identified 121 deaths among these athletes, with an average age at death of 45 years. Of these, 38% were sudden cardiac deaths. The risk was over five times higher for professionals compared to amateur bodybuilders. Limited autopsy data pointed to frequent heart enlargement or thickening, and sometimes coronary artery disease; some toxicology reports and public information also indicated anabolic substance abuse.

Dr. Vecchiato noted that professional bodybuilders are more likely to engage in extreme training, severe dietary restriction, dehydration, and use of performance-enhancing drugs, all of which can strain the heart, increase the risk of arrhythmia, and cause structural changes over time. The drive to achieve extreme physiques and the pressures of competition may further elevate these risks.

He emphasized that while physical excellence is admirable, pursuing extreme transformation can significantly cost heart health. He called for safer training, better medical oversight, and a culture that rejects performance-enhancing drugs.

For healthcare providers, the findings support the need for proactive cardiovascular screening and counseling for bodybuilders, even those who appear healthy. Dr. Vecchiato urged medical associations to work with sports federations and policymakers to promote safer practices, especially since professional athletes can influence gym-goers worldwide.

The research also points to the importance of broader anti-doping efforts, drug education, and targeted bodybuilding health monitoring programs. It challenges the assumption that appearance is a reliable indicator of health, revealing that even the most muscular physiques can hide serious risks. Still, the ST does not broadly criticize strength training or fitness; regular exercise remains highly beneficial for health and longevity.

About 15% of the deaths were classified as 'sudden traumatic deaths,' including car accidents, suicides, homicides, and overdoses. Dr. Vecchiato highlighted the need to address the psychological impact of bodybuilding culture and the role of substance abuse in increasing the risk of impulsive and self-destructive behaviors.

The study focused on male bodybuilders due to the greater availability of data, but similar research on female bodybuilders is underway. The researchers also plan to track trends in bodybuilding-related deaths over time as practices evolve.

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