In recent years, the related areas of fitness and figure competition have increased in popularity, surpassing that of female bodybuilding, and have provided an alternative for women who choose not to develop the level of muscularity necessary for bodybuilding. McLish would closely resemble what is thought of today as a fitness and figure competitor, instead of what is now considered a female bodybuilder. Fitness competitions also have a gymnastic element to them. A study by the Clinical Journal of Sport Medicine found that female bodybuilders who are taking anabolic steroids are more likely to have qualified for substance dependence disorder, to have been diagnosed with a psychiatric illness, or to have a history of sexual abuse.
Weight training aims to build muscle by prompting two different types of hypertrophy: sarcoplasmic and myofibrillar. Sarcoplasmic hypertrophy leads to larger muscles and so is favored by bodybuilders more than myofibrillar hypertrophy, which builds athletic strength. Sarcoplasmic hypertrophy is triggered by increasing repetitions, whereas myofibrillar hypertrophy is triggered by lifting heavier weight. In either case, there is an increase in both size and strength of the muscles (compared to what happens if that same individual does not lift weights at all), however, the emphasis is different.
Some bodybuilders use drugs such as anabolic steroids and precursor substances such as prohormones to increase muscle hypertrophy. Anabolic steroids cause hypertrophy of both types (I and II) of muscle fibers, likely caused by an increased synthesis of muscle proteins. They also provoke undesired side effects including hepatotoxicity, gynecomastia, acne, the early onset of male pattern baldness and a decline in the body's own testosterone production, which can cause testicular atrophy. Other performance-enhancing substances used by competitive bodybuilders include human growth hormone (HGH), which can cause acromegaly.
Many other important bodybuilders in the early history of bodybuilding prior to 1930 include: Earle Liederman (writer of some of bodybuilding's earliest books), Zishe Breitbart, Georg Hackenschmidt, Emy Nkemena, George F. Jowett, Finn Hateral (a pioneer in the art of posing), Frank Saldo, Monte Saldo, William Bankier, Launceston Elliot, Sig Klein, Sgt. Alfred Moss, Joe Nordquist, Lionel Strongfort ("Strongfortism"), Gustav Frištenský, Ralph Parcaut (a champion wrestler who also authored an early book on "physical culture"), and Alan P. Mead (who became an impressive muscle champion despite the fact that he lost a leg in World War I). Actor Francis X. Bushman, who was a disciple of Sandow, started his career as a bodybuilder and sculptor's model before beginning his famous silent movie career.
In the 1970s, bodybuilding had major publicity thanks to the appearance of Arnold Schwarzenegger, Franco Columbu, Lou Ferrigno, and others in the 1977 docudrama Pumping Iron. By this time, the IFBB dominated the competitive bodybuilding landscape and the Amateur Athletic Union (AAU) took a back seat. The National Physique Committee (NPC) was formed in 1981 by Jim Manion, who had just stepped down as chairman of the AAU Physique Committee. The NPC has gone on to become the most successful bodybuilding organization in America and is the amateur division of the IFBB. The late 1980s and early 1990s saw the decline of AAU-sponsored bodybuilding contests. In 1999, the AAU voted to discontinue its bodybuilding events.
The winner of the annual IFBB Mr. Olympia contest is generally recognized as the world's top male professional bodybuilder. Since 1950, the NABBA Universe Championships have been considered the top amateur bodybuilding contests, with notable winners such as Reg Park, Lee Priest, Steve Reeves, and Arnold Schwarzenegger. Winners generally go on to become professional athletes.