Site enhancement oil, often called "santol" or "synthol" (no relation to the Synthol mouthwash brand), refers to oils injected into muscles to increase the size or change the shape. Some bodybuilders, particularly at the professional level, inject their muscles with such mixtures to mimic the appearance of developed muscle where it may otherwise be disproportionate or lacking.[55] This is known as "fluffing".[56][57] Synthol is 85% oil, 7.5% lidocaine, and 7.5% alcohol.[56] It is not restricted, and many brands are available on the Internet.[58] The use of injected oil to enhance muscle appearance is common among bodybuilders,[59][60] despite the fact that synthol can cause pulmonary embolisms, nerve damage, infections, sclerosing lipogranuloma,[61] stroke,[56] and the formation of oil-filled granulomas, cysts or ulcers in the muscle.[60][62][63] Rare cases might require surgical intervention to avoid further damage to the muscle and/or to prevent loss of life.[64]
^ Burd, Nicholas A.; Yang, Yifan; Moore, Daniel R.; Tang, Jason E.; Tarnopolsky, Mark A.; Phillips, Stuart M. (2012). "Greater stimulation of myofibrillar protein synthesis with ingestion of whey protein isolate v. Micellar casein at rest and after resistance exercise in elderly men". British Journal of Nutrition. 108 (6): 958–62. doi:10.1017/S0007114511006271. PMID 22289570.
Some Bodybuilders often split their food intake into 5 to 7 meals of equal nutritional content and eat at regular intervals (e.g. every 2 to 3 hours). This approach serves two purposes: to limit overindulging in the cutting phase, and to allow for the consumption of large volumes of food during the bulking phase. Eating more frequently does not increase basal metabolic rate when compared to 3 meals a day.[38] While food does have a metabolic cost to digest, absorb, and store, called the thermic effect of food, it depends on the quantity and type of food, not how the food is spread across the meals of the day. Well-controlled studies using whole-body calorimetry and doubly labeled water have demonstrated that there is no metabolic advantage to eating more frequently.[39][40][41]
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.[43][44][45] Other performance-enhancing substances used by competitive bodybuilders include human growth hormone (HGH), which can cause acromegaly.
In the early 2000s, the IFBB was attempting to make bodybuilding an Olympic sport. It obtained full IOC membership in 2000 and was attempting to get approved as a demonstration event at the Olympics, which would hopefully lead to it being added as a full contest. This did not happen and Olympic recognition for bodybuilding remains controversial since many argue that bodybuilding is not a sport.[11]

In the last week leading up to a contest, bodybuilders usually decrease their consumption of water, sodium, and carbohydrates, the former two to alter how water is retained by the body and the latter to reduce glycogen in the muscle. The day before the show, water is removed from the diet, and diuretics may be introduced, while carbohydrate loading is undertaken to increase the size of the muscles through replenishment of their glycogen. The goal is to maximize leanness and increase the visibility of veins, or "vascularity". The muscular definition and vascularity are further enhanced immediately before appearing on stage by darkening the skin through tanning products and applying oils to the skin to increase shine. Some competitors will eat sugar-rich foods to increase the visibility of their veins. A final step, called "pumping", consists in performing exercises with light weights or other kinds of low resistance (for instance two athletes can "pump" each other by holding a towel and pulling in turn), just before the contest, to fill the muscles with blood and further increase their size and density.

Bodybuilding is the use of progressive resistance exercise to control and develop one's musculature for aesthetic purposes.[1] An individual who engages in this activity is referred to as a bodybuilder. In competitive bodybuilding, bodybuilders appear in lineups and perform specified poses (and later individual posing routines) for a panel of judges who rank the competitors based on criteria such as symmetry, muscularity, and conditioning. Bodybuilders prepare for competitions through the elimination of nonessential body fat, enhanced at the last stage by a combination of extracellular dehydration and carbohydrate loading, to achieve maximum muscular definition and vascularity, as well as tanning to accentuate the contrast of the skin under the spotlights. Bodybuilders may use anabolic steroids and other performance-enhancing drugs to build muscles.
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