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.
Comer has an athletic build that comes from years of martial arts and marathon training, not to mention amateur competitive bodybuilding, activities that have taken a toll on her now bandaged 40-something-year-old knees. — Quanta Magazine, "The Art of Teaching Math and Science," 16 June 2019 Teresa Giudice, who's best known as a personality on Bravo's Real Housewives of New Jersey, competed in her first bodybuilding contest Saturday. — Carly Mallenbaum, USA TODAY, "'Real Housewives' star Teresa Giudice shows off new muscles at bodybuilding competition," 10 June 2018 His first wife, Sitora Yusufiy, suggested in an interview with Time magazine, with little evidence other than his penchant for bodybuilding and mirror-gazing, that Omar Mateen could have been gay. — Tim Fitzsimons /, NBC News, "What really happened that night at Pulse," 12 June 2018 The physique competition will be held at McGlohon Theater and includes the following categories: bodybuilding, fitness, men’s physique, figure, bikini, classic physique and women’s physique. — Courtney Devores, charlotteobserver, "Your 5-minute guide to the best things to do in Charlotte | June 22-28," 21 June 2018 Fans who have been following Giudice closely on social media have watched the reality star workout in videos, but Giudice hasn't posted publicly about her first bodybuilding competition. — Carly Mallenbaum, USA TODAY, "'Real Housewives' star Teresa Giudice shows off new muscles at bodybuilding competition," 10 June 2018 Carolyn Marvin, who served as the graduate adviser for both Prosper and Nirenberg, pointed to his thesis, an autoethnography about the subculture of bodybuilding. — Josh Baugh, San Antonio Express-News, "Nirenberg knew immediately that he’d eventually marry Erika Prosper," 17 Mar. 2018 The bodybuilding competition is one of two hosted produced each year in Louisville by Kentucky Muscle promoter Brent L. Jones. — Matt Stone, The Courier-Journal, "Bodybuilders, fitness athletes go flex at 2018 KDF Derby Championships," 29 Apr. 2018 Father John Brown is basically a bodybuilding legend, having won two Mr. Universe titles and three Mr. World crowns. — Jr Radcliffe, Milwaukee Journal Sentinel, "Facts you may have missed about each Packers draft choice in 2018," 4 May 2018
Due to the growing concerns of the high cost, health consequences, and illegal nature of some steroids, many organizations have formed in response and have deemed themselves "natural" bodybuilding competitions. In addition to the concerns noted, many promoters of bodybuilding have sought to shed the "freakish" perception that the general public has of bodybuilding and have successfully introduced a more mainstream audience to the sport of bodybuilding by including competitors whose physiques appear much more attainable and realistic.

In natural contests, the testing protocol ranges among organizations from lie detectors to urinalysis. Penalties also range from organization to organization from suspensions to strict bans from competition. It is also important to note that natural organizations also have their own list of banned substances and it is important to refer to each organization's website for more information about which substances are banned from competition. There are many natural bodybuilding organizations; some of the larger ones include: MuscleMania, Ultimate Fitness Events (UFE), INBF/WNBF, and INBA/PNBA. These organizations either have an American or worldwide presence and are not limited to the country in which they are headquartered.

^ Mangano, Kelsey M.; Sahni, Shivani; Kiel, Douglas P.; Tucker, Katherine L.; Dufour, Alyssa B.; Hannan, Marian T. (February 8, 2017). "Dietary protein is associated with musculoskeletal health independently of dietary pattern: the Framingham Third Generation Study". The American Journal of Clinical Nutrition. 105 (3): 714–722. doi:10.3945/ajcn.116.136762. PMC 5320406. PMID 28179224 – via ajcn.nutrition.org.


In natural contests, the testing protocol ranges among organizations from lie detectors to urinalysis. Penalties also range from organization to organization from suspensions to strict bans from competition. It is also important to note that natural organizations also have their own list of banned substances and it is important to refer to each organization's website for more information about which substances are banned from competition. There are many natural bodybuilding organizations; some of the larger ones include: MuscleMania, Ultimate Fitness Events (UFE), INBF/WNBF, and INBA/PNBA. These organizations either have an American or worldwide presence and are not limited to the country in which they are headquartered.
Carbohydrates play an important role for bodybuilders. They give the body energy to deal with the rigors of training and recovery. Carbohydrates also promote secretion of insulin, a hormone enabling cells to get the glucose they need. Insulin also carries amino acids into cells and promotes protein synthesis.[26] Insulin has steroid-like effects in terms of muscle gains.[27] It is impossible to promote protein synthesis without the existence of insulin, which means that without ingesting carbohydrates or protein—which also induces the release of insulin—it is impossible to add muscle mass.[28] Bodybuilders seek out low-glycemic polysaccharides and other slowly digesting carbohydrates, which release energy in a more stable fashion than high-glycemic sugars and starches. This is important as high-glycemic carbohydrates cause a sharp insulin response, which places the body in a state where it is likely to store additional food energy as fat. However, bodybuilders frequently do ingest some quickly digesting sugars (often in form of pure dextrose or maltodextrin) just before, during, and/or just after a workout. This may help to replenish glycogen stored within the muscle, and to stimulate muscle protein synthesis.[29]
Comer has an athletic build that comes from years of martial arts and marathon training, not to mention amateur competitive bodybuilding, activities that have taken a toll on her now bandaged 40-something-year-old knees. — Quanta Magazine, "The Art of Teaching Math and Science," 16 June 2019 Teresa Giudice, who's best known as a personality on Bravo's Real Housewives of New Jersey, competed in her first bodybuilding contest Saturday. — Carly Mallenbaum, USA TODAY, "'Real Housewives' star Teresa Giudice shows off new muscles at bodybuilding competition," 10 June 2018 His first wife, Sitora Yusufiy, suggested in an interview with Time magazine, with little evidence other than his penchant for bodybuilding and mirror-gazing, that Omar Mateen could have been gay. — Tim Fitzsimons /, NBC News, "What really happened that night at Pulse," 12 June 2018 The physique competition will be held at McGlohon Theater and includes the following categories: bodybuilding, fitness, men’s physique, figure, bikini, classic physique and women’s physique. — Courtney Devores, charlotteobserver, "Your 5-minute guide to the best things to do in Charlotte | June 22-28," 21 June 2018 Fans who have been following Giudice closely on social media have watched the reality star workout in videos, but Giudice hasn't posted publicly about her first bodybuilding competition. — Carly Mallenbaum, USA TODAY, "'Real Housewives' star Teresa Giudice shows off new muscles at bodybuilding competition," 10 June 2018 Carolyn Marvin, who served as the graduate adviser for both Prosper and Nirenberg, pointed to his thesis, an autoethnography about the subculture of bodybuilding. — Josh Baugh, San Antonio Express-News, "Nirenberg knew immediately that he’d eventually marry Erika Prosper," 17 Mar. 2018 The bodybuilding competition is one of two hosted produced each year in Louisville by Kentucky Muscle promoter Brent L. Jones. — Matt Stone, The Courier-Journal, "Bodybuilders, fitness athletes go flex at 2018 KDF Derby Championships," 29 Apr. 2018 Father John Brown is basically a bodybuilding legend, having won two Mr. Universe titles and three Mr. World crowns. — Jr Radcliffe, Milwaukee Journal Sentinel, "Facts you may have missed about each Packers draft choice in 2018," 4 May 2018
In competitive bodybuilding, bodybuilders aspire to present an aesthetically pleasing body on stage.[16][17] In prejudging, competitors do a series of mandatory poses: the front lat spread, rear lat spread, front double biceps, back double biceps, side chest, side triceps, Most Muscular (men only), abdominals and thighs. Each competitor also performs a personal choreographed routine to display their physique. A posedown is usually held at the end of a posing round, while judges are finishing their scoring. Bodybuilders usually spend a lot of time practising their posing in front of mirrors or under the guidance of their coach.
The general strategy adopted by most present-day competitive bodybuilders is to make muscle gains for most of the year (known as the "off-season") and, approximately 12–14 weeks from competition, lose a maximum of body fat (referred to as "cutting") while preserving as much muscular mass as possible. The bulking phase entails remaining in a net positive energy balance (calorie surplus). The amount of a surplus in which a person remains is based on the person's goals, as a bigger surplus and longer bulking phase will create more fat tissue. The surplus of calories relative to one's energy balance will ensure that muscles remain in a state of anabolism.
Although muscle stimulation occurs in the gym (or home gym) when lifting weights, muscle growth occurs afterward during rest periods. Without adequate rest and sleep (6 to 8 hours), muscles do not have an opportunity to recover and grow.[citation needed] Additionally, many athletes find that a daytime nap further increases their body's ability to recover from training and build muscles. Some bodybuilders add a massage at the end of each workout to their routine as a method of recovering.[51]
Muscle growth is more difficult to achieve in older adults than younger adults because of biological aging, which leads to many metabolic changes detrimental to muscle growth; for instance, by diminishing growth hormone and testosterone levels. Some recent clinical studies have shown that low-dose HGH treatment for adults with HGH deficiency changes the body composition by increasing muscle mass, decreasing fat mass, increasing bone density and muscle strength, improves cardiovascular parameters, and affects the quality of life without significant side effects.[46][47][unreliable medical source?][48]
The first U.S. Women's National Physique Championship, promoted by Henry McGhee and held in Canton, Ohio in 1978, is generally regarded as the first true female bodybuilding contest—that is, the first contest where the entrants were judged solely on muscularity.[13] In 1980, the first Ms. Olympia (initially known as the "Miss" Olympia), the most prestigious contest for professionals, was held. The first winner was Rachel McLish, who had also won the NPC's USA Championship earlier in the year. The contest was a major turning point for female bodybuilding. McLish inspired many future competitors to start training and competing. In 1985, a movie called Pumping Iron II: The Women was released. It documented the preparation of several women for the 1983 Caesars Palace World Cup Championship. Competitors prominently featured in the film were Kris Alexander, Lori Bowen, Lydia Cheng, Carla Dunlap, Bev Francis, and McLish. At the time, Francis was actually a powerlifter, though she soon made a successful transition to bodybuilding, becoming one of the leading competitors of the late 1980s and early 1990s.
Bodybuilding developed in the late 19th century, promoted in England by German Eugen Sandow, now considered as the "Father of Bodybuilding". He allowed audiences to enjoy viewing his physique in "muscle display performances". Although audiences were thrilled to see a well-developed physique, the men simply displayed their bodies as part of strength demonstrations or wrestling matches. Sandow had a stage show built around these displays through his manager, Florenz Ziegfeld. The Oscar-winning 1936 musical film The Great Ziegfeld depicts the beginning of modern bodybuilding, when Sandow began to display his body for carnivals.
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