Muscle mania: the quest for the perfect body

Abstract

We describe the case of a young man with repeated hospital presentations for a variety of symptoms related to excessive bodybuilding and associated behaviours. He presented to our department (radiology) with right arm pain and loss of function. Ultrasound showed complete triceps rupture, rare in young patients and multiple cystic areas within the muscles of the arm. MRI revealed these to be multiple proteinaceous lesions within the muscle bellies and the possibility of self-innoculation was raised by the reporting radiologist. The patient subsequently admitted to injecting coconut oil to improve muscle contour lost secondary to injury. A review of his hospital presentations was then made and revealed further concerning practices performed by the patient to enhance his muscular appearance.

Delayed diagnosis of T3 supplementation in a bodybuilder presenting with tachycardia and features of sepsis

“…Androgen anabolic steroids (AAS) are taken to increase muscle mass but have a wide range of well-documented complications4 affecting the endocrine system including impaired lipid profile5 and reduced fertility with low sperm count and abnormal sperm morphology 6. AAS have been associated with cholestatic jaundice,7 focal segmental glomerulosclerosis8 and cardiomyopathy 9.…”

“…It is possible that details of the supplementation may not emerge during the first clerking and this case demonstrates the value of revisiting the history where there is diagnostic uncertainty. Furthermore, patients may not welcome the news that their self-medication choices are causing harm and may resist cessation advice, leading to disengagement with services,4 so good rapport is essential in producing a successful and permanent cure.…”

No pain no gain: tender nodules in a competitive bodybuilder

“…Site enhancing oils were seen as a simple solution to circumvent stubborn muscle groups and they were so widely adopted that their use is considered a public health issue in certain countries [6,7]. A variety of substances have been reported in the literature, including paraffin [6], ADE (a mix of vitamins A, D, and E in a vegetable oil base), [6], sesame oil [6,8], walnut oil [6], and coconut oil [9]. The most widely used SEO currently is Synthol, which was created in 1997 by the bodybuilder Chris Clark.…”

“…The most common complications are related to the skin and soft tissue around the injection site and the patient can present with neuropathy, erythema, infection, abscess formation, or subcutaneous nodules [8]. Intramuscular cyst formation has been reported in several cases, with some patients experiencing almost complete replacement of normal muscle with cystic scar tissue [8,9]. In one case, a patient developed spontaneous ulceration years after using Synthol, ultimately requiring antibiotics, surgical debridement, and negative pressure wound therapy [10].…”

Body, skill, and look: is bodybuilding a sport?

“…13 A further argument that bodybuilding is not a lived-body activity is worth noting here. Obsessive preoccupation with muscle mass is a pathology connected to the world of bodybuilding, leading to selfinjury and psychosis (Hameed et al 2016), and it is in many ways a kind of reverse anorexia nervosa, a condition in which the subject becomes obsessively preoccupied by the goal of losing weight. As pointed out by Dorothée Legrand (2010: 194): "anorexics seek the preservation of their body-as-subject by destructing their body-as-object", which means that the object of obsessive attention in anorexia is the Körper.…”