Abstract
Physique athletes strive for low body fat with high lean mass and have higher body image and eating disorder rates than the general population, and even other weightlifting populations. Whether athletes with a background or tendency to develop these issues are drawn to the sport, or whether it drives these higher incidences, is unknown. However, the biological drive of cyclical energy restriction may contribute to binge-eating behavior. Additionally, requisite monitoring, manipulation, comparison, and judgement of one’s physique may contribute to body image concerns. Contest preparation necessitates manipulating body composition through energy restriction and increased expenditure, requiring dietary restraint and nutrition, exercise, and physique assessment. Thus, competitors are at mental health risk due to (1) pre-existing or predispositions to develop body image or eating disorders; (2) biological effects of energy restriction on eating psychology; and (3) dietary restraint attitudes and resultant physique, exercise, and nutrition monitoring behavior. In our narrative review we cover each factor, concluding with tentative best-practice recommendations, including dietary flexibility, slower weight loss, structured monitoring, gradual returns to offseason energy intakes, internal eating cues, appropriate offseason body compositions, and support from nutrition and mental health professionals. A mental health focus is a needed paradigm shift in bodybuilding nutrition practice and research.
Highlights
Physique sport, or “competitive bodybuilding”, has existed since the turn of the century; judging standards and the philosophical ethos of its actors have changed over time
Competitors are at mental health risk due to (1) pre-existing or predispositions to develop body image or eating disorders; (2) biological effects of energy restriction on eating psychology; and (3)
Specific examples are outlined in Section 2; but, to initially familiarize the reader with their magnitude, we present the example of a 1991 cross sectional comparison of female physique athletes and weightlifting controls [12] in which physique athletes had significantly (p < 0.05) higher rates of uncontrollable urges to eat (58%), obsession with food (67%), and expressed greater terror of becoming fat (58%)
Summary
“competitive bodybuilding”, has existed since the turn of the century; judging standards and the philosophical ethos of its actors have changed over time. As the criteria have become more extreme, demands placed on athletes have increased as well To achieve these outcomes, modern competitors engage in resistance training to develop as much muscle mass as possible (during the “off-season”), typically training for years before first dieting to participate in a contest (with subsequent off-seasons between competition diets). Among men (90% of sample), higher body image concerns in bodybuilders compared to weightlifting non-competitors was reported in a recent meta-analysis [13], with symptoms associated with anxiety, depression, neuroticism, and perfectionism With that said, it is unclear whether competitors see their behavior, cognition, and emotional status as problems requiring mental health intervention, or required aspects of their chosen sport. Exert the restraint necessary to follow and ensure the effectiveness of competition preparation diets
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