Supplements, health, muscle and current body morphology trends


Dr. Pritam Neupane, MBBS, FACP, FCCP
Pulmonology/Critical Care – Memorial Hospital of Sweetwater County

Men have gone through different body image types throughout history. They have gone through the pot belly guy as the desired type in the late 1800s, the thin body frenzy of Hollywood in the ’20s to the muscular, strong guy in the ’80s popularized by celebrities like Schwarzenegger and Stallone. Current trends are that of definition and leanness. With changing perceptions, the population has constantly sought different remedies to keep up with the style.

Supplement users can be broadly categorized into two groups. One that uses it to help “promote and preserve health.” This group mainly includes middle age to senior individuals. The supplements used here often include vitamins, minerals, roots, leaf extracts, etc.  It could come as a surprise to many that the 1994 Dietary Supplement Health and Education Act (DSHEA) doesn’t require supplements to prove safety or prove that they in fact work at all. In that sense, one can literally package horse dung and sell it as supplement. Some of the high-quality research on this topic, funded by taxpayer money, in institutions like National Institutes of Health, has proven the obvious, that is, these supplements do not work. For e.g. St John’s wort to treat depression. Supplements like minerals and vitamins do have a role when used appropriately but the use often exceeds what is necessary. On the other hand, some of these supplements are outright harmful like the popular ephedra containing supplements of the 1990s which caused many serious effects like heart attacks, seizures, strokes and sudden deaths. Supplement industry parallels allopathic medicine sales and rakes billions of dollars in sales without any strong research or evidence to back up its claims. 

The other group that widely uses supplements is the younger population who use it for performance enhancement and muscle building. With easy access through the shelves of stores and internet, research estimates nearly 2.9 to 4 million individuals in the U.S. have used anabolic androgenic steroids at some point in their lives. It is very concerning that there is no transparency required when selling these products as one research showed that in a sample, 25% of products contained active ingredients not listed on the label and 59% contained different amounts of the compound than listed on the label. 

The idea of muscle bulking is also being fueled by magazines portraying these images which has led to insecurity in males concerning their own body and muscle size. A trait common to young men showing obsessive preoccupation with their muscle appearance is known as the “muscle dysmorphic disorder,” an official diagnosis of the American psychiatric association. Many of these individuals engage in weightlifting and are found to have elevated levels of mood and anxiety disorders, obsessive compulsive behavior, social and occupational functional impairment and higher rates of substance abuse. This is similar to how slimming down has plagued the female population for decades. 

While people might feel transiently proud of their arms when taking off their shirt at the local gym, these habits and products do have short- and long-term side effects. Usually physiologic doses of androgens do not obtain larger muscles, and to get the desired effects, it is necessary to take 10 to 100 times the usual prescribed dose. Its use also leads to tolerance and thus there is a constant need to increase the dose. Androgens through their widespread receptors in the brain have many other effects which could lead to aggression, mania-like symptoms, hostility, homicidal tendency and cognitive dysfunction. Withdrawal symptoms also are common when people do try to come off these and may include fatigue, depression and suicidality. This in turn leads to a vicious cycle of dependence.  Other pathologic effects include impotence, liver injury, thickening of heart muscle, etc. These pose real risks for congestive heart failure, blood clots, strokes, etc.

Generally, it has been the case that unless the alarm is sounded by the scientific community and unless regulatory bodies step in, the health care of the public is largely ignored by corporate America when there is money involved. Anyone remember Dr. Oz being scolded in the Senate room of the United States Senate for his false and fraudulent claims about his products? That took decades to happen. There are, thus, many cosmetic products and procedures, stem cell clinics and oxygen bars and of course the supplements floating around without any supervision or safety mechanism in place and with claims not supported by any real research. To make matters worse, through what is known as “consumer directed marketing,” pharmaceuticals are directly advertising to the population through social media and TV that has led to skyrocketing of testosterone supplements use.  

In conclusion, I know many such people personally who were dependent on anabolic steroids but who eventually came off them. They feel no different and still maintain good muscle mass and feel much better with some extra dollars in their pocket. If you are looking to be healthy, what really goes a long way is what is known as cardiorespiratory fitness than muscle mass or total body weight. This is done through healthy eating, less red meat, more fruits, vegetables, nuts, plenty of cardio exercise and some toning of muscle with weight in moderation. Let us foster the culture of “being healthy is cool” rather than bulking up and getting caught up in this endless, miserable cycle of obsession and supplements.

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