Bodybuilding and Mortality: Understanding the Benefits and Risks with Competition
Bodybuilding has always been more than just a sport: it’s a lifestyle. It’s a pursuit of strength, aesthetics, and discipline. For decades, people have looked at iconic figures like Eugen Sandow, Steve Reeves, Arnold Schwarzenegger, and later, the massive pros of the 1980s and 1990s, and thought, “This is the pinnacle of human physical achievement.” But beneath the glitz of competition, the world of professional bodybuilding hides a sobering truth: the mortality risk for bodybuilders, particularly at the professional level, is alarmingly high.
Over the past few years, several large-scale studies have started to quantify this risk, giving us data-backed insight into why some of the strongest, most dedicated athletes are dying far younger than the average population. And while the numbers may seem grim, understanding them is the first step toward changing the narrative. As health and fitness professionals, coaches, and enthusiasts, we have a responsibility to use this knowledge to help bodybuilders train smarter, compete safer, and live longer.
Mortality Trends in Bodybuilding Through the Years
One of the most striking analyses comes from a study published in the European Heart Journal in 2025 by Vecchiato and colleagues. They tracked 20,286 male bodybuilders competing in IFBB events between 2005 and 2020. Over an average follow-up of 8 years, there were 121 deaths, of which 46 were sudden cardiac deaths (SCD). The average age of those who died suddenly? 34.7 years. In other words, some of the fittest men in the world were dropping dead in their mid-30s, a shocking reality few in the bodybuilding community want to acknowledge.
Professional bodybuilders were particularly at risk. The study found that pros had a five times higher risk of sudden cardiac death compared to amateurs. Autopsies revealed cardiomegaly (enlarged hearts) and ventricular hypertrophy, structural changes in the heart often linked to anabolic steroid use, extreme mass, and chronic strain on the cardiovascular system.
It’s not just men who are affected. A companion study in the same journal, published later in 2025, examined 9,447 female bodybuilders competing in the same period. While female athletes showed lower overall mortality rates than men, the pattern was disturbingly similar: SCD was the leading cause of death, and professional athletes were far more likely to be affected than amateurs. What stood out in women was that 13% of deaths were due to suicide or homicide, over four times higher than in male competitors. This points to a serious psychosocial component in addition to the physiological risks, highlighting mental health as a critical factor in competitive bodybuilding.
When we step back and look at bodybuilding across the decades, a clear trend emerges. Researchers have divided the sport into three “eras” for historical context:
Bronze Era (1900–1930): Early strongmen like Eugen Sandow, where the focus was on vitality, symmetry, and functional strength. Average lifespan: 74.8 years, often longer than contemporaries.
Silver Era (1930–1960): Pre-steroid competitors like Steve Reeves and John Grimek. Training and diets were stricter than the Bronze Era, but drug use was minimal. Average lifespan: 80.2 years — these guys outlived the general population.
Golden Era (1960–1990): Arnold Schwarzenegger, Sergio Oliva, and Lee Haney. With the introduction of anabolic steroids, extreme bulking, and highly restrictive contest diets, average lifespan dropped to 68.6 years, a shocking 11.6-year decrease from the Silver Era.
The story here is clear: natural bodybuilding correlates with increased longevity. Competitive extremes, coupled with pharmacological enhancement, drastically reduce it.
What’s Driving the Rise in Mortality?
If you want to know why these mortality rates are climbing, it all comes down to two main factors:
1. Drugs: The Steroid Era
Steroids transformed bodybuilding in the Golden Era and beyond. Bronze and Silver Era athletes relied mostly on protein, liver tablets, and basic supplementation. But by the 1960s, multi-compound steroid protocols became standard for anyone hoping to compete at the top levels.
Chronic steroid use, particularly at high doses over many years, is linked to:
Cardiomegaly and left ventricular hypertrophy
Arrhythmias and sudden cardiac death
Hormonal disruption, infertility, and liver strain
For men, the autopsies tell the story. Enlarged hearts and thickened ventricles were common among deceased professionals. For women, the structural changes were less dramatic, but the risk of SCD was still present, showing that extreme pharmacological enhancement is dangerous for all athletes.
2. The Competition Standard
The sport itself changed dramatically in the Golden Era. Early competitions rewarded symmetry, vitality, and personality, but as Mr. Olympia and similar contests took over, the judges shifted the focus entirely to extreme muscle mass and definition.
This created a culture of bulking and cutting at extremes:
Massive off-season weight gain, followed by severe contest dieting
Chronic dehydration and diuretic use to get “stage-ready”
Intense cardiovascular and resistance training far beyond healthy levels
The combination of extreme body mass, restrictive dieting, dehydration, and steroids is a perfect storm for cardiovascular strain and mortality.
The Female Perspective: Unique Risks
While male bodybuilding gets most of the headlines, the risks for women are equally real, just slightly different. In the 2025 study of female competitors:
SCD was still the leading cause of death, though overall incidence was lower than in men.
Professional female athletes had 20 times the risk of SCD compared to amateurs, highlighting that competitive extremes, not gender, are the key risk factor.
Mental health concerns were more pronounced: suicide and homicide accounted for 13% of deaths, compared to under 3% in men.
These findings suggest that women may face additional psychosocial stressors, including body image pressure, gender-specific competition dynamics, and mental health vulnerability.
Lessons from History: Natural Training Works
The historical data offers a silver lining. Bronze and Silver Era bodybuilders lived longer than the general population, proving that the lifestyle of training, proper nutrition, recovery, and discipline is fundamentally healthy.
The danger isn’t bodybuilding itself — it’s extreme competition and pharmacological enhancement. If we want to keep athletes alive and thriving, we need to take a page from the early eras:
Focus on sustainable training
Prioritize cardiovascular health alongside muscle growth
Eliminate PED use (of course I’m not going to advocate for it!)
Avoid extreme weight cycling and dehydration practices
How Health and Fitness Experts Can Defy the Odds
As coaches, trainers, and healthcare professionals, we are in a unique position to influence both competitive and recreational bodybuilders. Here’s what we can do:
1. Education on Long-Term Health
Athletes often chase short-term success without understanding long-term consequences. We need to teach:
The risks of steroid use
The effects of extreme bulking and cutting on the heart
Proper nutrition strategies that support performance and longevity
2. Medical Screening
Regular cardiovascular and metabolic evaluations should be standard for competitive bodybuilders. This includes:
Echocardiograms for early detection of cardiomegaly
Blood panels to monitor liver, kidney, and hormonal health
Blood pressure and cardiac rhythm monitoring
3. Mental Health Support
Especially for female athletes, mental health is a serious concern. Integrated approaches could include:
Routine psychological screening
Access to sports psychologists or therapists
Peer support groups to reduce isolation and stress
4. Coaching with Longevity in Mind
We need a cultural shift: training for long-term health instead of extreme aesthetics. That means:
Programming for strength and functional performance
Emphasizing recovery, mobility, and cardiovascular conditioning
Avoiding unnecessary extreme dieting or dehydration protocols
…of course I say all of this and others will still continue to compete in bodybuildling and find themselves on the grandest of stages. If that is you, please understand the risks involved but end of the day, you are in charge of yourself and I can’t tell a grown person what to do and not to do.
Conclusion: Strength Should Serve Life
Bodybuilding is not inherently dangerous. The Bronze and Silver Era athletes proved that training hard, eating right, and prioritizing recovery can extend life and health. The problem comes when extreme aesthetics, pharmacological enhancement, and competition stress take over.
The 2025 studies of male and female athletes make this clear: professional-level competitive bodybuilding carries real, measurable risks, particularly for the heart and mental health. But as experts in health and fitness, we can change the narrative.
By educating athletes, prioritizing long-term wellness, integrating mental health support, and advocating for safer competitive standards, we can help bodybuilders defy the odds and live long, strong, and healthy lives. The goal is not just to build the biggest muscles It’s to build a body that serves a life well-lived.
Bodybuilding can be a celebration of health, strength, and human potential. It doesn’t have to be a race against mortality, if we commit to doing it the right way.
References
Vecchiato M, Ermolao A, Da Col M, et al. Mortality in male bodybuilding athletes. European Heart Journal. 2025;46(30):3006–3016. doi:10.1093/eurheartj/ehaf285
Vecchiato M, Ermolao A, Zane L, et al. Mortality in female bodybuilding athletes. European Heart Journal. 2025;ehaf789. doi:10.1093/eurheartj/ehaf789
Kindler M, et al. Anabolic steroid use and mortality in strength sports: A systematic review. Scandinavian Journal of Medicine & Science in Sports. 2023;33(2):154–169.