Competitive bodybuilding is often admired for its physical discipline and aesthetic extremes. Yet, a new study published in the European Heart Journal warns of a troubling trend. The study identifies a disproportionately high rate of sudden cardiac death, particularly among professional male bodybuilders.
Led by Dr. Marco Vecchiato of the University of Padova, Italy, the research is the first large-scale investigation to quantify the risk of premature death in the bodybuilding community. The study analyzed data from over 20,000 male bodybuilders. These individuals competed in International Fitness and Bodybuilding Federation events between 2005 and 2020.
STARTLING NUMBERS: 5X HIGHER RISK FOR PROS
Out of the 121 reported deaths among these athletes, 38% were attributed to sudden cardiac death. The average age at death? Just 45.
The distinction between amateur and professional athletes is perhaps more alarming. Professionals faced more than five times the risk of dying from sudden cardiac causes. According to the researchers, this spike correlates with the intense demands and practices common in elite competition.
INSIDE THE BODYBUILDER’S HEART: STRUCTURAL RED FLAGS
Where available, autopsy data revealed consistent patterns—most notably, enlarged or thickened hearts and signs of coronary artery disease. Some toxicology reports also pointed to the use of anabolic steroids and other performance-enhancing substances.
“Extreme training, rapid weight-cutting, and steroid use all place immense stress on the heart,” said Dr. Vecchiato. “Over time, these practices can lead to significant structural changes and increase the likelihood of fatal arrhythmias.”
A BROADER MENTAL HEALTH CRISIS?
While sudden cardiac death was the most common cause, the study also highlighted a disturbing number of sudden traumatic deaths. Car accidents, suicides, overdoses, and even homicides made up about 15% of the cases. Researchers believe these may be linked to the psychological toll of bodybuilding culture. This includes body image pressure. It also encompasses substance-induced mood disorders.
RETHINKING WHAT “HEALTHY” LOOKS LIKE
The findings challenge the common assumption that a sculpted physique equates to good health. “Looking fit doesn’t always mean being healthy,” Dr. Vecchiato emphasized. “This is especially true when extreme appearance goals are pursued at the expense of long-term well-being.”
A CALL TO ACTION: SCREENINGS, AWARENESS, AND CULTURE CHANGE
The study’s authors call for stronger anti-doping policies, improved medical supervision, and a cultural shift within the sport. They recommend regular cardiovascular screening even for young athletes. The researchers urge sports organizations to actively educate competitors about the hidden risks of extreme training. They also focus on substance abuse.
“For policy makers and governing bodies, this is a wake-up call,” said Dr. Vecchiato. “These deaths are not isolated. They reflect a systemic issue that needs immediate attention.”
The team is already working on a similar study focused on female bodybuilders. They plan to analyze trends over time. The goal is to determine whether evolving practices are influencing mortality risk.
Bottom Line: While bodybuilding can promote discipline and fitness, pursuing perfection can carry severe consequences. These consequences may be deadly, especially in its most extreme forms. This study is a stark reminder that appearances can be deceiving, and health must always come first.
