As chronic obstructive pulmonary disease (COPD) advances, about 35% of patients experience severe weight loss called pulmonary cachexia, including diminished muscle mass.[31] Around 25% experience moderate to severe weight loss, and most others have some weight loss.[31] Greater weight loss is associated with poorer prognosis.[31] Theories about contributing factors include appetite loss related to reduced activity, additional energy required for breathing, and the difficulty of eating with dyspnea (labored breathing).[31]
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Due to the growing concerns of the high cost, health consequences, and illegal nature of some steroids, many organizations have formed in response and have deemed themselves "natural" bodybuilding competitions. In addition to the concerns noted, many promoters of bodybuilding have sought to shed the "freakish" perception that the general public has of bodybuilding and have successfully introduced a more mainstream audience to the sport of bodybuilding by including competitors whose physiques appear much more attainable and realistic. https://www.facebook.com/Business-Insights-Health-Fitness-2340476989604625/
Many non-competitive bodybuilders choose not to adopt this conventional strategy, as it often results in significant unwanted fat gain during the "bulking" phase. The attempt to increase muscle mass in one's body without any gain in fat is called clean bulking. Competitive bodybuilders focus their efforts to achieve a peak appearance during a brief "competition season".[citation needed] Clean bulking takes longer and is a more refined approach to achieving the body fat and muscle mass percentage a person is looking for. A common tactic for keeping fat low and muscle mass high would be to have higher calorie and lower calorie days to maintain a balance between gain and loss. Many clean bulk diets start off with a moderate amount of carbs, moderate amount of protein, and a decently low amount of fats. "Gaining lean muscle means going for leaner cuts of meat, like flank steaks and fillets, chicken, and, of course, fish," says White[who?]. "Enjoy your meat with some starch: rice, beans, quinoa, whole-grain couscous, or sweet potato, for example".[20] To maintain a clean bulk it is important to reach calorie goals every day. Macronutrient goals will be different for each person, but, it is ideal to get as close as possible.
"When going out for fast food, I used to get the large-size value meal. Now, I satisfy a craving by ordering just one item: a small order of fries or a six-piece box of chicken nuggets. So far, I've shaved off 16 pounds in seven weeks, and I'm on track to being thinner than my high school self for my 10-year reunion later this year." —Miranda Jarrell, Birmingham, AL

Sandow organized the first bodybuilding contest on September 14, 1901, called the "Great Competition". It was held at the Royal Albert Hall in London. Judged by Sandow, Sir Charles Lawes, and Sir Arthur Conan Doyle, the contest was a great success and many bodybuilding enthusiasts were turned away due to the overwhelming amount of audience members.[4] The trophy presented to the winner was a gold statue of Sandow sculpted by Frederick Pomeroy. The winner was William L. Murray of Nottingham. The silver Sandow trophy was presented to second-place winner D. Cooper. The bronze Sandow trophy — now the most famous of all — was presented to third-place winner A.C. Smythe. In 1950, this same bronze trophy was presented to Steve Reeves for winning the inaugural NABBA Mr. Universe contest. It would not resurface again until 1977 when the winner of the IFBB Mr. Olympia contest, Frank Zane, was presented with a replica of the bronze trophy. Since then, Mr. Olympia winners have been consistently awarded a replica of the bronze Sandow.
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The least intrusive weight loss methods, and those most often recommended, are adjustments to eating patterns and increased physical activity, generally in the form of exercise. The World Health Organization recommended that people combine a reduction of processed foods high in saturated fats, sugar and salt[10] and caloric content of the diet with an increase in physical activity.[11]
The important role of nutrition in building muscle and losing fat means bodybuilders may consume a wide variety of dietary supplements.[42] Various products are used in an attempt to augment muscle size, increase the rate of fat loss, improve joint health, increase natural testosterone production, enhance training performance and prevent potential nutrient deficiencies.
The least intrusive weight loss methods, and those most often recommended, are adjustments to eating patterns and increased physical activity, generally in the form of exercise. The World Health Organization recommended that people combine a reduction of processed foods high in saturated fats, sugar and salt[10] and caloric content of the diet with an increase in physical activity.[11]
The least intrusive weight loss methods, and those most often recommended, are adjustments to eating patterns and increased physical activity, generally in the form of exercise. The World Health Organization recommended that people combine a reduction of processed foods high in saturated fats, sugar and salt[10] and caloric content of the diet with an increase in physical activity.[11]
Many patients will be in pain and have a loss of appetite after surgery.[25] Part of the body's response to surgery is to direct energy to wound healing, which increases the body's overall energy requirements.[25] Surgery affects nutritional status indirectly, particularly during the recovery period, as it can interfere with wound healing and other aspects of recovery.[25][29] Surgery directly affects nutritional status if a procedure permanently alters the digestive system.[25] Enteral nutrition (tube feeding) is often needed.[25] However a policy of 'nil by mouth' for all gastrointestinal surgery has not been shown to benefit, with some suggestion it might hinder recovery.[37][needs update]

The general strategy adopted by most present-day competitive bodybuilders is to make muscle gains for most of the year (known as the "off-season") and, approximately 12–14 weeks from competition, lose a maximum of body fat (referred to as "cutting") while preserving as much muscular mass as possible. The bulking phase entails remaining in a net positive energy balance (calorie surplus). The amount of a surplus in which a person remains is based on the person's goals, as a bigger surplus and longer bulking phase will create more fat tissue. The surplus of calories relative to one's energy balance will ensure that muscles remain in a state of anabolism.


The first U.S. Women's National Physique Championship, promoted by Henry McGhee and held in Canton, Ohio in 1978, is generally regarded as the first true female bodybuilding contest—that is, the first contest where the entrants were judged solely on muscularity.[13] In 1980, the first Ms. Olympia (initially known as the "Miss" Olympia), the most prestigious contest for professionals, was held. The first winner was Rachel McLish, who had also won the NPC's USA Championship earlier in the year. The contest was a major turning point for female bodybuilding. McLish inspired many future competitors to start training and competing. In 1985, a movie called Pumping Iron II: The Women was released. It documented the preparation of several women for the 1983 Caesars Palace World Cup Championship. Competitors prominently featured in the film were Kris Alexander, Lori Bowen, Lydia Cheng, Carla Dunlap, Bev Francis, and McLish. At the time, Francis was actually a powerlifter, though she soon made a successful transition to bodybuilding, becoming one of the leading competitors of the late 1980s and early 1990s.
This period also saw the rise of anabolic steroids in bodybuilding and many other sports. In bodybuilding lore, this is partly attributed to the rise of "mass monsters", beginning with Arnold Schwarzenegger, Sergio Oliva, and Lou Ferrigno in the late 1960s and early 1970s, and continuing through the 1980s with Lee Haney, the 1990s with Dorian Yates, Ronnie Coleman, and Markus Rühl, and up to the present day. Bodybuilders such as Greg Kovacs attained mass and size never seen previously but were not successful at the pro level. Others were renowned for their spectacular development of a particular body part, like Tom Platz or Paul Demayo for their leg muscles. At the time of shooting Pumping Iron, Schwarzenegger (while never admitting to steroid use until long after his retirement) said that "you have to do anything you can to get the advantage in competition".[citation needed] He would later say that he does not regret using anything.[8]

Unintentional weight loss may result from loss of body fats, loss of body fluids, muscle atrophy, or even a combination of these.[25][26] It is generally regarded as a medical problem when at least 10% of a person's body weight has been lost in six months[25][27] or 5% in the last month.[28] Another criterion used for assessing weight that is too low is the body mass index (BMI).[29] However, even lesser amounts of weight loss can be a cause for serious concern in a frail elderly person.[30]
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Intensive weight training causes micro-tears to the muscles being trained; this is generally known as microtrauma. These micro-tears in the muscle contribute to the soreness felt after exercise, called delayed onset muscle soreness (DOMS). It is the repair of these micro-traumas that results in muscle growth. Normally, this soreness becomes most apparent a day or two after a workout. However, as muscles become adapted to the exercises, soreness tends to decrease.[22]

Some bodybuilders use drugs such as anabolic steroids and precursor substances such as prohormones to increase muscle hypertrophy. Anabolic steroids cause hypertrophy of both types (I and II) of muscle fibers, likely caused by an increased synthesis of muscle proteins. They also provoke undesired side effects including hepatotoxicity, gynecomastia, acne, the early onset of male pattern baldness and a decline in the body's own testosterone production, which can cause testicular atrophy.[43][44][45] Other performance-enhancing substances used by competitive bodybuilders include human growth hormone (HGH), which can cause acromegaly.

In 2008 between US$33 billion and $55 billion was spent annually in the US on weight-loss products and services, including medical procedures and pharmaceuticals, with weight-loss centers taking between 6 and 12 percent of total annual expenditure. Over $1.6 billion a year was spent on weight-loss supplements. About 70 percent of Americans' dieting attempts are of a self-help nature.[23][24]

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