Stomach Distension and the Modern Bodybuilder: Fact vs. Fiction – Part #3

by Mike Arnold

Having addressed the role of both food and training in stomach distension, we’ll move onto the subject which tends to draw the most interest…drugs. Of all the PEDs used in modern BB’ing, GH & insulin have been deemed the primary culprits and rightly so. However, they are often misrepresented and in many cases attributed a far larger share of the blame than what they are responsible for. Insulin is said to cause distension through the build-up of visceral fat, but unlike subcutaneous fat (which is stored directly beneath the skin), visceral fat is located between and around the vital organs. This form of intra-abdominal fat, when stored to excess, is not only detrimental to one’s health, but adversely affects the appearance of the midsection as well.

Before going any further, I want to want to make a distinction between the stomach distension witnessed in the competition-ready BB’r versus one who is in off-season shape. While visceral fat build-up may contribute to distension in off-season BB’rs (to what degree can vary substantially), it is very unlikely to play a significant role in the competition ready BB’r. The primary argument put forth by those who claim that visceral fat is largely responsible for the distension observed on contest day assert that visceral fat is more difficult to lose than sub-q fat and therefore, even though the BB’r may be in shredded condition, he will still be carrying enough visceral fat to cause pronounced distension. This is pure hogwash. In numerous studies conducted over the last several decades, it has been shown that in males, visceral fat is lost just as rapidly as subcutaneous fat during times of caloric restriction. In females, visceral fat is lost even more rapidly than subcutaneous fat. By the time a BB’r has dieted down to 3-4% BF, visceral fat stores will have been reduced comparatively. There is virtually no way for a professional BB’r, especially in light of the pharmacology typically employed, to retain a large amount of visceral fat at such a low bodyfat percentage.

It should also be noted that exogenous insulin use, being counterproductive to fat loss, is generally minimized during contest prep, as the presence of insulin impairs the rate of lipolysis. More so, the risk factors associated with intra-abdominal fat storage are largely absent from BB’ing pre-contest regimens, making post-diet retention even more unlikely. Some of these known risk factors are: The consumption of alcohol, high fructose corn syrup, and trans-fat, as well as excess saturated fat and sugar in general. Tobacco use, lack of exercise, increased cortisol, and caloric intake above maintenance are other risk factors. Not only is the traditional pre-contest model commonly devoid of these risk factors, but it generally promotes a physiological environment which is disadvantageous to visceral fat storage. Furthermore, the PED protocols normally employed during the pre-contest phase work to combat visceral fat retention. Both testosterone and growth hormone have been clinically proven to decrease visceral fat, as have T3, Anavar, and trenbolone (among others). At the very least, the dietary guidelines, exercise habits, and drug programs utilized by pre-contest BB’rs makes the disproportionate preservation of visceral fat improbable.

So, when it comes to bulging guts displayed on the contest stage, insulin plays only a minor role, at best. It is possible for significant amounts of visceral fat to be retained when subcutaneous fat stores are low, but this would require a set of circumstances to be present which rarely manifest themselves in stage-ready BB’rs. When it comes to the off-season, it is a different story altogether, but since this piece is focusing primarily on distension witnessed in competition BB’rs, I am not going to specifically address the issue.

Moving on to the next drug on the list, let’s take a moment to address GH. The idea of bulging bellies and GH have become so synonymous that the term “GH gut” has become commonplace in the BB’ing community; so much so that one would be hard-pressed to find a single individual who is ignorant of its meaning. Few drugs, if any, have been both abhorred and adored for their physique altering effects, as much as GH. On one hand, we have those who blame GH for killing the aesthetics of our sport, while others are willing to spend $1,000’s per year to receive its benefits. In the eyes of some, GH has been labeled as a near-magical elixir of the PED world, capable of and necessary for transforming the physique from one of mediocrity to one of excellence. In reality, GH is prized for two primary functions; fat loss and increased IGF-1 levels. When combined with AAS, the two make a formidable team.

It is well known that GH is capable of causing organ growth. This indisputable fact can be confirmed with a simple PubMed search. While GH is capable of causing severe overgrowth of the internal organs, in order for this to occur it would have to be abused at very high doses for many years; at doses much higher than what the typical BB’r would use. I will also point out that the organ growth associated with GH use is permanent; once the organs grow, they will not shrink back to their normal size upon discontinuance of the drug. This last point is important to understand, as it allows us to compare the effects of high-dose GH use in real-world bodybuilders both pre and post use, as well as in BB’rs who have been known to use GH, but who have experienced a visually significant reduction in waist circumference within the course of one season. Comparing the differences under these circumstances allows us to better determine the extent to which GH is responsible for enlarged midsections. I could sit here for an hour relaying the experiences of clients and personal acquaintances who have used massive doses of GH for years, yet who still have what would be considered small waistlines. I could also sit here and speak about the cycles of anonymous pro BB’rs who have used massive doses of GH for many years, yet who still showcase waists absent of any extraordinary distension. From the reader’s perspective, using a bunch of nameless people to illustrate my point would be meaningless. Instead, we will look at pro BB’ing in general for validation.

It is widely accepted that GH use is rampant in professional BB’ing. While the doses used varies greatly, due to its exorbitant cost, there are few who would deny that this drug plays a central role in the PED programs of today’s BB’rs, with some using in excess of 20 IU per day. By all accounts, 20 IU is considered a “large” dose, one which only a relatively small percentage of professional BB’rs can afford. With this in mind, let’s compare the midsections of pro BB’rs in the open class to those of the 212’s (formerly 202’s). While there are certainly many open class competitors who do not exhibit serious distension onstage, why do the 212’s seem to be almost completely unaffected by this phenomenon? Could it be that these little guys just don’t use GH? Haha…next question. Well, maybe the 212’s just use much smaller dosages? No…I don’t think so. The truth is that GH use is just as promiment in the 212’s as it is in the open class and if anyone thinks that the flat midsections seen on the 212’s are due to smaller dosages of GH across the board, I can assure you that there are plenty of 212’s abusing the shit out of GH who have itty-bitty midsections, while many less successful open competitors who use little to no GH and have big-ass guts. By and large, any pro BB’r today who can afford to use GH is using it, regardless of whether they compete in the open or the 212 lb weight class. So, why do the 212’s display much less distension, in general? I’ll tell you this…it is not due to a discrepancy in GH use, but to a combination of the previously mentioned factors, with food consumption being particularly relevant.

Unlike the open competitors, some of the guys in the 212 have to nearly starve themselves just to make weight, while others have not yet filled out their frames and remain close to their competition weight even in the off-season. The difference in bodyweight observed between the two groups translates into a considerable difference in caloric intake, which has a direct impact on the volume of food consumed.

I am sure many of you have also noticed a distinct difference in the size of the midsections among the various competitors in the open class. Often there are two BB’rs of equal size, yet one has a much smaller waist than the other….and in some cases, the much larger BB’r has a flatter waist than the smaller BB’r. At the level of the Mr. Olympia, everyone has access to the same drugs and for most, they are all doing whatever it takes to win or place higher. If using more GH would make that happen, that is what would be done. Knowing this, if GH had such deleterious effects on the waist, it would make sense that most, if not all of the Olympia competitors would have massively distended waists by now. I mean, look at Jay Cutler. He is the biggest man in pro BB’ing and is also a multi-millionaire. Purchasing large amounts of GH would certainly not be a problem for him and although I don’t know Jay personally, I tend to think that “Mr. Olympia” is likely using as much GH as it takes to get the job done. Common sense dictates that if anyone is a candidate for GH-induced waist distension, it would be Jay Cutler, but wait a second, Jay can pull off a vacuum and has never had a distended waist. Sure, he may have a “wide” waist, which is purely genetic in nature, but he is definitely NOT suffering from distension.

How about Kai Greene? For the last 2-3 years Kai had been ridiculed for his distended waist, with the peak of criticism coming at the 2010 Olympia, when his waist was so big that he looked like he was about to birth a small child. At this time, many online posters ignorantly claimed that Kai had permanently ruined his body and could never bring his waist back down to what it was when he won the 2009 ASC. After all, GH causes permanent organ growth, so that means Kai’s “GH gut” was here to stay. He might be able to take some steps to bring it down a little bit, but for the most part, this problem was deemed un-fixable…a problem he was stuck with for the rest of his BB’ing career. Well, if ever there was a miracle man, it was Kai Greene, as he appeared on the Olympia stage in 2012 with a waist as small and flat as what he showed us at the 2009 ASC. Actually, in a last ditch effort to reduce his midsection right before the show, Kai had a revolutionary new medical procedure performed, in which parts of his internal organs were removed, similar to gastric bypass surgery. This procedure reduced the size of his midsection by over 50%, bringing his waist back to its 2009 ASC form and securing him a 2nd place spot at the Olympia (it wouldn’t surprise me to read something like this online). The bottom line is that if the majority of Kai’s distension had been attributed to enlarged organs due to GH abuse, he would not have been able to bring his midsection down so tremendously (Note: through what I believe to be credible sources, Kai has used extensive quantities of GH over the years; more than most).

This is not the 1st time we have witnessed a BB’r dramatically decrease the size of his waist over a single season and it won’t be the last. Over the last 10+ years of working with BB’rs and strength athletes, I have seen numerous individuals use anywhere between 1-30 IU of GH per day, with dozens using between 10-20 IU per day for years on end, yet still maintaining tight waistlines. I have seen the reality of GH use and what it does to midsections…and while it can and will increase one’s waist size over time, the extent to which it does so has been highly exaggerated. In almost all cases, the BB’rs with the greatest degree of distension are those whose caloric requirements are very high and must repeatedly force-feed themselves, although there are always exceptions to the rule. Rarely have I seen a small BB’r, despite his GH usage, display a big ole’ gut. As Dennis Wolf so aptly put it during one of his previous off-seasons, the principal cause of his distended abdomen was due to the “food baby” he was carrying at the time. While the term “food baby” may not be as exciting to use as “GH gut”, it would certainly be much more fitting in a large number of cases.

In the final part of this article, we will cover some of the steps which can be taken to minimize and/or correct stomach distension and how to effectively implement them into one’s program.