Stomach Distension: Causes & Cures – Part 2


by Mike Arnold

Having revealed the importance of a classic waistline earlier in this article, we will waste no time in exploring the numerous causes behind its polar opposite—stomach distention. According to many, its origin begins and ends with drug use, but as with most things in this sport, such a limited explanation is inadequate. In reality, there are numerous potential factors responsible for its development, with each one playing a greater or lesser role depending on the individual.

Stomach distension, while a rarity in previous eras, exploded onto the scene in the mid-90’s. Its sudden arrival led many to point the finger at the two primary differentiating factors between that generation and the prior one—the invasion of growth hormone an insulin. Such a conclusion was not unreasonable, as these drugs can indeed result in an enlarged midsection under certain circumstances. However, the degree to which this takes place can vary enormously and is attributable to both direct and indirect factors alike.

There are several mechanisms through which growth hormone and insulin can potentially contribute to stomach distention, but there are only two worth mentioning, as they are responsible for the overwhelming majority of gut growth witnessed when using these drugs. These are IGF-1 mediated hypertrophy of the internal organs and visceral fat accumulation.

The build-up of visceral fat is due primarily to insulin resistance; a common side effect of both growth hormone and insulin use. Insulin resistance is the inability of the body to properly respond to insulin at the receptor site. This is important to understand, as this hormone is responsible for the regulation of blood glucose (i.e. blood sugar) levels, a function critical for the maintenance of life itself. When the body’s response to insulin is diminished, blood glucose levels rise, prompting the pancreas to release additional insulin as a means of keeping blood glucose levels within a normal range. When insulin resistance progresses beyond a certain point, the individual is diagnosed as a Type II diabetic; a common illness in today’s society. At this stage, the body is no longer able to produce enough insulin to sufficiently to regulate blood sugar on its own, necessitating the use of insulin sensitizers (i.e. metformin, etc), and in severe cases, injectable insulin.

But how does this impact the waistline? As a fat storage hormone, insulin not only drives excess calories into fat cells, but prevents stored fat from being released into the bloodstream, where it can then be used for energy. In other words, the sustained elevation of blood insulin levels that occurs with insulin resistance is a significant risk factor in the accumulation of adipose tissue. While the lipolytic effect of growth hormone is generally strong enough to counteract the negative effect of insulin resistance on fat cells throughout the subcutaneous region (the area between the skin and muscle), it does not have the same positive impact on visceral fat stores (fat which is stored around the abdominal organs).

Therefore, even though a GH and insulin using bodybuilder may remain lean from a visual standpoint, he may be “obese” in terms of visceral fat storage. The extent to which this takes place can vary tremendously, with a direct correlation existing between the amount of visceral fat present and one’s level of insulin resistance. Basically, as insulin resistance worsens, the more likely one is to display a lean, bulging midsection. At any rate, such an appearance is wholly out of place on any bodybuilding stage and a vivid testimony to the gross incompetence displayed by many of today’s bodybuilders regarding the application of these potent drugs.

In addition to visceral fat build-up, growth hormone and insulin also increase IGF-1 levels on a dose-dependent basis. Although beneficial for muscle growth, IGF-1 is not muscle cell specific in its actions, meaning that IGF-1’s effects overlap into other areas of the body, such as the liver, kidney, and intestines, to name a few. With all of these abdominal organs possessing large numbers of IGF-1 receptors, organ growth becomes a real concern, especially for those individuals administering large dosages over an extended period of time. Although this affect does not manifest immediately and can vary tremendously depending on dosage and duration of use, the long-term use of these drugs, even at moderate dosages, will inevitably result in some degree of noticeable distension.

These effects are apparent even in non-drug using individuals. How can that be, you ask? All of us, as we get older, will experience age related changes to our body’s appearance as a result of long-term growth hormone and insulin exposure. Ever notice why the midsection isn’t quite a tight at age 45 as it used to be at age 20, even when bodyfat levels are exactly the same? Or, why do noses and ears tend to grow proportionately larger in the elderly compared to those in their youth? The effects of these naturally produced hormones are subtle, but continuous, leading to visible alterations in facial features and bodily shape over decades. However, it is not just bones and cartilage that we need to worry about, but the internal organs as well, as they are subject to the same long-term growth stimulation as the rest of the body. For those who choose to administer supraphysiological doses of growth hormone and insulin in an effort to augment their bodybuilding progress, the rate and extent to which these changes take place can increase dramatically, leading to the eventual development of “GH gut”.

Another piece of the puzzle, and which is responsible for a substantial part of the problem, is modern eating habits. More specifically, today’s bodybuilders consume exorbitant amounts of food; a prerequisite for both the build-up and maintenance of extreme levels of muscle mass. However, this extreme eating can be problematic from an aesthetic standpoint, causing distention through multiple potential mechanisms. Under normal circumstances, the digestive system is called upon to digest 2-3 meals per day, along with a few snacks here and there. On the other hand, an advanced bodybuilder might consume 2-3X as many calories spread out over 6-7 meals. As a result, food begins to pile up along the length of the digestive tract, making the stomach bulge outwards.

In many cases, this single factor deserves the largest percentage of the blame, especially in very large bodybuilders with speedy metabolisms, who must put down massive quantities of food on daily basis. In these individuals, food and liquid is being consumed more quickly than it can be processed, at least during waking hours, causing distension to gradually worsen as the day draws on. By early evening, it is not uncommon for many of these people to look half-way pregnant—with a food baby, that is. As we sleep, the digestive system has a chance to catch up on processing all the food and liquid that was forced upon it during the day, resulting in significantly less distension by morning time, but this is only temporary, as the bodybuilder will soon begin the process of force-feeding all over again.

Another issue related to food consumption is uneliminated digestive matter. This is particularly prominent among those who adhere to low fiber diets—a common practice among many of today’s bodybuilders. Fiber is necessary for keeping the walls of the digestive tract clean and free of debris, allowing food to move through unhindered. When fiber is insufficient, digestive matter sticks to the lining of the digestive organs and hardens, forming a layer of putrefying feces that can remain there for years. Over time, significant build-up can occur, resulting in auto-toxicity (the absorption of bacteria and toxins into the bloodstream, resulting in self-poisoning), and subsequent sickness and disease. As much as 50 lbs of this waste has been found lodged inside the colons of deceased individuals—John Wayne being perhaps the most notable. Obviously, the larger this build-up becomes, the more distended the stomach will get.

In addition to the above, some individuals are prone to experiencing digestive problems, such as gas and bloating, as well as various food allergies (example: gluten intolerance), all of which can cause varying degrees of stomach distension depending on severity.

Another common contributor to distension is the weakening of the abdominal wall, otherwise known as the transverse abdominis. This underlying, sheath-like muscle (the deepest of the abdominal muscles) wraps around the torso from front to back and spans from the ribs to the pelvis. Imagine and oversized weight-belt surrounding your entire midsection like a girdle and you will get an idea of what the transverse abdominis looks like. Along with assisting in respiration, its primary function is to stabilize the spine and help compress the internal organs.

Unfortunately, several of the practices employed by modern-day bodybuilders, such as over-eating, using certain weight training methods, and a failure to adequately strengthen this muscle through targeted exercise, have adversely affected the muscle’s integrity. Basically, it becomes stretched out, allowing the internal organs to spill forward and press against the abdominal wall, resulting in further distension.

Although the following is only a minor factor and does not technically qualify as distension, I would be remiss if I did not mention the effect that modern-day muscle mass has had on waist measurements. As the overall size of bodybuilders has increased, so to have their abdominal muscles. The body is an organism of balance; it hates when things start getting out of proportion and will seek to correct such imbalances whenever possible. We see this principle at work when a BB’r fails to train certain body parts, yet they continue to grow along with the rest of him.

For example, a bodybuilder who trains only his upper-body will notice that his legs tend to grow as well, despite the total absence of leg training. In certain cases, an individual may even add several inches to their legs without ever so much as touching a squat rack. To use myself as an example, I injured my knee back in 2003-2004 and ever since then I had not been able to train legs with any kind of intensity, so I scrapped training them altogether shortly after the injury. Since then I have increased my bodyweight from 245ish’ to 270ish’ through upper-body training alone and in the process, my legs not only maintained their pre-injury size, but they actually grew ½ of an inch. 10 years without any leg training and yet they grew beyond what they had been when I was training them.

In other cases the reverse has proven true, with some individuals gaining significant upper-body size through leg training. Of course, depending on the individual’s genetics, the amount of indirect growth experienced under these circumstances can vary quite a bit, but regardless, this balancing effect has been well known in the bodybuilding community for many decades. So, if half of the body can grow without being subjected to any training at all, what do you think will happen to the muscles of the midsection when a BB’r transforms his entire physique into a 280 lb behemoth? Does common sense not tell us that an average 280 lb bodybuilder is going to have more thickly developed abdominal muscles than a typical 210 lb bodybuilder, even if neither of them ever did a single ab exercise? Of course, he will. Not only will the balancing effect make up for some of the difference, but more muscular men tend to handle greater training weights, calling the abdominals into play to a greater degree as stabilizers.

Lastly, muscle control, or should I say a lack thereof, magnifies all the factors mentioned above. Instead of being able to present the illusion of having a smaller waist than you actually do, an inability to properly control your midsection will leave no doubt as to just how horrible your waist actually is. Often times, the defining characteristic between those competitors with a flat stomach and those without is nothing more than a matter of control. Muscle control is crucial to being able to manipulate your physique to its best advantage, without which you will be left at the mercy of your own natural genetics.

Coming up in Part #3 will we will discuss how to overcome the above-mentioned roadblocks, thereby providing you with the best opportunity for obtaining a classic waistline.