Physique inflation and its dangers to your health
We need to raise the interest rates in nuance when it comes to Instagram gym content
Top of the morning, sapien. Welcome to Common Sense Medicine, where I try and keep you up to date on the latest and greatest in longevity science. Not really much of a science update this week, but rather a few lessons that I’ve noticed in my life recently. If you want to get a science update, check back next week!
This weekend, I’ve been a complete wasteman. I don’t want to throw a pity party here, but I do wish that I spend less time on the phone and more time doing things that are going to move my life forward. So, like any reasonable person, I turned on David Goggins’ motivational podcasts for me to move out of bed and be a human being that day.
I think this intro is a good time to revisit some of the goals that I had for Q1 — bringing back video content (coming March 2025!) and building a better distribution channel for the newsletter. I’m determined to get a few videos out to you guys in March. Right now, though, I’m going to write about my thoughts on some observations about ‘physique inflation’ and how it affected me after staring at my screen for 7+ hours this weekend.
Other items on the differential:
Ambitious people who are successful just sleep less. Is that a quirk in their genetics, or something else? I enjoyed reading this essay which explores that phenomenon with examples from history and current day, along with a scientific discussion about it.
This week, I read an interesting article on how depression screenings can increase the prescription of antidepressants, even if they’re not indicated for that medication. The false positives might hurt more patients than they help, telling them that they have an issue which they might not have if they make depression screenings a quality metric.
THE WEEKLY DOSE
Physique inflation grows in value
Social media often polarizes toward extremes, especially in the health and wellness niche. Although there are voices advocating for nuance—urging us not to judge all influencers by the extremes—the viral content overwhelmingly showcases the most dramatic cases. For example, even when the majority of gym-goers display well-developed physiques that any casual observer would recognize as healthy, comments persistently label them as “mid.” This contradiction illustrates the skewed lens through which social media tends to view fitness.
This discussion on Reddit was interesting to me because it highlighted the phenomenon which is called “physique inflation.” In the last decade, as everyone’s gotten a megaphone to blast into the void, you see the voices that rise to the top are those who are in the top 0.01% or the bottom 0.01%. This isn’t bad—it allows for a more meritocratic way for people to get their voice heard—but it has deleterious consequences, namely, distorting the view of what “health” is.
Two key factors underpin this shift in perspective:
Advancements in Training and Aesthetic Optimization:
The proliferation of advanced training techniques and a deeper understanding of how to optimize one’s physique have enabled many to achieve impressive results. This knowledge has undoubtedly accelerated progress for newcomers in the gym.Streamlined Access to Exogenous Substances:
At the same time, the increased transparency and ease of access to performance-enhancing substances have contributed to a dangerous recalibration of expectations. While some may argue that informed choices about supplementation empower patient autonomy, this ease of information can also lead to a neglect of the significant risks—such as hormonal imbalances or more severe health complications—especially for younger individuals who have not yet fully matured.
There is a third factor which I didn’t include above which is generally lumped under “genetic causes” of physique inflation, but I’ve discussed that at length in multiple other blog posts so I’ve left it out of this one (see here, here).
Physique inflation is largely just psychology
Now, this may sound like a little bit of jealousy of people who are doing this quicker than I am. I’ve mentioned that I’m on a journey for building hypertrophy, and I’m unfortunately in a population of people who do not build muscle as fast as others.
However, this week, I’ve found myself watching short videos on Instagram which highlight people with physiques I’d love to have, and I think it was easy to knee jerk into the idea that people are “taking something” to get to a physique that I don’t have rather than admitting that they were probably more committed than I was at 16 to lift weights consistently.
I suspect that many young men who are not classically ‘fit’ feel this way as well when they look at these videos. Most of the young men who are tempted to use these androgen-boosting drugs are not rationally weighing the risks of polycythemia and hypogonadism against muscle synthesis — it’s a much more knee jerk reaction to win a bodybuilding competition or to get jacked quickly.1 In fact, people take steroids even through the “worst cough of their life, as if they’re coughing up a lung,” which shows that they might not be thinking rationally when doing steroids.
There’s no shame in admitting that you want to be muscular, and you’re not there yet. When I’m feeling demoralized, I am certainly thinking about my past regrets about not exercising in high school more, and focusing on the gym when I was a teenager and in college. Physique inflation has more psychological harms than people realize; it warps the definition of what ‘health’ should be. Because of this, I think that any person who is focused on longevity needs to have a good mindfulness routine to combat these feelings of inadequacy.
Health is a spectrum and a journey
Largely, in centenarian studies, we’ve found that your health is dictated by your genotype, and that people who are not as genetically gifted have to compensate by modifying their habits until they’re emulating the phenotype. I think our reactions to physique inflation have to be the same way.
The spectrum of health is vast — I’m not Michael Phelps or Michael Jordan, and I don’t know if even they’re truly the ‘healthiest’ person in the world. However, there is an inherent gestalt of who is healthier than who — if I put two people in front of you and their BMIs were 30 versus 19, assuming they both have no disabilities or disease, you would probably say the one who is BMI 19 is ‘healthier’ and you would (in a large but not all cases) be right. However, at some point, we have to realize that while there is a lot of things I can do, I can’t outwork someone who has just been given genes which predispose them to a long life.
Psychologically, therefore, the only way to respond to this situation is to focus on my own health and emulate the phenotype. There still isn’t an analogue for aging as there is for steroids for muscle building, but it does seem that in order to combat the inadequacy, you have to set your own goals rather than comparing to the inflated physiques of others’ (whether they are taking exogenous steroids, have a favorable genotype, or something else).
This is where the second part comes in — health is a journey. As you see in the goals that I have, it’s always about stepping right back up when you fall two steps back. There’s always places for improvement, even when you feel like you’re stuck in your ways and that the world is against you.
Practical takeaways
We’ve established that physique inflation is be real due to the ability of more people to project their physique across the world, and Hollywood and general culture responded to that (see the cover image of Hugh Jackman in Wolverine now versus in 2002). If 1% of the total male population on Instagram has good physiques, that’s still 12 Million People. If you assume that only 20% of them make Instagram content, that’s still 2.5 Million People. There’s just too many people in the world, and you’re constantly going to see that if you’re getting served up Instagram Reels of gym content.
Psychologically, health is a spectrum and a journey, and the response is largely psychologic and requires a realization that:
There are genetic freaks (or people who have injected steroids) in the world who can do things better than you can, but that doesn’t make your journey any less valid. Remember that health is a spectrum and a journey.
Have a good mindfulness routine and ignore gym content — this week I’m testing out reading physical books and trying to finish 1 book this week and cutting down on my screen time.
Create more time for things that are harder (working out, writing, etc.) rather than mindless scrolling by time tracking what I’m doing. Easier said than done, but also important to measure versus a vague promise that “you will do it”
Most importantly, I’m going to channel good energy when I’m exercising and be present, and remember that I’m going to start training for that half marathon as soon as this hypertrophy block is finished at the end of March.
THE PRESCRIPTION
Q1 2025: Hypertrophy Cycle Progress
The upshot: We’re gaining weight again! Pushing a little over 1 lb. this week, and trying to continue the progress that I’m making. 158 lbs seems more in reach now that this week I’ve pushed up to 155 lbs. for my largest weight. We’re moving pretty quickly, so will try and see if I can stabilize for this week and then keep pushing up.
REMEMBER, IT’S JUST COMMON SENSE.
Thanks so much for reading! Let me know what you thought by replying to this email.
See you next week,
Shree (@shree_nadkarni)
The information provided here is not medical advice. This does not constitute a doctor patient relationship and this content is intended for entertainment, informational, and educational purposes only. Always consult with a doctor before starting new supplementation protocols.
I feel like I have to clarify here that I have not used steroids in the past and I am not planning on using steroids in the future. To the extent that changes, I will DEFINITELY write about it.