Extreme fatigue, trouble sleeping and a messed-up metabolism are just some of the short-term consequences of the extreme training required in the increasingly popular and glammed-up world of female physique competitions.
Some argue the competitions are just glorified beauty pageants, albeit with more rigorous requirements. Others fear the sport's obsession with perfectiondoes untold emotional and physical damage.
However, the growing number of UAE-based women competing in this elite sport say it doesn't have to be that way, and, for them, it's all worth it - whatever the price.
Nadine Du Toit started competing three years - and 25 kilograms - ago. She has since become a pioneer in the UAE, where the sport is still in its early stages and there are no local competitions and little in the way of a support network.
The 34-year-old, who founded the Dubai-based life and fitness coaching company for women, www.glorygirlfitness.com, was originally inspired by her father, a trophy-winning bodybuilder. She started competing while working for Emirates Airline, eventually earning a pro card from the World Beauty Fitness and Fashion (WBFF) show, formerly the World Body Fitness Federation.
Although she gave up competing last year and moved into judging, the driven yet understated Du Toit blossomed in the spotlight. "I would have always loved to have been a singer or a dancer on Broadway," she explains. "I love performing. Competitions simply combine this with my love of fitness."
Backstage, she has created a network of friends from around the world, who help each other with costume preparations and provide support. "Having my fitness friends has really helped me between competitions," says Du Toit.
Jes Body, 26, is one of the growing number of women who is following in Du Toit's footsteps. "I train all the time and this gives you a goal," says the New Zealander. "I'm the healthiest when I'm doing stuff like this."
Now a personal trainer in Dubai, Body won the Fitness Universe bikini division in Paris last October. She is also preparing for the WBFF's European championships in London this November.
"It's inspiring," she says. "It's a real community. If you love working out and having a goal, it's great - but it's not for everyone."
The physical price
These female competitors train to get their body fat down to five per cent and sometimes just two per cent - well below the World Health Organisation's recommended minimum of 21 per cent for women aged 20-40 to avoid organ damage and a host of other physical problems.
For months before the big day, women engage in multiple weightlifting, cardio and high-intensity interval training; they reduce their calories in the four weeks before the competition by up to half. During "depletion week", they typically ingest no carbohydrates other than those found in vegetables.
In the hours before hitting the stage, dehydration is the goal, combined with carbohydrate-loading to help define the muscles and enhance appearances.
Some competitors also turn to steroids, but Du Toit refuses to mess with her metabolism that way. Instead, she trains hard and sticks to a rigid diet. "My mission has always been to show you can do this naturally," she says.
Body, who is already preparing for her next competition, says: "You can't be on a minimal diet if you want to build muscle. There so many under-eaters, which comes from a fear of fat and putting on weight, which leads to metabolic derangement."
However, even taking the natural route, the female body often cannot endure the months - or years - of under-eating and over-exercising the sport requires.
Getting to such a low body fat can really affect hormones and metabolism, admits Mirella Clark, a 33-year-old personal trainer and bodybuilder from the UK living in Abu Dhabi.
Clark trained for a gruelling three months to get down to two per cent body fat and win the WBFF's European championships in the short fitness model category in April.
"I got myself in the best shape of my life but it came at a price, in terms of the side effects of becoming so lean," she says.
Clark is getting her training and competing in now because she wants to "think about having a family" some day - she has not had her period since starting training in January. With such a low body-fat percentage, her body struggled to make serotonin and she experienced mild depression.
Calorie restriction and low body-fat lead to a drop in oestrogen, which is what interrupts menstruation in these competitors. This can lead to reduced fertility, explains Dr Shereen Habib, a Dubai-based family medicine doctor specialising in women's health.
The reduction in oestrogen can also cause a dangerous drop in bone density that can lead to bone thinning or bone loss. Since oestrogen also plays a role in moods, it can lead to low moods or mood swings that the endorphins produced by exercise can't always offset.
"So while exercise and fitness are good, and we all know the risks of obesity, obsessive over-exercising and calorie restriction in women can be detrimental to their overall well-being in the short and long term," Habib says.
The emotional side
The body can't help but change post-competition, even though it is often so minimal that an outsider would not be able to tell.
It is during those weeks and months after a competition, when the body's fat percentage rises and kilograms are inevitably put back on, that competitors can struggle to adjust.
"It's not in its usual state," explains Body, who went through her own body issues as a teenager before becoming a fitness professional.
As Du Toit says: "What hurts the most is other people's expectations of me outside the competition, so that's what I have to work hardest against. But this is where I can guide women. You don't have to be perfect all the time and it's not just about having the perfect body."
There is also a feeling of "disassociation with your body", she says.
Clark feels competing has left her with an unhealthy relationship with her body. "There were days when I just felt fat, even though I knew I was talking rubbish," she says. "In my head that's how I felt and that's what I saw when I looked in the mirror. Even on my day off, I'd forget how to eat normally."
Outside of the intense requirements of preparation, Clark felt "at a loss". She says her passion for competing has required so much dedication that she has barely seen her friends and family. She has become obsessed, she admits. "You don't hear about this stuff," she says. "You just hear about the glitz and glamour of the show. There really is a darker side."
For many women, the competing just becomes a way to legitimise a self-destructive obsession with food, diet and body image. "The reverse is also true," says Scott Abel, a former bodybuilding competitor-turned-life coach based in Canada.
"Competing can trigger eating disorders and disordered eating issues. All eating disorders begin with a diet."
Body sees the competitions differently. For her, they are "a positive way to manage body issues, once you learn to fuel the body correctly".
Clark agrees. "In terms of stepping on stage and the fitness industry, I was in the best shape, but not so much in real life. It plays with your mind though. You get so tiny and it's not realistic to walk around like that."
One woman’s story: ‘It just broke me’
Marti Wycherley, a 35-year-old personal trainer, has battled with eating and body-image issues since she was a teenager.
An unhealthy obsession with her body shape led to extreme exercise, dieting and experimenting with fat burners.
“If you keep doing this repeatedly, it gets harder and harder to get lean. That’s when women start being tempted to take things like fat burners and go to more extreme measures. Your body becomes more resistant but in turn, your body’s homeostasis gets out of sync. Your neurotransmitters are low because low carbs means lower serotonin so you just feel depressed.”
Overtraining meant she became weaker instead of stronger; spurning starchy carbohydrates led to sugar cravings, chocolate binges and depression. Her period stopped and she had trouble sleeping. Her weight would yo-yo, challenging for a fitness professional.
After two years of trying to compete, her dream faded. “I tried to get a handle on it but I just went the other way,” she says. “It broke me.”
She pledged to turn around her attitude to training and eating around, refusing to diet or train to extremes.
Almost three years on, she has regained her menstrual cycle and is sleeping through the night. She eats carbohydrates and no longer diets and binges. She insists on two days of rest rather than constant training.
Wycherley moved back to Dubai last October and made her second attempt at a physique competition in Yorkshire in May, held by the Natural Physique Association.
Gone are the extremes, with the aim to reach 14 – not five or two – per cent body fat.
“Because I’ve been consistent this time, no skipping meals or starving myself, my body is just getting better and better.”
Repairing the damage done
Scott Abel has seen the desire to win wreak physical and emotional havoc – particularly on women.
His books The Other Side of the Mirror, which tackles body image dependency disorder, and Metabolic Damage and the Dangers of Dieting, directly address the fallout of dedication to extreme fitness competitions, which he says are being propelled by a new culture of narcissism. They are also, he argues, particularly damaging to women.
“They fall into a trap that their bodies are something to work on and perfect, rather than to connect to and respect. It is very dangerous psychological ground.”
Competitors who believe that their post-competition physique deteriorates, no matter how imperceptibly to an outsider, are attempting to maintain “a false and unsustainable version of their own bodies”, he says.
Abel now works helping others who have done lasting damage through years of competing, problems that include depression and permanently weakened metabolisms.
He maintains that “there are no safe ways to compete”, despite what people say. “It’s taking the female body to an extreme it isn’t meant to go. How you get there is less important. Some bodies start rebelling and reacting at say 15 per cent body fat, some closer to 10 per cent, some not till the third or fourth competition diet. Like the smoker who gets lung cancer, no one thinks it will happen to them until it does.”
* Melanie Swan