The gruelling training sessions were supposed to be the beginning of the champion bodybuilder’s comeback. But Cedric McMillan never got that far – he was running on a treadmill when he suddenly suffered a suspected heart attack.
His death at the age of just 44 is the third in a matter of months and has prompted shock and fear in the highly competitive bodybuilding community.
McMillan, a father-of-four, served for more than 20 years in the US army, where he rose to the rank of Sergeant First Class and became a “star in the world of bodybuilding and fitness,” according to a post by Arnold Sports, the company founded by Arnold Schwarzenegger.
However, he had been complaining for weeks about his poor health as he pushed his body to prepare for upcoming competitions.
His unexpected death follows those of Shawn Rhoden, the 2018 Mr Olympia champion who suffered a heart attack last November, and George Peterson, who died from heart problems last October, believed to have been caused by steroids.
Now the debate is raging over the use of both muscle-gaining anabolic steroids, which are illegal if not prescribed by a doctor, and weight-loss diuretics, which are used widely before competitions.
Outside a gym in Washington DC, a 6’3” man who had just finished a weights session said: “This has to stop now. Someone needs to get a grip or more people are going to die. And for what? To look good on a poster?
“It’s like the Wild West with all these drugs and pills and tablets. Four kids without their father... This has to be a watershed moment.”
A gruelling price to pay
Some bodybuilders regularly consume more than 4,000 calories a day when “bulking” to gain muscle mass. This amount, nearly twice what the NHS recommends, causes their weight to balloon and can put a strain on the heart.
However, some go further and take anabolic steroids to further add to their muscle gain.
As the competition approaches, they then slash their calorie intake by half, but keep up their exercise to lose excess fat and present a lean, muscular figure.
McMillan, who finished in the top 10 of Mr Olympia four times in the past six years, would typically lose 13kg (29lbs) in this “cutting” process, dropping from 140kg to 127kg (308lbs to 280lbs) for competitions.
However, one of the most common complaints of a bodybuilder on the day of a show is “holding water”. This term describes the blurring of muscular definition caused by a relative excess of extracellular water.
In order to lose the water through urination, some bodybuilders take diuretics. The tablets are designed to help people with kidney problems, but can cause an electrolyte imbalance that can affect the function of the brain, muscles and heart when used incorrectly.
It is not known if McMillan used diuretics and there is no suggestion that they are linked to his death. However, a debate is now raging on how to combat the increasingly dangerous measures such athletes are taking.
“Diuretics are straight poison when used for bodybuilding purposes,” said one user on UG Bodybuilding, a popular bodybuilding forum.
Another commented: “Lose that fat the old fashion way or better yet don’t let yourself get that fat to begin with. But as far as being careful, 2020-present should serve as fair warning.”
Not everyone will listen. One person with the username Hard Gains said that he knew someone on “gear” who has written a will in case he dies, and that his children can be looked after by a friend.
“He said that he will never come off [the steroids] and he knows how it’s going to end for him,” the user said.
Another person added: “I’d rather die younger doing what I love than live to be 1,000 doing something else.”
And some have indeed died young. In 2017, Dallas McCarver, a 26-year-old bodybuilder, suffered an acute cardiac episode, choked on some food and died. His heart was found to be three times the size of a normal one.
The coroner said the condition of his heart indicated that steroid use played a contributing role in his death.
‘I can’t keep food down’
McMillan shared his personal health concerns as recently as Feb 28. It was known what exactly they were caused by.
“I’ve been having some issues with my stomach,” he said in a video posted on Instagram to his 500,000 followers:
“I can’t keep food down for some reason. It creates some stupid a-- hiccups. I’m hiccupping all day long and half the night. Any time I try to eat, even drinking water, it comes back up. Nothing wants to stay down.”
He went on to say that the issue had been troubling him for weeks and panned the camera to show a tabletop brimming with various tablet containers.
“My bathroom is full of medicine. The s--- that I’ve been taking, nothing was really working,” he said.
In an effort to stop his hiccups, McMillan said he stuck his fingers down his throat to make himself gag.
Chris Lewis, a body transformation coach, said that he saw this first hand: “I guess about five or six weeks ago, I was having a conversation with Cedric at my gym and I witnessed him going to the bathroom and making himself throw up to get rid of his hiccups.”
However, McMillan’s health had been deteriorating since a bout of coronavirus in 2020. Although he said he did not suffer while infected, he was admitted to hospital months later with pneumonia and placed on life support.
“I was nearly dead,” he said afterwards.
In an interview with Generation Iron, a bodybuilding news website, he revealed that the hospital phoned his family to tell them there was a chance he would not make it.
While it could not be confirmed, it was suggested that McMillan’s lungs had been filling up with liquid for months after his Covid infection, causing him breathing difficulties.
“I’ve been battling back and forth with myself, not really knowing what to do next,” he said in his last Instagram video.
“I’m feeling like, is it over? Does this mean I’m supposed to retire when I’m sick all the time?”
The near-death experience and ongoing stomach problems forced him to postpone a comeback to professional bodybuilding last month, but he had targeted the end of the year for a return.
He said he still wanted to do “the thing I love”.