#28–Mark & Chris Bell: steroids, powerlifting, addiction, diet, training, & helping others live well

KEYPOINTS

• 01

  Bigger, Stronger, Faster made Attia rethink what he'd assumed about steroids.

  Attia says that through medical training he simply assumed anabolic steroids were among the most dangerous things around, an impression reinforced by Lyle Alzado's death and a Sports Illustrated cover when Attia was in high school. Seeing Chris Bell's documentary around 2009 was the 'thin end of the wedge'. He quotes JFK's 1961 Yale speech about enjoying 'the comfort of opinion without the discomfort of thought', and stresses that the film doesn't argue steroids are good or bad.

• 02

  The film worked because it was honest about the family's own conflict.

  Chris modeled its structure scene by scene on Michael Moore's Bowling for Columbine and brought in that film's editor. Producer Alex Bono saw the core story when Chris mentioned that his brothers Mark and Mike were using steroids while he, the middle brother, was conflicted. Chris applies the same approach to a planned nutrition documentary: show what's actually happening, his own confusion about how to eat, rather than push a diet.

• 03

  Chris challenges opponents without trying to humiliate them.

  Attia praises the scene with the father of a high school athlete who died by suicide, whose death the father blamed on steroids, and says the evidence suggests steroids probably had little to do with it. Chris chose not to cross-examine a grieving parent. Instead he drew comparisons, noting that his own brother died in a sober-living facility with drugs involved, and that a 'steroid awareness night' at a ballpark sells beer to fathers who then drive their kids home.

• 04

  Chris's recovery required family intervention and long-term support.

  Their father had cried only rarely, Mark says, and the only time he ever yelled at Chris was to tell him he was an addict or an alcoholic, which Chris credits with saving his life. When Chris's girlfriend Lauren called Mark late at night, Mark and his wife booked flights for both of them to Sacramento. Chris went through three to four days of detox and then 60–70 days of rehab. Chris later said he felt alone in Los Angeles.

• 05

  Recovery, like getting strong, is 'never over'.

  Mark says there's no point where you arrive and stay. Years later, Chris's life had 'restarted at 40' and healing was still ongoing. Chris now says he's grateful for the addiction because it lets him help others. He says his film Prescription Thugs has prompted viewers to recognize their own opioid problems.

• 06

  The Bells built strength from early on with minimal training volume.

  A chiropractor who doubled as a powerlifting coach told a teenage Mark to squat to fix his knees, despite bodybuilding magazines warning it was bad for them. Within six months Mark went from a broomstick to 315 pounds for eight reps, and he squatted over 500 in high school. Influenced by Mike Mentzer's low-volume approach, they often did one heavy lift and left. Their brother Mike squatted about 675 by 18 or 19.

• 07

  Steroids raise your ceiling but don't replace genetics.

  Mark says steroids mainly let people gain mass. If genetics get you to 'level four', drugs might get you to six, but not to the eight to ten of genetic outliers like Phil Heath or Jay Cutler. Mark has used them since 25, now with a prescription. Chris believes heavy use, trenbolone plus testosterone and oral steroids right after rehab, left his tendons too weak and caused his torn triceps.

• 08

  Attia approaches low testosterone in a methodical way.

  He treats only when free testosterone is about one to two standard deviations below the mean and the patient has symptoms. He then works through nine steps: high SHBG (from insulin, thyroid, estrogen or genetics), too much conversion to DHT or estradiol, low DHEA, or weak FSH/LH signaling from the brain, often addressing these without giving testosterone itself. He rarely starts anyone above 50 mg twice a week, while Chris says everyone he knows takes 200 mg.

• 09

  Sleep and cortisol are common reasons the brain doesn't signal for testosterone.

  When testosterone, FSH and LH are all low, Attia's top diagnosis is sleep deprivation. High cortisol diverts hormone precursors (the pregnenolone 'steal') and blocks the deep sleep in which FSH and LH are released. On statins, Attia says theory predicts lower sex hormones but the data don't show it, because the body prioritizes cholesterol for cell membranes and hormones.