He came up with it after years of studying steroid users in Boston-area gyms and comparing them not just to non-steroid users in the same gyms, but also to bodybuilders from different eras. For a 1995 study, Pope and his coauthors estimated the FFMIs of Mr. America winners from 1939 to 1959, before steroids were readily available. The group includes future B-movie star Steve Reeves, whose physique was so iconic that he was name-checked in The Rocky Horror Picture Show . The average FFMI was . (One of the highest was George Eiferman, Mr. America 1948, with a FFMI. His upper body was later the model for George of the Jungle, a 1960s cartoon character.) Even today, with all we’ve learned about training and nutrition, an FFMI in the mid 20s is still considered the ceiling for natural bodybuilders. Anything above 26 or 27 is suspect.
During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex. Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. Although it has been shown that there is considerably less adrenal suppression following a single morning dose of prednisolone (10 mg) as opposed to a quarter of that dose administered every six hours, there is evidence that some suppressive effect on adrenal activity may be carried over into the following day when pharmacologic doses are used. Further, it has been shown that a single dose of certain corticosteroids will produce adrenal cortical suppression for two or more days. Other corticoids, including methylprednisolone, hydrocortisone, prednisone, and prednisolone, are considered to be short acting (producing adrenal cortical suppression for 1¼ to 1½ days following a single dose) and thus are recommended for alternate day therapy.
This is the scenario: a guy, say age 21, becomes serious about gaining muscle. He’s 5′ 10″, 7″ wrists, 9″ ankles, average genetics for muscle size-and-proportioned. He’s played sports, but never done more than an occasional resistance workout. Now, he begins a good training-eating-and-resting program. With his genetics, he has the potential for naturally gaining 45 pounds of lean mass if he stays consistent with progressive training/proper eating for a continuous 3 to 4 years.
But, about three months after beginning his training, he starts taking steroids. He does three steroid cycles in the following 18 months, and includes proper post-cycle therapy. That entire time, he’s continuing to consistently train and eat properly. Before the end of two years, he’s gained 45 pounds of lean mass (which with steroids, by the way, is not necessarily typical but neither improbable). At that point, he permanently quits using steroids, but he does continue properly training and eating for another two years. At the end of four years, he carries the same 45 pounds of lean mass.