If you read some of the pros on here one thing becomes apparent. Regardless of what type of physique they possess they may still have the maturity or mental development of a child. Same with professional athletes in other sports. I'd say most of them who go to great lengths abusing drugs etc. do suffer from insecurity, obsessive compulsive traits, and perhaps body dysmorphia. Look at what Greg Valentino and Derek Anthony have done to themselves. Are these the actions of people who are healthy in mind and spirit and wish to exercise for health benefits or are these extremely insecure individuals seeking validation in "big" muscles?
Some people who bodybuild have the right idea. They are extremely secure and confident and bodybuild as a way of perfecting the physical aspect of life. Training the muscles etc. has a great benefit in the functioning of the body. These people also address other areas such as sound mental health, relationships and so forth. Unfortunately, people doing it for the right reasons seem to be few and far between when it comes to the competitive level of extreme bodybuilding. Sorry for the long post.