OK, I'm confused here!
The initial set of pictures posted by Disgusted are (as he describes) HIV patients whom may have been treated with antiretroviral therapy. What we witness in these pictures is Lipodystrophy, a metabolic syndrome of,as yet, unclear pathogenesis. As you can see from the pictures there is a loss of body fat from the limbs and a build up in the trunk ; so-called centri-petal obesity. I have no argument with what these pictures demonstrate. They have NOTHING to do with Dennis James though!
Dennis James (to my knowledge) is not HIV positive and thus is unlikely to have partaken of antiretroviral therapy. He is none-the-less a professional bodybuilder and as such is highly likely to have partaken in the use (at high levels) of Human Growth Hormone, anabolic steroids and insulin.
The clinical evidence is that Human Growth Hormone will REDUCE visceral fat stores (in fact it is used as treatment in patients such as the ones illustrated). I have yet to see an insulin dependent diabetic develop lipodystrophic signs from insulin usage.
I would be interested to know to what extent insulin plays in the pecontest preparation of professional bodybuilders? Certainly in the offseason with insulin usage there could be some build up fat. To my mind 12-16 weeks of serious dieting coupled with resistance training and cardio will cause significant depletion of bodyfat stores including any visceral fat. Add to this that growth hormone will also reduce the visceral fat level and I struggle to find visceral fat the sole culprit for this distension.
Thus I am unclear on just how much blame can be put on insulin and visceral fat as the culprit for the abdominal distension of some of todays bodybuilders.
Perhaps visceral fat has some role, however surely the use of Human growth hormone and its effects on organomegaly (liver, pancreas, spleen) and muscle hypertrophy (including the smooth muscle of the intestinal wall) HAS to be part of the problem as well?
Just my thoughts (excuse the noob!)
Dave.