DEAR DR. DONOHUE: I exercise seven days a week for six hours each day. I make sure I eat well. I get enough protein by drinking four protein shakes and eating six eggs every day. I am 5 feet 11 inches and weigh 210 pounds. I have had my body fat checked two ways – skin folds and electrically. I have 8 percent body fat.

Even though I do all this work, I cannot achieve the muscle size I want. I look in the mirror and see a scrawny body. I don’t know what more I can do. I think about this all the time. Do you have any suggestions? – P.M.

ANSWER: I have a serious suggestion for you. You should consider that you very likely have an unhealthy obsession with your body. Anyone of your height and weight is not scrawny. Your mind is distorting what you see in the mirror.

Having 8 percent body fat means that more than 90 percent of your weight is muscle and bone. That’s a very low body fat percentage. Few have that little body fat.

You work out daily for long periods of time. You don’t need any more exercise. You watch your diet and take extra steps to make sure you’re getting enough protein. You’re getting more than enough nutrition.

You might have what’s called body dysmorphic syndrome. It’s a psychological state in which people fixate on some aspect of their body and believe it not to be up to par when, in reality, there is nothing wrong with it. One subset of body dysmorphic syndrome is muscle dysmorphia. Here the target of obsessive thoughts is inadequate muscle development when all objective evidence shows excellent musculature.

Thinking about this all the time is an indication that you have gone overboard. If you are ignoring other aspects of life – and you must be, given the amount of time you spend in the gym – you need help from a mental health professional. That person can coach you in techniques to overcome this preoccupation with muscle size and your erroneous interpretation of your muscle development.

DEAR DR. DONOHUE: I am a high-school swimmer, and I do best in speed races of short distances. I have heard that holding your breath while swimming increases your speed. Can you tell me how this is done, and if it works? – R.S.

ANSWER: You’re talking about controlled frequency breathing during practice, not during competition. Normally a swimmer takes a breath every second or third stroke. In controlled frequency breathing training, the swimmer takes a breath every sixth to eighth stroke.

By doing so, the swimmer puts him- or herself in a state of relative oxygen depletion. In speed races, swimmers develop an oxygen debt because the body cannot supply enough of it to meet the demands of rapid swimming.

By deliberately depriving their bodies of oxygen while training, swimmers imitate the state of oxygen lack that comes during competition. The body is forced to adapt to the lower supply of oxygen. This is supposed to give the swimmers an edge when they are competing.

I can’t tell you if it really works. Try it. It won’t hurt you. Let me know the results.

DEAR DR. DONOHUE: I lift weights with a group of very dedicated bodybuilders. They’ve been saying that the best way to build muscles is to lift very slowly. Are they correct? – C.H.

ANSWER: Traditionally, weightlifters are told to lift the weight in two seconds and lower it in four. The lowering part of the exercise involves eccentric muscle contraction. Eccentric contraction means the muscle is lengthening during that phase of the exercise. Eccentric contractions are said to provide a greater stimulus for muscle growth than are concentric contraction, the phase of lifting when muscles shorten.

The theory of very slow lifting says you greatly increase the stress on muscles by taking much longer to lift and lower the weight than you would do in the traditional routine. The lifter takes 10 seconds to get the weight to the maximum height and five seconds to lower it to the starting position.

I do know of one recent study that debunks the very slow lifting technique. One study is not proof positive. There’s no law that says you can’t experiment.

DEAR DR. DONOHUE: I am 27 and have been very athletic since age 7. My left knee suddenly has been giving me fits. From time to time, it swells and hurts, and sometimes when I bend it, it locks for a few minutes. My family doctor says I have a loose body. What is that? – T.F.

ANSWER: Your family doctor refers to a condition called osteochrondritis dissecans, where a piece of the cartilage that covers the bone’s end at a joint separates. If the separation is complete, the fragment drops into the joint. That’s a loose body. It causes pain, joint swelling and can lock the joint in a bent position.

An orthopedic doctor, if he or she agrees that your problem is a loose body, can retrieve the broken-off cartilage with a scope and special instruments inserted into the joint through small incisions. That almost always solves the problem forever.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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