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The Cost of Self-Esteem
The typical avatar for this would be a guy in his 20s or his 30s that is going to the gym and maybe using steroids. Why does it start to drop off in 40s? Well, some folks will come and get treatment but I think another significant contributor is called spontaneous remission. It's where the disorder kind of resolves on its own. The process of that happening is not dissimilar to how you felt about training and dieting when you were say 20 compared to now.