Bodybuilders dying as coaches and judges encourage extreme measure

 Elena Kosinova noticed she couldn't move while leaned over a fan waiting for her spray tan to finish.  

 The Czech bodybuilder cramped again hours before the 2021 Europa Pro contest, exactly like in Portugal weeks earlier.  

 Friends and competitors knew Kosinova for her bodybuilding extremes—training, diets, medications.  

 On that scorching August morning, she murmured to fellow Czech athlete Ivana Dvorakova, "I won't be able to do it." Really sick.”  

 Dvorakova helped Kosinova lie down on the concrete floor while others offered her water, salt, and sugar .

 Kosinova discussed her diuretics before convulsing and losing consciousness.  

 Four witnesses or briefed on the incident said the ambulance took about an hour to arrive in Alicante, Spain.   

 Kosinova, a 46-year-old mother who wanted to win the Olympia, died before the tournament.  

 Czech bodybuilder Alena Kosinova, far right, at a 2021 Portugal tournament.  

 In Spain for the Europa Pro contest weeks later, the 46-year-old mother cramped terribly and lost consciousness the morning before the show.   

 The Washington Post obtained it.  

 Shelby Starnes, her American coach, rarely attended shows. Soon after Kosinova died, Starnes received an alarming email from another client, Jodie Engle.  

 The 30-year-old single mother posted that she was hospitalized and may need open-heart surgery.  

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