As much as they’re scoffed at, gym bros deserve some credit. What they do is hard. Most of us are too lazy to even get our asses off the couch to use the bathroom during an episode of Dark, let alone spend hours lifting heavy objects until our chests tear holes in our t-shirts.

But not all gym bros are as hard working as they seem. Take, for example, the bro in this gif, which rose to the top of the subreddit r/WTF on Friday. There’s swole, and then there’s whatever this guy is — an alarming degree of over-inflatedness that seems to denote sickness rather than strength.

The caption of the gif, posted by Reddit user HumanNutrStudent, is “Don’t inject synthetic oil in your muscles my fellow gym bros.” Doing so may sound like a bizarre practice to people who don’t spend much time in serious weight rooms, but it’s a phenomenon that has caused medical problems in the past.

Synthetic oils, also known as site enhancement oils, aren’t anything new in the body building community. In 2015, Romario Dos Santos Alves, a former bodyguard and bodybuilder from Brazil, made news when he admitted that his habit of injecting synthol — a popular synthetic oil/anesthesia combination — successfully inflated his muscles but put his life at risk.

In another case, a 25-year-old weightlifter who injected coconut oil into his biceps wound up in the hospital, as doctors reported in the British Medical Journal in 2015. Like most people who dabble in oil injections, whether synthetic or not, this person was trying to augment the curve of his muscles. He turned up at the hospital, the paper’s authors wrote, agitated and sweating profusely because he was suffering from pain and a loss of function in his right arm.

The patient in the case study had completely ruptured his triceps muscle, and an MRI revealed multiple cysts — small, hard bumps in the arm filled with fluid. Injections can also cause tumors, muscle fibrosis, deformity, and loss of function, the researchers wrote, noting that this practice has been around since the 19th century. Even more serious side effects can include “oil embolism, myocardial infarction, cerebral stroke, ulcers and infections,” according to another case study in the Journal of Medical Case Reports, published in 2012.

When it comes to injections, infections generally occur because harmful bacteria in the oil, on the needle, or on the surface of the skin (that get pushed through) enter the bloodstream; the worst-case scenario is that the bacteria and their toxins grow and spread throughout the body, causing sepsis.

An even more serious implication of this phenomenon is its relationship to body dysmorphic order, which, in the body building community, manifests as the belief that one’s body is not lean enough or muscular enough. The problem is a serious and ongoing concern in the community, as many users in the Reddit thread pointed out.

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