Buffing up their image: teenage boys' abuse of steroids

No doubt facilitated by Lance Armstrong’s now infamous interview with Oprah Winfrey in which he finally admitted to the use of performance enhancing drugs during his cycling career, most people are now aware that some elite athletes use performance enhancing substances to enhance their athletic performances.  However, what may not be as well known is that some of these substances – in particular, anabolic steroids – are used by a significant number of non-elite athletes. Most worrying is a recent trend towards increased use by teenage boys, not for gains in athletic performance, but to facilitate the development of a larger and more defined musculature.

While body-image concerns relating to thinness have long been recognised as an issue among young women, the perceived need to develop an appearance characterised by broad shoulders and well-developed arm and chest muscles can also lead to issues with body image among men.  It is this desire to attain what is often referred to as a mesomorphic body type that is thought to underpin the increased use of substances such as anabolic steroids.  Frequent media exposure to male stereotypes characterising mesomorphic appearances has been suggested as one factor leading to men’s dissatisfaction with their own bodies and a desire to develop their musculature for aesthetic purposes.  Friends and peers have been proposed as another key influence.  More specifically, friends and associates who emphasise the importance of muscle development in males – both through their comments and their own muscle-enhancing behaviours – may increase an individual’s perceived need to develop their muscles.

Given issues with socially desirable responding in surveys, obtaining accurate estimates of the prevalence of use of Performance and Image Enhancing drugs (PIED) is difficult.  However, even acknowledging the likelihood of under-reporting, research has estimated prevalence rates of five to ten per cent for certain at-risk groups.  Such prevalence rates become of particular concern when one considers the potentially harmful health consequences associated with use of anabolic steroids.  In adolescent boys, these include possible effects on the hormonal (e.g., infertility, breast development, shrinking testicles, male-pattern baldness), musculoskeletal (e.g., short stature, tendon rupture), cardiovascular (e.g., disturbed cholesterol profile, increased blood pressure, left ventricular enlargement), and cutaneous (e.g., acne, cysts, oily scalp, jaundice) systems, as well as on the liver (e.g., cancer, tumours).

In the School of Sport, Exercise, and Rehabilitation Sciences at the University of Birmingham, we are currently investigating psychosocial factors that facilitate the use of PIED.  Informed by evidence from across disparate life domains that shows people are more likely to engage in harmful conduct when they can rationalise such behaviour, our research has investigated a series of psychosocial mechanisms that may allow users of PIED to rationalise their use.  This work has shown that across a range of populations (e.g., bodybuilders, sportsmen, adolescent gym goers), users of PIED utilise six such mechanisms to rationalise their PIED use.  Also, our recent work has shown that adolescent male PIED users are more adept at using these mechanisms – and use them more frequently – than matched non-users. Two of the more frequently used mechanisms are displacement (i.e., when people view their actions as the result of social pressure and not something for which they are personally responsible) and diffusion (i.e., when accountability for harmful conduct is distributed amongst a large number of offenders) of responsibility.  The nature of these mechanisms shows how it is possible that as well as influencing body-image perceptions that encourage adoption of PIED use – as described earlier – peers may also encourage PIED use by facilitating use of psychosocial mechanisms that help rationalise their use.

The increasing trend towards use of PIED in young men to improve their body image is worrying given the possible health consequences associated with their use.  Research suggests that peers may have an important influence both on teenage boys’ body-image perceptions and on psychosocial mechanisms that may facilitate rationalisation of PIED use aimed at addressing body image concerns.  As such, it is important researchers continue to pursue research in this area with a view to developing interventions aimed at reducing PEID use in at-risk populations.