Prevalence of Performance-Enhancing Substance Use and Associated Factors among Portuguese Gym/Fitness Users

Is the use of performance and image enhancing drugs (PIEDs) in women an issue of concern? The findings from a stakeholder consultation

OBJECTIVES

There is limited research into the use of performance and image enhancing drugs among women who participate in sport, despite evidence that women do use these substances and experience related harms. The aim of this project is to capture stakeholder perspectives on the current research, policy, and practice landscape in Australia regarding women's performance and image enhancing drug use in regulated and unregulated sport settings.

DESIGN

Qualitative interviews.

METHODS

Thirty-two semi-structured interviews were conducted online with stakeholders from Australia between September and December 2021. Interviews ranged between 15 and 90 min in duration. Data were imported into the NVivo (Version 12) platform and analysed using thematic analysis.

RESULTS

Thirty-two participants (20 females and 12 males) who held a variety of roles (e.g., coach/strength coaches, gym owners, anti-doping agents, athletes) were interviewed. Fourteen participants reported performance and image enhancing drug use. There were four overarching themes generated from the data: 'participation in untested sports'; 'environmental factors driving use'; 'individual rationalisation'; and, 'the dark side of performance and image enhancing drug use'.

CONCLUSIONS

Performance and image enhancing drug use was identified as an issue of concern for women competing in non-elite strength and power-based sports. Of particular concern is the influence of unqualified advice from third parties (i.e., coaches and partners) regarding performance and image enhancing drug use. The environments in which performance and image enhancing drug use occurs can impact individual decisions of women and eventuate in significant and long-lasting physical and psychological harms.

Perceived Body Image towards Disordered Eating Behaviors and Supplement Use: A Study of Mauritian Gym-Goers

Purpose: Individuals with body image distortions tend to develop an obsession with calorie intake and weight, leading to compounded coping strategies such as modified eating behaviors, supplement use, and excessive exercise. In the local context, little is known about the equation connecting body image to improper eating behaviors and other potential coping mechanisms. This study primarily aims at critically identifying the nexus between features of disordered eating behavior including supplement use, and body image. Methodology: A probabilistic randomized sample of 305 gym members was assessed based on their level of body satisfaction and its influence on their eating habits and supplement use through a structured survey. Findings: Only 37% of the participants were satisfied with their body image. The results concurred with the notion of a poor body image influencing body esteem (χ2 (10) = 137.21, p < 0.05; Cramer V = 0.474). While exercise motivated the use of supplements, a significant relationship was also observed between disordered eating habits and supplement use (χ2 (4) = 48.63, p < 0.05; Cramer V = 0.399). A predictive model was successfully drawn inclusive of the disordered eating behaviors dimensions as a potent predictor of body image (χ2 (56) = 397.12, p < 0.001. Implications: This study presents an in-depth analysis of the magnitude of disordered eating behaviors with respect to individuals in the local fitness industry, and the need for professional support programs toward the re-alignment of body image in an effort to curtail the development of eating disorders in Mauritian gym-goers.

Performance-Enhancing Substance Use and Sexual Risk Behaviors among U.S. Men: Results from a Prospective Cohort Study

Performance-enhancing substance (PES) use is common among young men and prior research has documented cross-sectional associations between anabolic-androgenic steroid (AAS) use and sexual risk behaviors. However, this relationship remains understudied among a longitudinal cohort of young adult men, and research on prospective associations between legal PES (e.g., creatine) use and sexual risk behaviors is lacking. The current study addressed these oversights using data from the National Longitudinal Study of Adolescent to Adult Health (N = 5,451). AAS use and legal PES use were assessed at Wave III (ages 18-26) and 10 indicators of sexual risk behavior were assessed at seven-year follow up (Wave IV; ages 24-32). Linear and logistic regression analyses were conducted adjusting for demographic and behavioral confounders. Participants who reported AAS use and legal PES use had significantly higher number of one-time sexual partners and higher odds of multiple sex partners around the same time in the past 12 months. Participants who reported AAS use had higher odds of any STI in the past 12 months. These results extend prior research on the risk behaviors and adverse effects of PES use. Health care professionals should assess for PES use among young adult men and provide guidance on healthful sexual behaviors.

Characteristics of Gym-Goers Performance-Enhancing Substance Use

The use of prohibited performance-enhancing substances (PES) in fitness and gym settings is a public health concern as knowledge concerning its short-term and long-term adverse health consequences is emerging. Understanding the underlying psychosocial mechanisms of PES use and the characteristics of the gym-goers who use PES could help identify those who are most vulnerable to PES use. The aim of this study was to investigate the profile (e.g., sociodemographic factors, exercise profile, gym modalities, peers, and social influence) and psychosocial determinants (e.g., attitudes, subjective norms, beliefs, and intentions) of PES users in gym and fitness contexts. In total, 453 gym-goers (mean age = 35.64 years; SD = 13.08) completed an online survey. Neural networks showed a global profile of PES users characterized by a desire to increase muscle mass, shape their body, and improve physical condition; being advised by friends, training colleagues and coaches or on the Internet; less formal education, and more positive beliefs for PES use. These results may support public health and clinical interventions to prevent abusive use of PES and improve the health and well-being of gym-goers.

Enhancing the Self: Amateur Bodybuilders Making Sense of Experiences With Appearance and Performance-Enhancing Drugs

In this paper, we implemented a methodological framework of interpretative phenomenological analysis (IPA) and a theoretical conceptualization of multiple selves to explore the subjective accounts of six amateur bodybuilders using appearance- and performance-enhancing drugs (APEDs). The participants made sense of their bodybuilding careers and experiences with APEDs in a way that showed a multiplicity and complexity of reasons for using APEDs, which stemmed from tensions they perceived between the context of bodybuilding and other life domains. The participants’ reasons for the use of APEDs included not only enhancing their body, appearance and performance but also enhancing other subjectively important psychological characteristics, such as agency and self-control, the development of knowledge and expertise, sense of meaning, well-being, and quality of life. In the analysis, we integrated these themes through the concept of the “extraordinary self,” based on which our participants strived for self-actualization through bodybuilding and the use of APEDs. In the sense making of our participants, a potential “exit point” subverting their APED use emerged from a tension between such “extraordinary selves” and the “ordinary selves” through which they perceived APEDs as preventing them from living normal, balanced lives outside the context of bodybuilding. However, success in balancing the two selves also created the possibility of the future use of APEDs.