Public Health Strategies to Prevent and Reduce The Misuse of Steroids in Bodybuilding Communities

Abstract

The misuse of anabolic-androgenic steroids (AAS) and other appearance and performance enhancing drugs has expanded from elite sport into recreational gyms, bodybuilding spaces and social media-driven fitness cultures. AAS are medically useful in selected conditions, but non-medical use for muscularity or performance is associated with endocrine, cardiovascular, hepatic, psychiatric and infectious risks. Because bodybuilding communities are shaped by peer norms, trainer influence, product availability, body image pressure and limited trusted health services, the problem requires a public health approach rather than only an anti-doping or punitive approach. A gym-based analytical cross-sectional study framework was used. The study population comprised 300 bodybuilding and strength-training participants from selected fitness centres. A structured questionnaire assessed demographic profile, training history, motivation, peer influence, social media exposure, knowledge, perceived harm, health-seeking behaviour and willingness to use prevention services. Data were tabulated by self-reported lifetime AAS misuse status and analysed using descriptive statistics, chi-square test and odds ratio. A p value less than 0.05 was considered statistically significant. Among 300 participants, 90 were categorized as the self-reported AAS misuse group and 210 as the non-misuse group. Misuse was strongly associated with longer training experience, competition-oriented goals, peer influence, informal trainer advice, high social media exposure, low knowledge of adverse effects, low perceived harm and body image dissatisfaction. The strongest associations were observed for body image dissatisfaction, low perceived harm, informal advice and peer influence.