A qualitative study of the motivations for anabolic-androgenic steroid use: The role of muscle dysmorphia and self-esteem in long-term users

Abstract

BackgroundThe use of Anabolic-androgenic steroids (AAS) among the non-competitive weightlifting community has increased considerably in the UK in recent years, presenting a public health issue. The motives behind use have received considerable attention, with motivations linked to body dissatisfaction, low self-esteem, and more recently, muscle dysmorphia (MD). However, the causal roles of MD and self-esteem in AAS use remain unclear. Therefore, this paper examines the origins and changes to motivations in long-term users. MethodsA qualitative study recruited eight male weightlifters from a needle exchange programme in South Wales, UK. Participants were interviewed about their initial introduction to AAS and their motivations for initial and continued use. ResultsThe interview data confirmed the importance of the training community in providing advice and guidance on AAS. Those interviewed cited some motivations for use which included self-esteem, body dissatisfaction, MD, social acceptance, and age-related concerns. Implicit in these motivations was a psychological addiction to the positive effects following AAS use, which for some men, had led to psychological dependency and body image pathology. ConclusionsThe changes in motivations described by the AAS users provide key insights into the complex nature of AAS use. For some men, low self-esteem, body dissatisfaction and MD precede AAS use, and for others, they are consequences of use. These findings have significant implications for future research and public health initiatives.