Exercise and Use of Enhancement Drugs at the Time of the COVID-19 Pandemic: A Multicultural Study on Coping Strategies During Self-Isolation and Related Risks.

Mami Shibata,Ornella Corazza,Alejandra Rebeca Melero Ventola,Artemisa Rocha Dores ,Naomi Fineberg ,Ricardo M Santos-Labrador ,Attila Szabó ,Krisztina Ábel ,Aistė Pranckevičienė ,Eva María Arroyo-Anlló ,Inga Griškova-Bulanova ,María Ángeles Gómez-Martínez ,Irene P Carvalho ,Julius Burkauskas,Konstantinos Ioannidis,Fernando Barbosa,Pierluigi Simonato,Giovanni Martinotti,Zsolt Demetrovics,Kei Kobayashi,Hironobu Fujiwara,Roisin Mooney,Ilaria De Luca

doi:10.3389/fpsyt.2021.648501

Abstract

Introduction: Little is known about the impact of restrictive measures during the COVID-19 pandemic on self-image and engagement in exercise and other coping strategies alongside the use of image and performance-enhancing drugs (IPEDs) to boost performance and appearance.Objectives: To assess the role of anxiety about appearance and self-compassion on the practice of physical exercise and use of IPEDs during lockdown.Methods: An international online questionnaire was carried out using the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), and the Self-Compassion Scale (SCS) in addition to questions on the use of IPEDs.Results: The sample consisted of 3,161 (65% female) adults from Italy (41.1%), Spain (15.7%), the United Kingdom (UK) (12.0%), Lithuania (11.6%), Portugal (10.5%), Japan (5.5%), and Hungary (3.5%). The mean age was 35.05 years (SD = 12.10). Overall, 4.3% of the participants were found to engage in excessive or problematic exercise with peaks registered in the UK (11.0%) and Spain (5.4%). The sample reported the use of a wide range of drugs and medicines to boost image and performance (28%) and maintained use during the lockdown, mostly in Hungary (56.6%), Japan (46.8%), and the UK (33.8%), with 6.4% who started to use a new drug. Significant appearance anxiety levels were found across the sample, with 18.1% in Italy, 16.9% in Japan, and 16.7% in Portugal. Logistic regression models revealed a strong association between physical exercise and IPED use. Anxiety about appearance also significantly increased the probability of using IPEDs. However, self-compassion did not significantly predict such behavior. Anxiety about appearance and self-compassion were non-significant predictors associated with engaging in physical exercise.Discussion and Conclusion: This study identified risks of problematic exercising and appearance anxiety among the general population during the COVID-19 lockdown period across all the participating countries with significant gender differences. Such behaviors were positively associated with the unsupervised use of IPEDs, although no interaction between physical exercise and appearance anxiety was observed. Further considerations are needed to explore the impact of socially restrictive measures among vulnerable groups, and the implementation of more targeted responses.

Highlights

Little is known about the impact of restrictive measures during the COVID-19 pandemic on self-image and engagement in exercise and other coping strategies alongside the use of image and performance-enhancing drugs (IPEDs) to boost performance and appearance
Such changes could lead to distress or impairment of citizens’ physical, social, and occupational domains [16], generating risk conditions that potentially affect the mental well-being of the general population, especially of those who are most exposed and vulnerable, such as patients diagnosed with COVID-19, those who have been in quarantine or other forms of social isolation, frontline healthcare providers [(6, 17, 18); for a review], and possibly other key workers
We investigate the impact of the socially restrictive measures imposed by the COVID-19 pandemic on self-image and the practice of excessive, or even potentially problematic, physical exercise and the use of Image and Performance-Enhancing Drugs (IPEDs) as coping strategies to boost appearance during the period of its most restrictive policies (April–May 2020)

Summary

Introduction

Little is known about the impact of restrictive measures during the COVID-19 pandemic on self-image and engagement in exercise and other coping strategies alongside the use of image and performance-enhancing drugs (IPEDs) to boost performance and appearance. On March 11, 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) outbreak to be a pandemic situation as a result of the severe acute respiratory syndrome associated with the coronavirus 2 (SARS-CoV-2) and its highly contagious nature [1]. This virus can affect the immune response and, in addition to respiratory complications [2], can have adverse effects on brain function and mental health [3, 4]. Such changes could lead to distress or impairment of citizens’ physical, social, and occupational domains [16], generating risk conditions that potentially affect the mental well-being of the general population, especially of those who are most exposed and vulnerable, such as patients diagnosed with COVID-19, those who have been in quarantine or other forms of social isolation, frontline healthcare providers [(6, 17, 18); for a review], and possibly other key workers (i.e., those workers who are crucial to keeping the country running safely, such as police officers, journalists, people delivering food and transportation)

Objectives

Results

Conclusion