Hormonal Catalysts in the Addiction Cycle of Muscle Dysmorphia: A Neuroendocrine Perspective

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Abstract Muscle dysmorphia (MD) is a subtype of body dysmorphic disorder characterized by an obsessive belief that one’s body is insufficiently muscular. This review provides a comprehensive examination of the addiction cycle in MD, particularly in the context of anabolic steroid and performance-enhancing drug (PED) use. Utilizing a systematic search across databases such as PubMed, PsycINFO, Scopus, and Web of Science, the review draws on peer-reviewed literature published in the past two decades to uncover the roles of hormonal and neural alterations in perpetuating this cycle. Inclusion and exclusion criteria were meticulously applied to ensure a robust analysis of relevant studies. The article details the interaction between exogenous hormonal supplementation from steroids and PEDs and brain receptors, which significantly disrupt neurotransmitter systems and affect mood, cognition, and stress responses. The synthesis of data reveals that hormonal imbalances due to substance abuse lead to profound changes in brain plasticity and function, instigating psychiatric disorders and complicating withdrawal and treatment. Therapeutic strategies are critically assessed, with emphasis on the success of cognitive-behavioral therapy, the role of pharmacological management, and the promise of emerging treatments targeting neuroendocrine disruptions. The review suggests an integrated, holistic treatment model that includes hormonal therapy and neurological considerations, underscoring the importance of personalized and sustained interventions. In conclusion, the intricate cycle of addiction in MD, fueled by the hormonal effects of steroids and PEDs on the brain, calls for an integrated approach to treatment. Future research should focus on the neuroendocrine impact of these substances to refine therapeutic strategies for MD.