Epidemiology
Image and Performance Enhancing Drugs (IPEDs) are becoming increasingly prevalent within the bodybuilding community, with the emergence of Instagram influencers and the “Love Island look”, many people are becoming more aware of IPEDs, and their effects on an individual’s capacity to increase muscle mass and change body image. Where previously IPEDs may have been viewed as a means to improve performance within the elite sporting world, it appears a shift is occurring, with 34% of surveyed gym-goers reporting an awareness of IPED use within their gym(30).
IPED use in the UK:
According to the Crime Survey for England and Wales, IPEDs have seen an exponential growth in use over recent years with numbers of people having taken some form of anabolic steroid rising by almost 40% between 2005 to 2016 in those aged between 16-59 years (194,000 in 2005/06 to 271,000 in 2015/16)(31).
In terms of use by sex, data indicates that the numbers for use for males and females are stable, with roughly 6% of males and 1% of females who regularly attend a gym using anabolic steroids(30), and of those surveyed in a different study, 94% of IPED users were male(31). This gives insight into the populations most at risk of the negative impacts of IPED use.
The most common age at which initial use of IPEDs occurs is 20-24 years old, with increasing numbers of anabolic steroid use being found in those aged 16-24, with around 19000 more adults using anabolic steroids in 2016/17 compared to 2015/16(31,32). Perhaps more concerning is that the youngest reported age of initiating IPED use was 14 (31).
In the UK, the greatest proportion of people taking anabolic steroids described themselves as white British (70%), with the second most common ethnicity being Pakistani (3%) (33), however more recent studies indicate that the proportion of IPED users that are white British could be as high as 80%(31).
Determinants of use:
The use of any drug (or combination of drugs) is a complex psychosocial issue, often with multiple factors as to why an individual chooses to take a substance. It would appear within the IPED-using community the most common motivation for use was to gain muscle, with 62% of respondents stating this as their primary goal. Alongside this, gaining strength and losing fat were also mentioned as motivation for IPED use. Other uses have been outlined by users including; increasing sex drive (8.6%), gaining a tanned appearance (4.5%) and to decrease wrinkles (4.5%)(33). Some evidence also suggests the use of IPEDs is not simply aesthetic, but also with a performance focus, especially for those desiring an increase in athletic performance (31).