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The Health Threat Posed by the Hidden Epidemic of Anabolic Steroid Use and Body Image Disorders Among Young Men.
J Clin Endocrinol Metab. 2019 04 01; 104(4):1069-1074.JC

Abstract

CONTEXT

The prevalence of body image disorders and anabolic-androgenic steroid (AAS) use is increasing, despite the evidence of their serious adverse health effects and despite the passage of laws regulating their sales. Here we review the evolution of the dual emerging epidemics of body image disorders and AAS use, adverse health effects of AASs, and the need for an integrated health policy and regulatory response.

EVIDENCE ACQUISITION

We searched for studies published prior to June 2018. Quality of evidence was low to moderate because of its observational nature; heterogeneity of eligibility criteria; variable doses; reliance on retrospective self-reported data in many studies; and variable quality of outcome ascertainment.

EVIDENCE SYNTHESIS

Most AAS users are nonathlete young men, who use these substances to look lean and more muscular. Some of these men suffer from "muscle dysmorphia," a form of body dysmorphic disorder. AASs has been associated with cardiovascular disorders, psychiatric disorders, AAS-withdrawal hypogonadism, infertility, neurotoxic effects, musculoskeletal injuries, liver toxicity, and needle-borne infections. Potential adverse effects may be compounded by the use of other substances (e.g., opioids) and high-risk behaviors. Unregulated Internet sales of AASs and selective androgen receptor modulators, which are easily purchased without a prescription, are of concern because of their potential to fuel the epidemic among adolescents and the military.

CONCLUSIONS

Integrated nationwide efforts are necessary to raise public awareness of this epidemic, to study long-term health effects of AASs and treatment strategies, and to reform regulations to stem the epidemics of AAS use and body image disorders.

Authors+Show Affiliations

Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts.Harvard Medical School, Boston, Massachusetts. Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts.Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts. Boston Claude D. Pepper Older Americans Independence Center, Boston, Massachusetts.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

30239802

Citation

Goldman, Anna L., et al. "The Health Threat Posed By the Hidden Epidemic of Anabolic Steroid Use and Body Image Disorders Among Young Men." The Journal of Clinical Endocrinology and Metabolism, vol. 104, no. 4, 2019, pp. 1069-1074.
Goldman AL, Pope HG, Bhasin S. The Health Threat Posed by the Hidden Epidemic of Anabolic Steroid Use and Body Image Disorders Among Young Men. J Clin Endocrinol Metab. 2019;104(4):1069-1074.
Goldman, A. L., Pope, H. G., & Bhasin, S. (2019). The Health Threat Posed by the Hidden Epidemic of Anabolic Steroid Use and Body Image Disorders Among Young Men. The Journal of Clinical Endocrinology and Metabolism, 104(4), 1069-1074. https://doi.org/10.1210/jc.2018-01706
Goldman AL, Pope HG, Bhasin S. The Health Threat Posed By the Hidden Epidemic of Anabolic Steroid Use and Body Image Disorders Among Young Men. J Clin Endocrinol Metab. 2019 04 1;104(4):1069-1074. PubMed PMID: 30239802.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Health Threat Posed by the Hidden Epidemic of Anabolic Steroid Use and Body Image Disorders Among Young Men. AU - Goldman,Anna L, AU - Pope,Harrison G, AU - Bhasin,Shalender, PY - 2018/08/08/received PY - 2018/09/10/accepted PY - 2018/9/22/pubmed PY - 2020/2/15/medline PY - 2018/9/22/entrez SP - 1069 EP - 1074 JF - The Journal of clinical endocrinology and metabolism JO - J. Clin. Endocrinol. Metab. VL - 104 IS - 4 N2 - CONTEXT: The prevalence of body image disorders and anabolic-androgenic steroid (AAS) use is increasing, despite the evidence of their serious adverse health effects and despite the passage of laws regulating their sales. Here we review the evolution of the dual emerging epidemics of body image disorders and AAS use, adverse health effects of AASs, and the need for an integrated health policy and regulatory response. EVIDENCE ACQUISITION: We searched for studies published prior to June 2018. Quality of evidence was low to moderate because of its observational nature; heterogeneity of eligibility criteria; variable doses; reliance on retrospective self-reported data in many studies; and variable quality of outcome ascertainment. EVIDENCE SYNTHESIS: Most AAS users are nonathlete young men, who use these substances to look lean and more muscular. Some of these men suffer from "muscle dysmorphia," a form of body dysmorphic disorder. AASs has been associated with cardiovascular disorders, psychiatric disorders, AAS-withdrawal hypogonadism, infertility, neurotoxic effects, musculoskeletal injuries, liver toxicity, and needle-borne infections. Potential adverse effects may be compounded by the use of other substances (e.g., opioids) and high-risk behaviors. Unregulated Internet sales of AASs and selective androgen receptor modulators, which are easily purchased without a prescription, are of concern because of their potential to fuel the epidemic among adolescents and the military. CONCLUSIONS: Integrated nationwide efforts are necessary to raise public awareness of this epidemic, to study long-term health effects of AASs and treatment strategies, and to reform regulations to stem the epidemics of AAS use and body image disorders. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/30239802/The_Health_Threat_Posed_by_the_Hidden_Epidemic_of_Anabolic_Steroid_Use_and_Body_Image_Disorders_Among_Young_Men L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2018-01706 DB - PRIME DP - Unbound Medicine ER -