Mapping the pathway to anabolic-androgenic steroids (AAS) use

This short communication introduces a model for the use of anabolic-androgenic steroids (AAS), with body dissatisfaction as the central factor, shaped by sociocultural, psychological, and behavioral influences. Media-driven body ideals, gender, and sexual orientation may significantly influence body image, while low self-esteem and certain personality traits also contribute to dissatisfaction. Disordered eating behaviors (DEB) and intense physical exercise act as indirect contributors, particularly in fitness communities, where “conventional” body modification methods (i.e., exercise and diet) may fail to meet internalized ideals.

The model highlights a vicious cycle: body dissatisfaction drives AAS use, which, in turn, worsens dissatisfaction. Social media amplify this cycle by promoting unrealistic standards, while marginalized groups, including LGBTQI+ populations, face additional pressures to conform to heteronormative beauty norms. The overlap between body dissatisfaction, DEB, and intense physical exercise underscores the need for nuanced research to disentangle these inferences.

The model predominantly reflects Western body ideals, limiting its applicability across cultures. Addressing body dissatisfaction through early interventions targeting both societal standards and individual vulnerabilities is critical. Also, approaches accounting for aspects of sex and gender diversity are essential to promote body acceptance and reduce the risk of AAS use and DEB.