Anabolic Steroid Abuse Among Males with Eating Disorders
By
Kim R. Lipsman, LPC, MEd, CHt, SEP
Healthy Futures
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In the 1930s anabolic steroids were developed by scientists to facilitate the growth of skeletal muscle in laboratory animals. The research findings lead scientists to create anabolic steroid substitutes for human hormones. Anabolic steroids use and abuse started in the 1950s to enhance athletic performances in male athletes. Due to its fast increase of building muscle mass, the spread of anabolic steroids became popular in the body building arena. Other segments of different populations increasingly began to take these synthetic substances related to the male androgens or sex hormones. The effects of anabolic steroids promote the growth of skeletal muscle and development of male sexual characteristics. Originally, anabolic steroids were developed to treat delayed puberty, some impotency, and rebuilding of the body ravaged by infection or disease such as HIV. Anabolic steroids are taken by tablets, capsules, injections directly into the muscle or combinations of oral and injections called ‘stacking’ (Rimrock Foundation, 2005).
Anabolic steroids are easy to obtain. They can be purchased without a prescription. Many commercial sources for androstenedione (Andro) and dehydroepain-drosterone (DHEA) can be bought in retail, food, health food stores and through the internet. Many times the anabolic steroids are referred to as a dietary supplement (Rimrock Foundation, 2005). They are not a food product, but are often found in food product areas of stores. There are no age requirements to purchase anabolic steroids like alcohol or cigarettes. Health and fitness magazines also advertise these ‘supplements’ as a way to increase lean muscle mass. The promise of spectacular results in a short amount of time with minimal effort are described in the advertising script along with where to obtain this ‘supplement’ and a well sculpted male physique (Andersen, Cohn & Holbrook, 2000).
People have many reasons for abusing anabolic steroids. Improving sports performance such as bodybuilding, wrestling, gymnastics, track, swimming, baseball, basketball, and other competitive athletic venues are some reasons for abuse of steroids. The abuse depends on the specific sport. The sport of bodybuilding has one of the highest abuse of anabolic steroids. Some adolescents abuse steroids like abusing other illicit drugs. Muscle size or reducing body fat is another reason people abuse steroids. This group of people abuse anabolic steroids due to the distorted image of themselves. Body dysmorphia in which men think that they look small and weak, abuse anabolic steroids to get larger and muscular is part of eating disorder behavior that occurs with women, but mostly with men(Rimrock Foundation, 2005; Pope, Pope, Menard, Fay, Olivardia, Phillips, 2005).
There are many health risks for abusing steroids. Acne and breast development in men can occur. Heart attacks and liver cancer are prominent. For men, sperm reduction, shrinking testicles, impotence, pain during urination and baldness are some health side effects of abuse using steroids. In both men and women, liver cysts, liver cancer, blood clotting, cholesterol changes, and hypertension can create potentially fatal effects. A correlation between anabolic steroid abuse and highly aggressive acts such as fighting, physical abuse, sexual abuse, and crimes are scientifically documented. Abusers of steroids that inject the drug also add the risk of acquiring viral infections including HIV, hepatitis B, hepatitis C, bacterial illnesses, and fatal inflammation of the heart lining due to contaminated needles by other abusers (Pope, Pope, Menard, Fay, Olivardia, Phillips, 2005).
Anabolic steroid abusers show evidence of the drug becoming addictive. Abusers of steroids continue to use even when physical problems, behavioral problems, relationship problems, mood swings, fatigue, loss of appetite, insomnia, low sex drive and above all the desire to take more even when large amounts of time and money invested to get the drug. Withdrawal symptoms are reported such as depression, headaches, muscle and joint pain, and loss of appetite when the steroid use is stopped (Pope, Pope, Menard, Fay, Olivardia, Phillips, 2005).
It is common for men to have issues with self-esteem. More men are identified with pressure to look a certain way. Bullying, teasing, body image expectations of what a body ‘should’ look like, and comments from friends and family about a male’s body impact the self esteem in more men. Shameful feelings of the body over perceived flaws and having no one or few people to share their feelings are some of the reported factors from men about the beginning eating disorder behavior. More body distortion and body dysmorphia is being recognized by scientists in research studies. Abdominal fat or a heavy midsection is reported to be the most teased body area for men. Eating disordered men report body image distress and start to counteract by engaging in behaviors to change their body type (Andersen, Cohn & Holbrook, 2000). The men concerned and perceiving themselves as not having large enough or muscular bodies become consumed with dieting and other activities associated with altering their body mass. Abuse of anabolic steroids is being used to alter the muscle and body mass. Men preoccupied with their physical features not being big enough is called “reverse anorexia nervosa” or “biggerexia” use steroids to get significant bulk results. A study of 156 male weight lifter where 88 used steroids and 68 did not, showed steroid using weight lifters reported greater body dissatisfaction 19 (44%) than the non using weight lifters 1(2%). In a similar study in Canada 43 bodybuilders, 48 runners, and 48 martial arts athletes showed lower self-esteem scores from the steroid users driving themselves to ‘bulk’ up than the non-users (Pope, H., Gruber, A., Choi, P., Olivardia, R. & Phillips, K., 1997). Even though the individuals tested spend hours working out, they report going to great lengths to not have their bodies seen in public. They may wear baggy clothing; avoid beaches, swimming pools and locker rooms. Any where their body might be seen or exposed is avoided with only one exception which is a body building competition. The study showed the steroid using athletes experience impaired relationships and intimate relationships are negatively affected. Achieving a perceived desired body becomes an all consuming lifestyle. Many men with steroid abuse and body dysmorphia behavior refuse to stop their regiment even though there are adverse medical risks and the high cost of the drugs. Other eating disorder behaviors associated with muscle or body dysmorphia are frequent comparison with others, mirror checking, weighing and reassurance-seeking behavior. A described fear of male bodybuilders also can feed steroid use and eating disorder call ‘femiphobia’ or the fear of becoming less of a man (Rimrock Foundation, 2005; Pope, Pope, Menard, Fay, Olivardia, Phillips, 2005).
It is reported that one out of every ten males in the United States has an eating disorder. It is also reported that this statistic may be low. Unlike the anorexia eating disordered individuals that restrict food from their daily intake of nutrients, the eating disorder male using steroids can hide the eating disorder behavior from those around them including medical doctors. A man can go to the doctor or a physician and have signs of an eating disorder or steroid abuse and the doctor will not ask him about either abuse. Society, including the medical profession has geared their identification of eating disorders to females (Weltzin, 2005). In the beginning of an eating disorder, men using steroids to bulk up can hide behind a seemingly healthy physique. They may not look pale and thin like anorexia nervosa individuals. Instead of starving themselves, the men using steroids cut down on their eating and over exercise. The appearance in the individuals with eating disorders may look different, but the suffering and health risks are the same (Black, 2010). The eating disordered male concerned with not being sufficiently large enough becomes consumed by weightlifting, dieting, steroid use masked as supplements and other associated activities (Pope, H., Gruber, A., Choi, P., Olivardia, R. & Phillips, K., 1997).
Sociocultural factors maybe an important factor in body dysmorphic eating disordered males. Media in the form of magazines, films and television shows increasingly popularize muscularity as a form of masculinity. The fitness boom in American is also a contributor in this eating disorder condition. Muscle dysmorphia is a member of a ‘family’ of disorders such as body dysmorphic disorder, eating disorder, obsessive-compulsive disorder and other mood disorders. Several other common underlying predispositions share common physiologic abnormal features giving muscle dsymorphia a symptom of choice among males. Predisposition to anabolic steroid use from men dissatisfied with their body image may exist in an individual’s biology and enhanced in the cultural factors from the media. One anabolic steroid eating disordered abuser commented in a muscle dysmorphic study, “Why should I go back to being Clark Kent, when I can be Superman?”(Pope, H., Gruber, A., Choi, P., Olivardia, R. & Phillips, K., 1997).
The U.S. Department of Justice Drug Enforcement Administration (USDOJ) recognizes that anabolic steroid use is widespread. The department also recognizes the precursors to medically dangerous consequences. It reports and estimated 1,084,000 of the adult population are abusing anabolic steroids. The number for youth abuse under 18 may be even higher (USDOJ, 2004). Many researchers and the USDOJ admit more studies need to be done to understand steroid abuse needs to be studied (USDOJ, 2004; Pope, H., Gruber, A., Choi, P., Olivardia, R. & Phillips, K., 1997). It is difficult to get an accurate reflection of how prevalent male eating disorders and steroid abuse is in the U.S. population (Weltzin, 2005). The need for further research to counter the prevailing increase of anabolic steroid use among eating disordered individuals and competitive athletes and the risk factors is outcome of another study by researchers from the University of South Florida (Powers, P., Johnson, C., 1996).
Because steroids are not considered as serious a social problem as alcohol, tobacco or marijuana, long term research on this substance and it’s wide spread abuse. Eating disorder and anabolic steroid abuse treatment is important in helping the individual, usually male; recover (Battaglia, 2000). The risk for anyone addicted to anabolic steroids withdrawing without proper supervised treatment can cause severe depression for months, trouble sleeping, suicidal behavior and the desire to take more steroids (msnbc.com, 2005). Treatment components to males that suffer from eating disorders and suffering from anabolic steroid addiction include male only therapeutic groups/programs, testosterone replacement therapy, exercise and nutrition re-education components, anger management therapy, distress tolerance skills training, and relationship counseling (Battaglia, 2000). Eating disorder treatment centers as well as substance addiction centers are places the eating disordered male abusing anabolic steroids can go for safe long term effective recovery (Eating-disorder.com, 2007; Rimrock Foundation, 2005).
References
Andersen, A., Cohn, L., Holbrook, T. (2000) Making weight: Men’s conflicts with food weight, shape & appearance. Carlsbad, California: Gurze Books.
Battaglia, E. (2000) Eating-disorder.com. Treating eating disorders in boys and men. http://wwww.eating-disorder.com.
Black, B. (2010) Men now falling victim to eating disorders. HealthScoutNews. http://www.caringonline.com.
Eating-disorder.com. (2007) Prevalence of eating disorders in males. http://www.eating-disorder.com/eating-treatment.
Pope, H., Gruber, A. Choi, P., Ovlivardia, R., Phillips, K. (1997) Muscle dysmorphia: an under recognized form of body dysmorphic disorder. Psychosomatics: Vol. 38, Num. 6, Nov. – Dec.
Pope, C., Pope, H., Menard, W., Fay, C., Olivardia, R., Philliops, K. (2005) clinical features of muscle dysmorphia among males with body dysmorphic disorder. Body Image, 2005 Dec. 2(4): pgs. 395-400.
Powers, P., Johnson, C. (1996) Small victories: prevention of eating disorders among athletes. Psychiatry and Behavioral Medicine, College of Medicine, University of South Florida, Tampa, Florida: Eating Disorders, Vol.4, Issue 4, Feb 1996, pg. 364-377.
Rimrock Foundation. (2005) Chemical addiction fact sheets: Anabolic steroids. http://www.rimrock.org.
Steroid addiction a risk for young athletes: withdrawal can cause depression, suicidal behavior. (2005) http://www.msnbc.msn.com.
U.S. Department of Justice Drug Enforcement Administration (USDOJ). (2004). A guide for understanding steroids and related substances. http://www.deadiversion.usdoj.gov.
Weltzin, T. (2005). Do I look fat? A documentary on gay men, body image and eating disorders. Blah Blah Blah Productions. http://www.doilookfatthemovie.com.
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