Throughout history, men have been concerned about their appearances, with long-standing ideals of masculinity emphasizing physical fitness and virility. In ancient Greece, for instance, the ideal male physique was characterized by strength, symmetry, and athleticism.

Today, the accessibility of performance and image-enhancing drugs (PIEDs) has increased dramatically, driven in part by their promotion on social media platforms. PIEDs include various substances such as anabolic-androgenic steroids, human growth hormone, and off-label medications like insulin, which individuals use to enhance their physical appearance or athletic performance.

Social media platforms, particularly Instagram and TikTok, inundate users with images and videos that suggest steroid use is a quick solution for achieving a muscular physique. Some influencers claim to promote a 'natural' approach to fitness but are later exposed for using steroids, leading young, impressionable followers to question whether steroids are the only viable option for attaining their desired physiques.

A Concerning Trend Among Young Men

Recent research indicates a rising trend in muscle-building behaviors, including steroid use, particularly among younger males. This trend is largely fueled by societal pressures that glorify hypermasculine ideals. Influencers with substantial followings often set unrealistic standards of physical perfection, normalizing extreme body ideals that extend beyond fitness into the realm of identity formation centered around the ideal male body.

This trend poses serious health risks. In addition to well-documented dangers like heart disease and liver damage, steroid use can result in psychological issues such as mood swings, aggression, and depression. Tragically, some individuals in the fitness community, including influencers and bodybuilders, have died unexpectedly from complications related to steroid use. For example, a well-known Australian fitness influencer passed away at 30 due to a heart attack linked to anabolic steroid use.

Strategies for Safer Use

Many fitness influencers engage in online coaching, a rapidly growing industry that encompasses training, dietary advice, and supplement guidance. This coaching often extends to drug use, where some provide strategies for the safer application of steroids and other enhancement drugs based on harm reduction principles.

While these approaches do not promote drug use, they offer methods to help mitigate the associated risks. Transparency around steroid use is gaining traction among elite bodybuilders. Recently, athletes and trainers have collaborated with researchers to discuss the importance of health monitoring practices, including regular blood testing as a critical method for reducing the hazards linked to steroid use.

However, the lack of formal regulation raises concerns about the reliability of advice available online, as not all influencers prioritize safety, and some may endorse practices that are dangerous.

A Collaborative Approach to Education

Addressing this issue necessitates a shift in focus from blaming influencers or shaming young men for their choices to promoting education, support, and collaboration with those affected by PIEDs. By working alongside credible community figures and influencers, it is possible to raise awareness about the risks of steroid use while providing accurate, evidence-based health information.

An example of a successful initiative is the Steroid QNECT program launched by the Queensland Injectors Voice for Advocacy and Action (QuIVAA), which offers peer education and resources to individuals using steroids. Since its launch earlier this year, the program has successfully engaged hundreds of users by providing vital harm reduction information and bridging significant gaps in education.

As the trend of muscle building continues to rise, it is essential for peers, policymakers, researchers, and health professionals across various sectors to collaborate in disseminating accurate and well-balanced education about the potential dangers of steroid use, particularly for young men.