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Big is not better: the cost of steroids

“Just like women, men want to look like a magazine cover — and that means developing muscle.”
If all that achieved was to drive men to the gym more regularly, that would be a good thing. But it has become a recognised disorder in some men and boys. Muscle dysmorphia (or body dysmorphic syndrome) is an individual’s real or imagined perception of themselves as being small and under-developed, usually despite being large and muscular. 

Clinical psychologist Linde Viviers says it’s a similar distortion of body image as that experienced by anorexics, but reversed. 

This — along with pressure to stand out in increasingly competitive sports, demanding rugby players who are way in excess of 100 kg, for example — often drives boys to compulsive and excessive gyming, and the use of some kind of supplement – anything from benign creatine to anabolic steroids, supplements that often contain some form of testosterone. And there’s a cost to using steroids.

“South African research suggests as many as 4% of high school boys use anabolic steroids, for enhancing sport performance and some for aesthetic reasons and body bulking-up,” says Professor Demetris Constantinou. 

“They are unfortunately readily available, and you will recall [recently] the Hawks raided a steroid-manufacturing plant in Pretoria with millions worth of equipment and drugs. These would have been specifically for illicit use for sports or for body image purposes.” 

He says there are many risks: “Some may be reversible and some may not be. Some may be benign and some serious and even life-threatening. In young people the growth may be affected. There is a real threat of physiological and psychological drug dependence that may even lead to the abuse of other street drugs. Heart disease, heart failure, liver cancer, blood clots, strokes and other serious conditions may occur.” 

In addition, users may suffer from “roid rage” and there is increased incidence of suicides among anabolic steroid abusers. 

And that’s not all. Muscle can bulk up quickly; it takes much longer for tendons, which have very little blood flow, to adapt to the extra load, Dr Ross Tucker of the University of Cape Town’s Sports Science Institute points out. 

“They adapt slowly and they heal slowly.” 

The result? “A common injury is biceps that tear off the bone because the tendon is overloaded,” says a Johannesburg physiotherapist. “And you see many boys with repeated hamstring injuries,” adds Kaiser.

Bone can be affected too. “In younger males the growth areas of the bones are relatively weak and therefore may be injured, such that tendons may be pulled off at their attachment and sometimes pull a piece of bone off with it,” says Constantinou.

What’s the solution? “Imagine if a gym brand took an active interest in getting the steroids industry out of gym culture,” says Tucker.

While well known gym brands are not involved in the anabolic steroid industry, much of the activity that relates to this drug abuse takes place on their premises, including excessive gyming. 

Through education, awareness, vigilance on the part of staff and even instituting voluntary testing for drugs, the major gyms could potentially play a huge role in reducing the abuse.

Better regulation of steroids and supplements is needed, says Kaiser. More stringent policing and more substantial sanctions for abuse, Tucker suggests. And parents can help by understanding the enormous pressure on sports-mad boys, and doing their best to counteract it rather than add to it, Kaiser suggests.

Symptoms of muscle dysmorphia

According to clinical psychologist Linde Viviers, people with muscle dysmorphia display a cluster of behaviours, including:

  • Missing social interaction due to exercise programme or fear of not being able to eat the right food;
  • Neglecting personal relationships due to time spend exercising and following eating plan;
  • Working out in spite of injury;
  • Never being satisfied with muscle mass;
  • Maintaining an extreme workout programme;
  • Maintaining a diet that is excessively high in protein;
  • The excessive use of food supplements; and
  • Steroid abuse and often resorting to plastic surgery to achieve the perfect body.

This lifestyle health supplement is made possible by advertising support from Metropolitan Health, with agreed monthly themes. Contents and photographs were sourced independently by the M&G’s supplements editorial team.

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