Anabolic steroid use and body image psychopathology in men: delineating between appearance- versus performance-driven motivations

Objective: Anabolic androgenic steroid (AAS) use has been robustly associated with negative body image, and eating- and muscularity-oriented psychopathology. However, with AAS being increasingly utilized for both appearance and athletic performance-related purposes, we investigated whether comorbid body image psychopathology varies as a function of motivation for usage. Method: Self-reported motivation for current and initial AAS use was recorded amongst 122 AAS using males, alongside measures of current disordered eating and muscle dysmorphia psychopathology. Results: Those reporting AAS for appearance purposes reported greater overall eating disorder psychopathology, F(2, 118)=7.45, p=0.001, η_p ²=0.11, and muscle dysmorphia psychopathology, F(2, 118)=7.22, p< 0.001, η_p² =0.11, than those using AAS primarily for performance purposes. Additionally, greater dietary restraint, F(2, 116)=3.61, p=0.030, η_p² =0.06, functional impairment, F(2, 118)=3.26, p=0.042, η_p²=0.05, and drive for size, F(2, 118)=10.76, p<0.001, η_p²=0.15, was demonstrated in those using ASS for appearance purposes. Discussion: Motivation for AAS use may be important in accounting for differential profiles of body image psychopathology amongst users. Men whose AAS use is driven primarily by appearance-related concerns may be a particularly dysfunctional subgroup.