Body image and steroid use in male bodybuilders

1 Sep 1995

Body image and steroid use in male bodybuilders / A.G. Blouin, G.S. Goldfield. - (Eating Disorders 18 (1995) 2 (September); p. 159-165)

  • PMID: 7581418
  • DOI: 10.1002/1098-108x(199509)18:2<159::aid-eat2260180208>;2-3


This study was designed to examine the association between body image and eating-related attitudes among male bodybuilders in relation to two athletic comparison groups, runners and martial artists. It was also of interest to examine whether steroid use may be associated with body image disturbances in athletes. The volunteer sample of 139 male athletes recruited from fitness centers comprised 43 bodybuilders, 48 runners, and 48 martial artists (tae kwon do practitioners). Standardized measures of body dissatisfaction, drive for thinness, drive for bulk, bulimia, self-esteem, depression, maturity fears, and perfectionism as well as questionnaires designed to measure attitudes toward steroids, and rates of steroid use were administered in a manner that encouraged disclosure. Bodybuilders reported significantly greater body dissatisfaction, with a high drive for bulk, high drive for thinness, and increased bulimic tendencies than either of the other athletic groups. In addition bodybuilders reported significant elevations on measures of perfectionism, ineffectiveness, and lower self-esteem. They also reported the greatest use of anabolic steroids and most liberal attitudes towards using steroids. Steroid users reported that the most significant reason for using steroids was to improve looks. Steroid users reported an elevated drive to put on muscle mass in the form of bulk, greater maturity fears, and enhanced bulimic tendencies than nonusers. The results suggest that male bodybuilders are at risk for body image disturbance and the associated psychological characteristics that have been commonly reported among eating disorder patients. These psychological characteristics also appear to predict steroid use in this group of males.

CCDS 1995 Karen Wilkinson vs CCDS

6 Sep 1995

Karen Wilkenson (the Athlete) applies for Category II Reinstatement. She was suspended from competition for four years for a violation of the Anti-Doping rules. On acquisition of her husband about tampering her doping controls she underwent an doping test under the condition: "ensure that the athlete provides a witnessed urine sample wearing a short-sleeve shirt. It is our understanding that she may be manipulating the process by substituting urine from a stored reservoir". The test took place in her office on July 7, 1995. Her sample tested positive on metabolites of the prohibited substance nandrolone.

The athlete denied any personal knowledge as to how the banned substance entered her body. Her "defence" is that her estranged husband, Mr. Brantley, had secretly put the drug in her soft drink and she unknowingly drank it. She relies entirely on Mr. Brantley to explain the circumstances of how the drug was administered to her. Experts proved that parts of the testimony can't be true.

Dr. Wilkinson's application for Category II Reinstatement has been denied.

ASDA Annual report 1994-1995 (Australia)

12 Sep 1995

© Commonwealth of Australia
ISSN 1037-378


Chapter 1
Introduction 1
Responsible Minister 3
Membership 3
Organisational structure 5
Presentations 6
Social justice 6
internal and external scrutiny 6

Chapter 2
Testing, research and policy 9
Objectives and resources 9
Drug testing 9
Register of Notifiable Events 14
Drug testing officials 15
Analytical services 16
Research 18
Policy 19
International Court of Arbitration for Sport 21
Special interest groups 21
Legislation 24
Special operational issues 26

Chapter 3
Education 29
Objectives and resources 30
School-based education programs 30
Sport-based education programs 31
information services 35
Public relations 37

Chapter 4
International 41
Objectives and resources 41
Working with international sporting federations 42
International agreements 43
International visitors 46
Drug tests statistical survey 47
Information dissemination 48
Working with government agencies 48

Chapter 5
Corporate 49
Objectives and resources 49
Planning and evaluation 49
Research 53
National activities 54
Finance 56
Human resource management 58
Staff development 59
Social justice 60
Administrative services 64

Chapter 6
Financial statements 67
1 Objects, functions and powers of the Australian Sports Drug Agency as specified in the Australian Sports Drug Agency Act 1990 84
2 Powers of the Minister under the Australian Sports Drug Agency Act 1990 86
3 Presentations by ASDA officials 1994-95 88
4 Doping control laboratories accredited by the International Olympic Committee 90
5 International Olympic Committee Medical Code 100
6 ASDA testing for period 1 July 1994 to 30 June 1995 100
7 User pays testing 1 July 1994 to 30 June 1995 101
8 Summary of Entries on Register of Notifiable Events 1994-95 102
9 1994-95 Memorandum of Understanding between the Australian Government Analytical Laboratories and the Australian Sports Drug Agency 104
10 State Coordinators of the School Development in Health Education Project 107
11 Educational resource material distribution 1994-95 108
12 Sports Drug Education Unit advisory committees 109
13 Portfolio evaluation steering committee 110
14 Memorandum of Understanding between the Australian Sports Drug Agency and the Chinese Olympic Committee Anti-Doping Commission 111
15 International testing statistics 1993 113
16 Agency resources to international clients 1994-95 116
17 Complementary Drug Testing Legislation definition of competitor 118
18 Summary of compliance with reporting guidelines 119
1.1 Financial and staffing resources summary 6
1.2 Expenditure by program 7
2.1 Summary of entries on Register of Notifiable Events by doping class and sport 15
2.2 Summary of defaulting competitors on the Register of Notifiable Events: 1991-92 to 1994-95 15
3.1 Drugs in Sport Hotline — summary 37
5.1 Strategic Plan performance information 51
5.2 Total number of employees at 30 June 1995 59
5.3 Summary of training undertaken 59
5.4 Categories of training 60

1.1 Mission, vision and corporate values of the Strategic Plan 1995-97 1
1.2 Outcome Hierachy 2
1.3 Primary functions of each program area 3
1.4 Organisation of the Australian Sports Drug Agency 5

The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis

30 Sep 1995

G K Lijesen, I Theeuwen, W J Assendelft, and G Van Der Wal
Br J Clin Pharmacol. 1995 September; 40(3): 237–243.


1. A meta-analysis was conducted to assess if there is scientific ground for the use of human chorionic gonadotropin (HCG) as adjunctive therapy in the treatment of obesity.
2. Published papers relating to eight controlled and 16 uncontrolled trials that measured the effect of HCG in the treatment of obesity were traced by computer-aided search and citation tracking.
3. The trials were scored for the quality of the methods (based on four main categories: study population, interventions, measurement of effect, and data presentation and analysis) and the main conclusion of author(s) with regard to weight-loss, fat-redistribution, hunger, and feeling of well-being.
4. Methodological scores ranged from 16 to 73 points (maximum score 100), suggesting that most studies were of poor methodological quality. Of the 12 studies scoring 50 or more points, one reported that HCG was a useful adjunct. The studies scoring 50 or more points were all controlled.
5. We conclude that there is no scientific evidence that HCG is effective in the treatment of obesity; it does not bring about weight-loss of fat-redistribution, nor does it reduce hunger or induce a feeling of well-being.

Detection in blood and urine of recombinant erythropoietin administered to healthy men.

1 Nov 1995

Wide L, Bengtsson C, Berglund B, Ekblom B. Detection in blood and urine of recombinant erythropoietin administered to healthy men.
Med Sci Sports Exerc. 1995 Nov;27(11):1569-76.

CAS 1995_144 International Olympic Committee (IOC) - Advisory Opinion

21 Dec 1995

Avis consultatif TAS 95/144 Comités Olympiques Européens (COE)

Anti-Doping Rules
Competence to regulate doping in multidisciplinary competitions organized by Associations of National Olympic Committees

Related case:
CAS 1994/128 UCI vs CONI
January 5, 1995

On 5 January 1995, at the request of UCI and CONI (TAS 94/128 UCI-CONI), the Court of Arbitration for Sport (CAS) ruled in an advisory opinion about four questions. In the matter about the authority in international competitions the CAS Panel ruled that the UCI is authorized as International Federation and NOC and any other national sports body are subsidiair.

Because of this redered opinion TAS 94/128 the Intenational Olympic Committee (IOC) requested in August 1995 the CAS Panel to render an advisory opinion about 2 questions:

1.) Can Associations of National Olympic Committees (NOC) that organize multidisciplinary international competitions, such as the Pan American Games, the Mediterranean Games, the European Youth Olympic Days, in particular, fully implement the IOC Anti-Doping Rules?
2.) Are the NOC Associations authorized in this matter?

On 21 December 1995 CAS Panel rules:

1.) The Anti-Doping Rules applied to multidisciplinary competitions organized by continental or regional NOC Associations fall under the IOC Medical Code as enforcement of Rule 48 of the Olympic Charter.

2.) Without prejudice to the answer to the first question, it seems advisable that NOC Associations organizing multidisciplinary competitions in their constitutive texts should clearly refer to the IOC Medical Code constituent the applicable anti-doping rules.

3.) In multidisciplinary competitions organized by NOC Associations any other anti-doping regulations than the IOC Medical Code can only be applied subsidiair.

IOC Medical Commission - 1996 List of Prohibited Classes of Substances and Prohibited Methods

1 Jan 1996

1996 List of Prohibited Classes of Substances and Prohibited Methods / IOC Medical Commission. – International Olympic Committee (IOC), 1996

Prohibited Classes of Substances and Prohibited Methods

January 1996

A. Stimulants
B. Narcotics
C. Anabolic Agents
D. Diuretics
E. Peptide and glycoprotein hormones and analogues

A. Blood doping
B. Pharmacological, chemical and physical manipulation

A. Alcohol
B. Marijuana
C. Local anaesthetics
D. Corticosteroids
E. Beta-blockers

Source: Bibliothèque du CIO / IOC Library

Evaluation of the use of doping among bodybuilders in the Netherlands [1996]

1 Jan 1996

Onderzoek naar het gebruik van prestatieverhogende middelen bij bodybuilders in Nederland / A. de Boer, S.F. van Haren, F. Hartgens, D. de Boer, A.J. Porsius. - Universiteit Utrecht; i.o.v. Nederlands Centrum voor Dopingvraagstukken (NeCeDo). – Rotterdam : NeCeDo, 1996

  • ISBN 908009285l

Evaluation of the use of doping among bodybuilders in the Netherlands / A. de Boer, S.F. van Haren, F. Hartgens, D. de Boer, A.J. Porsius. – Utrecht University; Netherlands Centre for Doping Affairs (NeCeDo). - Rotterdam : NeCeDo, 1996

  • ISBN 908009285l


1.1 Aanleiding tot het onderzoek
1.2 Doelstelling
2,1 Studie-opzet
2,2 Plaats van uitvoering
2.3 Deelnemers
2.4 Vragenlijst
2.5 Analyse
3.1 Algemene karakteristieken van de deelnemers
3.2 Gewichtstraining
3.3 Androgene-anabole steroïden
3.3.I Perceptie schadelijkheid
3.3.2 Prevalentie gebruik en preparaatkeuze
3.3.3 Toepassingswijze
3,3.4 Motivatie gebruik
.3.3.5 Gewenste en ongewenst effecten
3.3.6 Herkomst en begeleiding
3.4 Andere prestatie verhogende middelen
3.5 Determinanten voor het gebruik van AAS
3.6 Risicogedrag onder gebruikers van androgene-anabole steroïden
4. Discussie
4.1 Deelnemers
4.2 Androgene-anabole steroïden
4.2.I Perceptie schadelijkheid
4.2.2 Prevalentie gebruik en preparaat keuze
4.2.3 Toepassingswijze
4.2.4 Gewenste en ongewenste effecten
4.2.5 Herkomst en begeleiding
4.3 Andere prestatie verhogende middelen
4.4 Determinanten voor het gebruik van androgene-anabole
4.5 Risicogedrag naast het gebruik van androgene-anabole steroïden
5. Conclusie
6. Aanbevelingen


The aim of the study described in this report was to evaluate the use and handling of doping by bodybuilders in the Netherlands. Twelve hundred questionaires were aministered to bodybuilders who visited the Dutch Championship of Bodybuilders in 1994. Twenty-four percent of the questionnaires (291 participants) were returned to the investigators with acceptable information.
The number of male and female participants was 227 (79%) and 59 (21%), respectively and the average age was 28 years (range 15 to 63). Anabolic-androgenic steroids (AAS) were ever used by 128 (44%) of the participants (female 17% and male 52%). Stratification for competitive versus recreational bodybuilders showed ever-use by 77% (female 57%, male 79%) and 37% (female 12%, male 45%), respectively. Fourty-seven different proprietary-titled AAS preparations were mentioned by the participants and, especially, male bodybuilders often switched between different compounds. Mostly, the compounds were obtained from the black market (more than 70%) and most AAS-using bodybuilders had no medical guidance (less than 30%). The average duration of regular use of AAS was 3.5 years (range 0.2 to 40 years). The doses per week for all AAS varied from 10 to 800 mg.
The route of administration was oral in 18%, parenteral in 9%, while 71% used both routes. The average duration of a course of AAS was 8.6 weeks (±2.4; range 3.5-20) and the average number of courses per year was 2.0 (±1.0; range 1.0-6.5). Fifty-seven percent reported to have ever used more then one AAS concomitantly ('stacking').
Combinations of 2, 3 and 4 AAS occurred in 49, 37, and 14%, respectively. The combination of a methandrostenolone and nandrolone preparation was reported most often. Between courses 12% reported to use AAS as maintenance therapy.
Especially, niethonolone (Primobolan®) was used for this purpose (by 73%). Part of the maintenance therapy was to overcome withdrawal symptoms (reported by 18%) after an AAS course. Six percent of the male bodybuilders reported to be addicted to AAS.
Almost 90% of the AAS-using bodybuilders reported to experience side-effects of these compounds. Most often reported were increased sexual drive (51%) and aggressiveness (47%), hypertension (21%) and fluid retention (37%). Women, especially, reported acne (50%) and increase in body hair (30%). Twenty-three percent of the male and 17% of the female participants had ever used doping other then AAS. Especially, chorionic gonadotrophin, clenbuterol, lonamin®, tamoxifen and clomiphene citrate were reported.
For a number of determinants there was a statistically significant association with the ever-use of AAS: gender (male versus female: odds ratio 5.2 with 95% confidence interval 2.5-10.8), age(> 35 versus 15-25 years: odds ratio 2.3; 1.1-4.8), motivation for bodybuilding (expansion of muscle volume versus other reasons: odds ratio 6.0; 2.3-15.9 and competitive versus recreational bodybuilding: odds ratio 5.0; 2.5-10.0). Also intensity of bodybuilding, body weight and the use of dietary supplements were strongly associated with AAS-use. Among the bodybuilders who had ever used AAS, the use of soft and hard drugs was increased compared to nonusers of steroids (odds ratio 2.0; 1;2-3.4). The odds on ever smoking among ever users of AAS was 2.0 times higher (1.3-3.3) compared to bodybuilders who never used steroids. There was no association between the use of alcohol and steroid-use (odds ratio 0.8; 0.5-1.3). The use of drug-doping other than AAS was reported 6.3 times as often (3.2-12.5) among users of MS. This risk-behavior was more pronounced among male bodybuilders.
In conclusion, although the representativeness of this study is unknown the use of doping appears to be wide spread among bodybuilders in the Netherlands. Due to the often unknown origin of the compounds, the lack of medical guidance and other risk-behavior among AAS-users, these bodybuilders have an increased risk for health problems.


In dit rapport is een onderzoek beschreven waarbij het gebruik van prestatie verhogende middelen middels een vragenlijst is geïnventariseerd bij bodybuilders in Nederland. In 1994 werden op de Nederlandse kampioenschappen bodybuilding twaalfhonderd vragenlijsten uitgedeeld aan bezoekers die aan bodybuilding deden en aan deelnemers van de wedstrijd. In totaal werden 291 vragenlijsten (24%) met bruikbare informatie geretourneerd.
Het aantal mannelijke en vrouwelijke deelnemers was respectievelijk 227 (79%) en 59 (21%) en de gemiddelde leeftijd was 28 jaar (uitersten 15 tot 63 jaar). Van de deelnemers had 44% (vrouwen 17% en mannen 52%) ooit anabole-androgene steroïden (AAS) gebruikt. Voor de bodybuilders die aan wedstrijden deelnamen was dit 77% (vrouwen 57% en mannen 79%) en voor de recreatieve bodybuilders 37% (vrouwen 12% en mannen 45%). Het aantal gebruikte merkpreparaten was 47 en met name de mannelijke bodybuilders wisselden vaak van preparaat. De preparaten kwamen meestal van de zwarte markt en er was beperkt sprake van medische begeleiding. De AAS werden vaak parenteraal toegediend, de kuurlengte was gemiddeld 8 weken en gemiddeld werden 2 kuren per jaar gebruikt. Het gelijktijdig toedienen van meerdere AAS ('stacking') kwam bij 68% van de AAS-gebruikers voor en 12% gebruikte tussen de kuren in ook nog AAS als onderhoudstherapie. Voor een deel diende het laatste ter onderdrukking van onthoudingsverschijnselen en 6% van de mannelijke AAS-gebruikende bodybuilders achtte zichzelf verslaafd aan AAS. Wedstrijdbodybuilders en vrouwen bleken voor wat betreft de genoemde factoren respectievelijk onveiliger en veiliger om te gaan met AAS.
Bijna 90% van de bodybuilders gaf aan bijwerkingen te ondervinden van het gebruik van AAS. Met name werden een verhoogde sexuele aandrang (51%) en agressiviteit (47%), hoge bloeddruk (21%) en vochtretentie (37%) genoemd. Vrouwen gaven tevens acné (50%) en toegenomen haargroei (30%) op.
Drieëntwintig procent van de mannelijke en 17% van de vrouwelijke bodybuilders hadden ooit gebruik gemaakt van andere prestatie verhogende middelen dan AAS. Met name Pregnyl®, clenbuterol, Ionamine®, Nolvadex® en Clomid® werden hierbij opgegeven. Voor een aantal factoren werd een duidelijke samenhang aangetoond met AAS gebruik. Duidelijk risicofactoren voor AAS-gebruik waren het mannelijk geslacht, oudere leeftijd, vergroting van de spiermassa als motivatie voor gewichtstraining en competitiedeelname. Ook duur en intensiteit van training, lichaamsgewicht en het gebruik van voedingssupplementen hingen sterk samen met AAS-gebruik. Ten opzichte van de bodybuilders die geen AAS gebruikten, vertoonden de mannelijke en in mindere mate de vrouwelijke AAS-gebruikende bodybuilders tevens een risicogedrag ten aanzien van het gebruik van genotmiddelen (tabak en soft en hard drugs) en andere prestatie verhogende middelen.
Alhoewel de representativiteit van deze studie onduidelijk is, is het gebruik van prestatie verhogend middelen bij bodybuilders waarschijnlijk wijd verspreid. Door de onbekende herkomst van de preparaten en het gebrek aan medische begeleiding lopen deze sporters duidelijke gezondheidsrisico's

Drug education and the college athlete: evaluation of a decision-making model.

1 Jan 1996

Tricker R, Connolly D.
J Drug Educ. 1996;26(2):159-81.
Department of Public Health, Oregon State University, Corvallis 97331-6406, USA.

In general there is a lack of information describing the components and structure of drug education and prevention programs (DEPP) for college student athletes. While concern about the prevalence of drug abuse among college student athletes has increased, a relative lack of clarity remains regarding what elements of drug education prevention programs have been successful or unsuccessful in this setting. In an effort to address this issue at Oregon State University a two-credit ten-week DEPP was implemented as a requirement for all collegiate athletes. This article describes the evaluation of this program.

Altogether 635 student athletes from three National Collegiate Athletic Association (NCAA) Division One universities provided data in this two-year evaluation project. Participants were student athletes from Oregon State University (OSU), a Mid-Western University (MWU), and another Pacific North-Western University (PNWU). Pre- and post-test data were collected regarding knowledge about drugs, attitudes toward drug use, drug use, and decision-making factors. Students at OSU and MWU were enrolled in a structured DEPP, and the third group from PNWU was used as a control and did not receive regular instruction.

The baseline data taken before the drug education course indicated that athletes at OSU, MWU, and PNWU were no different in their knowledge of drugs, attitudes toward drugs, or perception of the value of drug education in preventing drug abuse among student athletes. However, the data at the end of the ten-week course revealed many significant improvements among OSU and MWU students athletes, in knowledge, attitude related to performance enhancing drugs and recreational drugs, and perceptions of drug education.

At the end of the course 88 percent of the participating OSU athletes agreed that drug education can be effective in preventing drug abuse among student athletes.

[PubMed - indexed for MEDLINE]

The Adolescents Training and Learning to Avoid Steroids (ATLAS) Prevention Program Background and Results of a Model Intervention

1 Jan 1996

Linn Goldberg, MD; Diane L. Elliot, MD; Gregory N. Clarke, PhD; David P. MacKinnon, PhD; Leslie Zoref, PhD; Esther Moe, PhD; Christopher Green, MEd; Stephanie L. Wolf
Arch Pediatr Adolesc Med. 1996;150:713-721

Objective: To develop and test a school-based intervention to prevent anabolic androgenic steroid use among high-risk adolescent athletes.

Design: Nonrandom controlled trial.

Setting: Two urban high schools.

Participants: Fifty-six adolescent football players at the experimental school and 24 players at the control school.

Intervention: Eight weekly, 1-hour classroom sessions delivered by the coach and adolescent team leaders, and eight weight-room sessions delivered by research staff. The intervention addressed sports nutrition and strength training as alternatives to steroid
use, drug refusal role play, and antisteroid media campaigns.

Outcome Measures: A preintervention and postintervention questionnaire that assessed attitudes toward and intent to use steroids and other drugs; knowledge of drug effects; and diet, exercise, and related constructs.

Results: Compared with controls, experimental subjects were significantly less interested in trying steroids after the intervention, were less likely to want to use them even if their friends used them, were less likely to believe steroid use was a good idea, believed steroids were more dangerous, had better knowledge of alternatives to steroid use, had improved body image, increased their knowledge ofdiet supplements, and had less beliefin these
supplements as beneficial.

Conclusions: Significant beneficial effects were found despite the sample size, suggesting that the effect of the intervention was large. This outcome trial demonstrates an effective anabolic androgenic steroid prevention program for adolescent athletes, and the potential of team-based interventions to enhance adolescents' health.

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