Associations in intentions to use anabolic-androgenic steroids among non-consuming boys and men with probable eating disorders and muscle dysmorphia

J Eat Disord. 2025 Nov 11;13(1):257. doi: 10.1186/s40337-025-01435-3.

ABSTRACT

BACKGROUND: Anabolic-androgenic steroids (AAS) are used to achieve a muscular and lean body to align with current ideals for boys and men. Identifying associations with intentions to use AAS, a precursor to actual use, is critical for prevention efforts. This study aimed to examine whether boys and men with a probable eating disorder or probable muscle dysmorphia have stronger intentions to use AAS, and whether these intentions differ between these conditions.

METHODS: Data from a sample of 1,515 participants from the Study of Boys and Men who had never used AAS were analyzed. To address the study aims, one adjusted linear regression analysis was conducted along with post-hoc Wald tests.

RESULTS: Probable anorexia nervosa/atypical anorexia nervosa, bulimia nervosa, and muscle dysmorphia were associated with greater intentions to use AAS compared to those with none of these conditions. Post-hoc Wald tests revealed that there were no significant differences in intentions to use AAS between those with probable anorexia nervosa/atypical anorexia nervosa, bulimia nervosa, and muscle dysmorphia; however, there were significant differences between these conditions and probable binge-eating disorder.

CONCLUSION: The findings from this study add to a growing literature underscoring similar muscularity-oriented features across anorexia nervosa/atypical anorexia nervosa, bulimia nervosa, and muscle dysmorphia. Assessment of intentions to use AAS may be warranted among boys and men with eating disorders and muscle dysmorphia to ensure the provision of prevention and early-intervention strategies.

PMID:41219901 | DOI:10.1186/s40337-025-01435-3