Body ideals, steroids, and a path to health

Why do we worry about our bodies so much in Western cultures? Researchers have used something called the Tripartite Model to try to understand. This model says that pressure from parents, peers, and the media to look a certain way, like being thin (now ‘lean’) for women or muscular for men, makes us take those standards to heart and compare ourselves to others. But here’s the kicker: these ideals can be challenging to achieve. So, trying to measure up and always falling short makes us unhappy with our bodies. And that unhappiness can lead to some not-so-great habits all in the pursuit of that “ideal” look. Over time, this can mess with our heads too. 

For men, thinking they need to be super muscular has its own set of problems. It’s tied to feeling dissatisfied with their muscle mass, always comparing their bodies to others, and sometimes taking risks just to get ‘jacked’. In a nutshell, these unrealistic body ideals can take a toll on our mental and physical well-being. 

Striving for a muscular ideal

The rising connection between having a muscular body and being seen as masculine among young men is a worrying trend. Many young men, in their pursuit of masculinity, inherently link it to having a muscular physique. This notion is strongly reinforced by popular culture, where figures like Zyzz and Joesthetics (among others) have embodied this muscular ideal and gained significant followings through online platforms.  

Although both have unfortunately passed away, their influence cultivated a distinct aesthetic subculture, creating a shared identity with defined norms and behaviours among its members. The widespread dissemination of messages like those influencers and microcelebrities can significantly impact men’s psychological well-being. Young men striving for a specific body ideal, without the context of the substances which may be required to “attain” that ideal, may experience distress if their results do not align with those of influencers, particularly if those influencers use drugs to facilitate a muscular and ‘shredded’ body and lie about it, for example the Liver King. 

Image and performance enhancing drugs

This inner-conflict and body ideal striving can often lead to risky behaviours like using image and performance enhancing drugs (IPEDs). Research shows that when men are dissatisfied with their bodies, it can lower their self-esteem, pushing them to use strategies to improve their physique. This might involve extreme exercise, dieting, using supplements, and even turning to IPEDs like Anabolic Androgenic Steroids (AAS), – all of which are becoming increasingly common among young men.  

Social identity and group norms play a pivotal role in initiating and sustaining AAS use in Australia, where it responds to societal expectations rather than deviance. From this perspective, using IPEDs such as AAS becomes a way to meet the heightened societal demands. And demand for IPEDs has increased in Queensland for over a decade. Between 2007 and 2015, there were over 100,000 recorded service occasions involving males intending to inject IPEDs at Queensland Needle Service Providers, with a notable increase from a median of 268 occasions per month in 2007 to 1278 in 2015. 

Many use these substances for non-medical reasons, often resorting to illegal means, a concern in Queensland particularly as these are Schedule 1 substances (the same as methamphetamine) and so come with heavy penalties. This contributes to a sense of stigma within the IPED-using community. My research has shown here’s even a “code of silence” among users, making them hard to reach for health professionals. Bryce, a 33-year-old male who participated in a recent study stated “Yeah, it’s still like very, you know, hush, hush. I know a lot of people that use or have used, but it’s still a very taboo subject.” 

When it comes to Australia, social media has seen a surge in open IPED use and promotion. But surprisingly, this hasn’t necessarily improved public health or awareness. IPED users, even though they are concerned about their health, often turn to fellow users on social networks rather than seeking immediate medical advice. These networks are deeply ingrained in the culture, relying on individuals with ‘capital’ acquired through their personal experiences. In a nutshell, addressing the needs of those who use IPEDs should involve tailoring public health approaches to better resonate with this group. 

“Yeah, it’s still like very, you know, hush, hush. I know a lot of people that use or have used, but it’s still a very taboo subject.”

Party Drugs

Alcohol and party drugs

The high use of AAS and other PIEDs among young men, particularly when used in combination with illicit drugs, is concerning.

The outcomes for these young men are often the use of obsessive–compulsive exercise and diet regimes as well as AAS and PIED use to obtain their muscular ideals. The concurrent use of recreational drugs, known as polysubstance use, increases the related harms dramatically and therefore warrants further investigation.

The high levels of determination in achieving a muscular ideal as observed in this group may stem from identity formation issues in adolescence related to body image, self-esteem, social status, and early dating experiences. The factors that perpetuate young men’s focus on their body image comprise social media pressures, identification with a muscularity-centred subculture/other young men pursuing similar goals, and the positive attention they receive from their peers.

Public health campaigns are crucial

One promising approach in addressing the challenges of IPED use involves engaging with and leveraging peers with lived experience. By involving individuals who have gone through similar struggles, we can effectively mitigate harm, manage unrealistic body image expectations, and foster a sense of safety and community within this demographic. Peers can link in with researchers to deliver effective harm reduction messaging to the public. These peer-led initiatives create a space for understanding, empathy, and targeted support, vital for tackling the stigma and unique concerns associated with IPED use. We need better partnerships between research, medical professionals, and those with lived experience in the community to make a real difference.  


Dr Timothy Piatkowski is an early career researcher and lecturer in Applied Psychology at Griffith University within the Centre for Mental Health and the Health and Psychology Research Innovations Laboratory. He is a member of The Loop Australia, which is a national organisation for drug checking and drug checking research. He is also a Director of the Board for Queensland Injectors Voice for Advocacy and Action (QuIVAA). His research philosophy centres around a strong belief in harm reduction as a guiding principle, emphasising its role in promoting safety and informed decision-making surrounding illicit substance use

3: Good Health and Well-being
UN Sustainable Development Goals 3: Good Health and Well-being