Steroid Use, Eating Disorders Are Common Among Female Bodybuilders

From the WebMD Archives

Feb. 14, 2000 (New York) -- A new study shows that male bodybuilders aren't the only ones taking steroids to bulk up. In addition to showing that female bodybuilders also take steroids to improve their physiques, the alarming research, published in the current issue of Psychotherapy and Psychosomatics, shows that eating disorders are also common among these women.

The study, one of the first to examine the issue of steroid use in women, looked at 75 female athletes who were recruited by posters at gym and bodybuilding contests in Boston, Houston, and Los Angeles. One-third of the women reported past or current steroid use. The study investigators found that women who used steroids were more muscular than their non-steroid-using counterparts and were also more likely to use other performance-enhancing substances.

The new study also showed that women bodybuilders are more likely than their non-iron pumping counterparts to suffer from eating disorders and body image disorders, including the newly dubbed eating disorder/bodybuilder type (ED/BT), a disorder marked by high-protein, high-calorie, low-fat diets eaten at regularly scheduled intervals and muscle dysmorphia, a disorder marked by a distorted body image.

"The take-home message is that the gym culture, which is becoming increasingly accessible to many people, is potentially dangerous for women at risk of body image disorders, substance abuse disorders, or eating disorders -- all of which are related," study author Amanda J. Gruber, MD, tells WebMD. Gruber is a clinical instructor in psychology at Harvard Medical School and the associate chief of substance abuse research at the Biological Psychiatry Laboratory at MacLean Hospital in Belmont, Mass.

"It's not just about bodybuilders either. There are other women in gyms who are taking performance-enhancing supplements such as ephedrine to increase lean body mass and promote weight loss," she says. Gruber conducted the study with her colleague Harrison G. Pope Jr., MD, chief of the biological psychiatry laboratory at MacLean Hospital.

Anabolic steroids, also called ergogenic drugs, mimic the bodybuilding traits of the male hormone testosterone. According to data cited in the new study, 145,000 American women have abused steroids at some point in their lives, and studies of high school girls show that this number is even higher among younger women.

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"While men tend to experience isolated steroid abuse, women who abuse steroids are more likely to also have insane diets and engage in compulsive behavior," Gruber adds. "If you are a women at risk for a body image disorder, had an eating disorder in the past, or are at risk for a substance abuse disorder, and you start going to a gym, your risk will increase because you are exposed to people who engage in these unhealthy behaviors"

In the study, 16 of the 25 steroid users reported at least one psychological effect as a result of anabolic steroid use, including moodiness, irritability, and aggressiveness. One in 16 of these women reported engaging in a violent act while taking these drugs. Such acts are often referred to as "'roid rage."

Nineteen women reported at least one medical problem related to steroid use. Of these, the most serious was kidney failure.

In the study, 55 of 75 women were found to have ED/BT, and 65 of 75 had muscle dysmorphia, meaning that even though they had big muscles, they still regarded themselves as small. In addition, 55 of 75 had "nontraditional gender role," a disorder marked by a preference for typical male clothing, pastimes, jobs, and friends.

Steven Levenkron, author of the just-published book Anatomy of Anorexia and a psychotherapist in private practice in New York, tells WebMD that the "use of high-risk anabolic steroids are perhaps a barometer of how far women will go to achieve the perfect body." The perfect body tends to be viewed as being underweight and overmuscled, he points out.

Steve Crawford, MD, associate director of the Center for Eating Disorders at St. Joseph Medical School in Towson, Md., puts it this way: "Athletes are under pressure regarding their appearance -- especially in sports like bodybuilding, diving, gymnastics, and figure skating."

Pressure to achieve abnormal goals regarding appearance may encourage athletes to engage in self-destructive and unhealthy behavior such as the use of anabolic steroids, Crawford points out.

James Rosen, PhD, a professor of psychology and the director of the Body Image Therapy Program at the University of Vermont in Burlington, urges caution in interpreting the new study findings. "A lot of researchers who study body disorders and eating disorders are unfamiliar with elite competitive athletes," he tells WebMD. "The behavior may look like eating disorders, but the motivation and psychology behind them are very different."

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"I don't necessarily think that taking steroids represents a psychological desire to deal with body image," Rosen says. "For most of these women, rigid eating and compulsive behavior are part of the sport of bodybuilding."

Vital Information:

  • A recent study of female bodybuilders showed that one-third reported current or past steroid use, and a large majority of these women were found to have an eating disorder.
  • Eating disorder/bodybuilder type (ED/BT) is marked by high-protein, high-calorie, low-fat diets; eating at regularly scheduled intervals; and a distorted body image.
  • One expert cautions that elite athletes, such as bodybuilders, may show behaviors similar to those with eating disorders, but the psychology driving these behaviors is very different.
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