Drugs muscle their way into men’s fitness

Male college students in the United States and Europe want to add more muscle to their bodies because they think that will make them more attractive to females.

They are wrong.

Asked by researchers to choose bodies they would most like to have, the students picked computer images with 30 pounds more muscle than they actually had. Asked to select their most-wanted body from the same computer images, female college students chose men with 15 to 30 pounds less muscle than most males consider ideal.

“In other words, the bodies that men already had were closer to what women actually want than what men think they want,” says Harrison Pope, a Harvard Medical School professor of psychiatry who headed the study. “The Leonardo DiCaprio-look out-muscles the Jean-Claude Van Damme-look,” he notes.

Pope, who heads the Biological Psychiatry Laboratory at Harvard-affiliated McLean Hospital in Belmont, Mass., worries that men’s distorted view of muscularity may be a factor in a disturbing situation that has recently been observed. He and colleague Drew Arvary found that some males who use anabolic steroids to “bulk up” go on to abuse heroin, morphine, and other opiate drugs.

Among 227 men admitted to a private facility in New Jersey for dependence on heroin and other opiates, Pope and Arvary found that 21 of them had a history of steroid use. None of the men, all in their 20s, reported any drug abuse before they began taking steroids. Also, most of them first purchased opiates from the same dealer who sold them steroids without the required prescription.

“These finding suggest that anabolic steroids may serve as ‘gateway’ drugs to dependence on opiates such as heroin,” Pope wrote in The New England Journal of Medicine in May.

Obsessing about muscles

Pope and his colleagues conducted a body-image survey with males attending colleges in Boston, Paris, and Innsbruck, Austria. The name of the Boston-area college is confidential, but it’s not Harvard.

As far as using steroids to add the desired 30 pounds of muscle, Pope says, “I think that rates of anabolic steroid use among Harvard men are lower than you’d find in a school strongly focused on the prestige of its sports teams. But I don’t have any hard data on that.”

Dissatisfaction with their bodies, of course, goes beyond males in college. Pope also questioned bodybuilders in a local gym. To get them to participate, he offered free body-fat and muscle-mass estimates. He then showed the men computer images and asked them to select representations of their actual bodies, the bodies they would like to have, and the bodies most desired by women. Their choices revealed the same kinds of distortions as college men, but not to such a severe extent.

The gym group saw themselves as not much bigger than the average American male, when their muscle measurements revealed them to be considerably bigger. “They were serious weightlifters who were impressively muscular to even a casual observer,” Pope says. “But they wanted to be even bigger. They wanted another 15 pounds of muscle on top of what they already had.”

Still, that’s only half of what college men wanted to add.

When asked to choose a body that women, or society in general, would find ideal they picked images more than 10 pounds more muscular than their muscular selves. Pope contrasts that with a “street corner survey,” done by another researcher, in which the overwhelming majority of women ranked photos of advanced bodybuilders as “extremely repulsive.”

In a book published last month, called The Adonis Complex (Free Press), Pope and co-authors Katharine Phillips of Brown University and Roberto Olivardia of Harvard Medical School discuss such studies in more detail, along with what they call the general problem of “male body obsession.”

One survey they describe used figure drawings to show adults averaging 45 years old. These older men didn’t show the same distortions as college students. There was little difference between estimates of their actual bodies, their ideal bodies, and the bodies they thought women prefer. Older women, in selecting their ideal of a male body, chose bodies similar to what the older men had guessed they would like.

The different points of view lead Pope and others to conclude that muscle obsessions are greatest in younger men. “The younger men have been saturated with steroid-pumped media images and aggressive advertising from the body-image industries,” Pope says. “Men who grew up in the 1960s and 1970s weren’t exposed to these societal forces in their youths. Consequently they don’t have as many muscle hang-ups.”

Scratching the itch

A frequent visitor to gyms, Pope notes that middle-aged and older men think nothing of stripping in a locker room or taking showers in the presence of others. However, he adds, “men in their 20s and younger, almost always drive home in sweaty workout clothes and shower in private.”

High school boys display the same self-consciousness. Pope tells the story of an expensive new locker room being constructed in a school in an affluent community in Connecticut. It featured an open area with some 25 showers in a line across one wall.

“I don’t use it, and I’ve never seen anyone in my class use it,” a student told Pope. “Once in a while, you’ll see some old faculty member or middle-aged guy in there, but me and my friends would never strip down and take a shower in public like that.”

Pope fears that this body obsession pushes many young men into using steroids, which may, in turn, raise their risk of trying heroin and other addictive opiates. A youngster may start with muscle-growth supplements, such as creatine, available in health stores. Mark McGwire became a role model for one of these products, androstenedione, in 1998 when he hit more home runs in a season than any other player in the history of the game.

Athletes who want to enhance their performance, and young men who want to look better and to attract women, may progress to anabolic steroids, which are synthetic forms of testosterone in pill or injectable form. “Typical college kids who take steroids will say that they have never had any problem with them,” Pope notes. “There are long-range medical dangers, including an increased risk of heart attacks and prostate cancer, but many young people don’t worry about what could happen when they reach their 50s and 60s.”

However, evidence exists for much shorter-term psychiatric problems. “In susceptible individuals, large does of anabolic steroids can produce severe mood changes, irritability, aggression, and even violence,” Pope points out. “And, more commonly, withdrawal from steroids can produce lethargy, depression, and thoughts of suicide. Steroid withdrawal can be somewhat similar to opiate withdrawal, and this might account for increasing numbers of bodybuilders who go from steroids to opiates.”

To relieve withdrawal symptoms, “scratching the itch” as it’s called, steroid users may turn to opiate-related pain killers, such as Nubain, or to the actual opiates.

“Perhaps opiates scratch the itch the way nothing else does,” Pope says. “That’s why we think opiate use is breaking into a new population.”