Pub Date : 2025-11-04DOI: 10.1016/j.peh.2025.100390
Etienne Grobler , Cheneal Puljević , Benjamin Bonenti , Jason Ferris , Monica J. Barratt , Adam Winstock , Steve Vigorous , Amber Domberelli , Geoff Spurling , Timothy Piatkowski
Background
Anabolic–androgenic steroid (AAS) consumption is associated with significant physical and psychological health risks, often linked to unregulated supply chains and difficulty accessing informed healthcare. Therefore, this study examines how healthcare access difficulties and independently testing AAS purity and content relate to self-reported undesirable effects among AAS consumers.
Methods
Data from 854 respondents (95.6% male) reporting past-year AAS consumption in the 2024 Global Drug Survey were analysed. Respondents provided information on healthcare access, AAS testing behaviours, and undesirable physical (e.g., cardiovascular) and psychological (e.g., mood disturbances) effects. Chi-squared tests assessed differences across four groups defined by combinations of difficulty accessing healthcare and AAS testing.
Results
Respondents not testing their AAS and experiencing difficulty accessing healthcare (n = 196) reported significantly higher frequencies of several undesirable effects compared to the other three groups (n = 102–390). Significant differences were observed for decreased sexual function (χ² (3) = 10.19, p = .017, φc = 0.109), decreased fertility (χ² (3) = 11.54, p = .009, φc = 0.116), negative impacts on sexual organs (χ² (3) = 8.08, p = .044, φc = 0.097), anger/aggression (χ² (3) = 13.27, p = .004, φc = 0.125), depression/low mood (χ² (3) = 10.62, p = .014, φc = 0.112), and irritability (χ² (3) = 8.66, p = .034, φc = 0.101).
Conclusion
Difficulties accessing healthcare and not testing AAS are associated with higher reported AAS-related undesirable effects, though consumer-specific and contextual factors may be central. These findings highlight the need to address systemic and psychosocial barriers to reduce AAS-related harms.
{"title":"Associations between anabolic-androgenic steroid testing, healthcare access and undesirable effects among international consumers","authors":"Etienne Grobler , Cheneal Puljević , Benjamin Bonenti , Jason Ferris , Monica J. Barratt , Adam Winstock , Steve Vigorous , Amber Domberelli , Geoff Spurling , Timothy Piatkowski","doi":"10.1016/j.peh.2025.100390","DOIUrl":"10.1016/j.peh.2025.100390","url":null,"abstract":"<div><h3>Background</h3><div>Anabolic–androgenic steroid (AAS) consumption is associated with significant physical and psychological health risks, often linked to unregulated supply chains and difficulty accessing informed healthcare. Therefore, this study examines how healthcare access difficulties and independently testing AAS purity and content relate to self-reported undesirable effects among AAS consumers.</div></div><div><h3>Methods</h3><div>Data from 854 respondents (95.6% male) reporting past-year AAS consumption in the 2024 Global Drug Survey were analysed. Respondents provided information on healthcare access, AAS testing behaviours, and undesirable physical (e.g., cardiovascular) and psychological (e.g., mood disturbances) effects. Chi-squared tests assessed differences across four groups defined by combinations of difficulty accessing healthcare and AAS testing.</div></div><div><h3>Results</h3><div>Respondents not testing their AAS and experiencing difficulty accessing healthcare (<em>n</em> = 196) reported significantly higher frequencies of several undesirable effects compared to the other three groups (<em>n</em> = 102–390). Significant differences were observed for decreased sexual function (χ² (3) = 10.19, <em>p</em> = .017, φc = 0.109), decreased fertility (χ² (3) = 11.54, <em>p</em> = .009, φc = 0.116), negative impacts on sexual organs (χ² (3) = 8.08, <em>p</em> = .044, φc = 0.097), anger/aggression (χ² (3) = 13.27, <em>p</em> = .004, φc = 0.125), depression/low mood (χ² (3) = 10.62, <em>p</em> = .014, φc = 0.112), and irritability (χ² (3) = 8.66, <em>p</em> = .034, φc = 0.101).</div></div><div><h3>Conclusion</h3><div>Difficulties accessing healthcare and not testing AAS are associated with higher reported AAS-related undesirable effects, though consumer-specific and contextual factors may be central. These findings highlight the need to address systemic and psychosocial barriers to reduce AAS-related harms.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"14 1","pages":"Article 100390"},"PeriodicalIF":3.7,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health behavior change and maintenance are essential for preventing chronic diseases and promoting well-being. However, a persistent intention-behavior gap highlights the complexity of sustaining health-promoting behaviors over time. The Physical Activity Adoption and Maintenance (PAAM) model 1.0, based on in dual-process theories, provides a framework for understanding the interaction between explicit (reflective) and implicit (automatic) processes in physical activity (PA) regulation. Recent evidence suggests that PA behaviors and their determinants are more dynamic than previously conceptualized, necessitating an updated framework. This paper introduces the PAAM model 2.0, which expands upon its predecessor by incorporating intraindividual variability in key constructs such as intention and self-control. The revised model also underscores the role of anticipated affect in intention formation and behavior regulation. While originally designed for PA, the PAAM model 2.0 offers a generalized framework applicable to other repetitive health behaviors, including medication adherence, dietary regulation, and sleep routines. The model’s implications for research and practice are discussed, emphasizing the need for dynamic assessments and tailored interventions. By integrating state-like fluctuations and integrated regulatory processes, the PAAM model 2.0 advances our understanding of long-term health behavior change and provides a foundation for effective, evidence-based interventions.
改变和保持健康行为对预防慢性疾病和促进福祉至关重要。然而，持续存在的意向-行为差距凸显了长期维持健康促进行为的复杂性。基于双过程理论的PAAM （Physical Activity Adoption and Maintenance）模型1.0为理解身体活动调节中显性（反思）和隐性（自动）过程之间的相互作用提供了一个框架。最近的证据表明，PA行为及其决定因素比以前概念化的更动态，需要更新框架。本文介绍了PAAM模型2.0，它通过在关键结构（如意图和自我控制）中纳入个体内部可变性来扩展其前身。修正后的模型还强调了预期影响在意向形成和行为调节中的作用。虽然最初是为PA设计的，但PAAM模型2.0提供了一个适用于其他重复性健康行为的通用框架，包括药物依从性、饮食调节和睡眠习惯。讨论了该模型对研究和实践的影响，强调需要动态评估和量身定制的干预措施。通过整合状态波动和综合监管过程，PAAM模型2.0促进了我们对长期健康行为改变的理解，并为有效的循证干预提供了基础。
{"title":"Reconceptualizing self-regulation in health behaviors: A dynamic perspective on the PAAM model","authors":"Darko Jekauc , Ines Pfeffer , Tilo Strobach , Chris Englert","doi":"10.1016/j.peh.2025.100394","DOIUrl":"10.1016/j.peh.2025.100394","url":null,"abstract":"<div><div>Health behavior change and maintenance are essential for preventing chronic diseases and promoting well-being. However, a persistent intention-behavior gap highlights the complexity of sustaining health-promoting behaviors over time. The Physical Activity Adoption and Maintenance (PAAM) model 1.0, based on in dual-process theories, provides a framework for understanding the interaction between explicit (reflective) and implicit (automatic) processes in physical activity (PA) regulation. Recent evidence suggests that PA behaviors and their determinants are more dynamic than previously conceptualized, necessitating an updated framework. This paper introduces the PAAM model 2.0, which expands upon its predecessor by incorporating intraindividual variability in key constructs such as intention and self-control. The revised model also underscores the role of anticipated affect in intention formation and behavior regulation. While originally designed for PA, the PAAM model 2.0 offers a generalized framework applicable to other repetitive health behaviors, including medication adherence, dietary regulation, and sleep routines. The model’s implications for research and practice are discussed, emphasizing the need for dynamic assessments and tailored interventions. By integrating state-like fluctuations and integrated regulatory processes, the PAAM model 2.0 advances our understanding of long-term health behavior change and provides a foundation for effective, evidence-based interventions.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"14 1","pages":"Article 100394"},"PeriodicalIF":3.7,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-02DOI: 10.1016/j.peh.2025.100355
Luke A. Turnock , Jennifer Germain , Mikey Hirst , Evelyn Hearne
Background
GLP-1 weight-loss medicines (e.g. Semaglutide; Tirzepatide) are increasingly prevalent, with many users accessing these drugs off-label through the internet for lifestyle purposes. However, to date there has been little research examining their use for anti-ageing purposes. This article fills this gap by examining the perspectives and experiences of older bodybuilders on forums regarding their use of GLP drugs for anti-ageing.
Methods
This research was a netnography of the two largest bodybuilding and steroid specific forums on the web, exploring 12,392 unique posts from the top 160 threads, captured in 2024. Qualitative thematic analysis of posts was undertaken.
Findings
GLP drugs were felt to have a number of benefits for anti-ageing, longevity and general wellbeing. Many older bodybuilders took them for their anti-inflammatory effects, which allowed them to train despite age-related joint pain and general inflammation. Further, many bodybuilders highlighted emerging scientific research regarding GLP medicines’ potential benefits for anti-ageing more broadly, including brain and heart health, and improving insulin sensitivity when older. The role of ‘expert’ users on forums sharing findings from scientific research encouraged forms of use beyond existing clinical guidelines, but also facilitated harm reduction by encouraging forum users to switch from higher risk drugs like HGH and growth hormone secreting peptides to GLP medicines for anti-ageing.
Discussion
It is clear that anti-ageing is a significant motivator for GLP use among older bodybuilders, and public health policy must understand and acknowledge older users’ distinct motivations and approaches to use in order to best serve this population. The role of forum folk pharmacology in both encouraging unapproved therapies, but also enabling harm reduction through encouraging safer approaches to drug use is also important to understand when considering public health approaches to this population.
{"title":"Off-label Semaglutide & GLP-1 weight-loss medicine use for anti-ageing: A Netnography of older bodybuilders’ experiences and understandings","authors":"Luke A. Turnock , Jennifer Germain , Mikey Hirst , Evelyn Hearne","doi":"10.1016/j.peh.2025.100355","DOIUrl":"10.1016/j.peh.2025.100355","url":null,"abstract":"<div><h3>Background</h3><div>GLP-1 weight-loss medicines (e.g. Semaglutide; Tirzepatide) are increasingly prevalent, with many users accessing these drugs off-label through the internet for lifestyle purposes. However, to date there has been little research examining their use for anti-ageing purposes. This article fills this gap by examining the perspectives and experiences of older bodybuilders on forums regarding their use of GLP drugs for anti-ageing.</div></div><div><h3>Methods</h3><div>This research was a netnography of the two largest bodybuilding and steroid specific forums on the web, exploring 12,392 unique posts from the top 160 threads, captured in 2024. Qualitative thematic analysis of posts was undertaken.</div></div><div><h3>Findings</h3><div>GLP drugs were felt to have a number of benefits for anti-ageing, longevity and general wellbeing. Many older bodybuilders took them for their anti-inflammatory effects, which allowed them to train despite age-related joint pain and general inflammation. Further, many bodybuilders highlighted emerging scientific research regarding GLP medicines’ potential benefits for anti-ageing more broadly, including brain and heart health, and improving insulin sensitivity when older. The role of ‘expert’ users on forums sharing findings from scientific research encouraged forms of use beyond existing clinical guidelines, but also facilitated harm reduction by encouraging forum users to switch from higher risk drugs like HGH and growth hormone secreting peptides to GLP medicines for anti-ageing.</div></div><div><h3>Discussion</h3><div>It is clear that anti-ageing is a significant motivator for GLP use among older bodybuilders, and public health policy must understand and acknowledge older users’ distinct motivations and approaches to use in order to best serve this population. The role of forum folk pharmacology in both encouraging unapproved therapies, but also enabling harm reduction through encouraging safer approaches to drug use is also important to understand when considering public health approaches to this population.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"14 1","pages":"Article 100355"},"PeriodicalIF":3.7,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.peh.2025.100386
Thomas Zandonai , Sofia Venturini , Ornella Corazza
{"title":"Ketamine and psilocybin for athletes: A therapeutic breakthrough or a slippery slope?","authors":"Thomas Zandonai , Sofia Venturini , Ornella Corazza","doi":"10.1016/j.peh.2025.100386","DOIUrl":"10.1016/j.peh.2025.100386","url":null,"abstract":"","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"14 1","pages":"Article 100386"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.peh.2025.100392
René Paasch , Gunnar Mau , Oliver Korol
Background
The use of anabolic–androgenic steroids (AAS) in recreational fitness has become increasingly widespread, posing serious health risks and creating challenges for prevention and harm reduction.
Objective
The aim was to identify distinct groups of recreational fitness athletes based on attitudes, intentions, and risk perception, and to analyze their prevention needs.
Methods
A standardized online survey (N = 772; n = 749 with complete TPB data) assessed four psychological scales: intention, avoidance, risk perception, and risk acceptance. These variables were analyzed using a hierarchically validated k-means cluster analysis, which is particularly suited to identifying heterogeneous subgroups in large datasets and provides stable solutions. In addition, open-ended responses (n ≈ 600) from the same sample on motives for use, informational needs, and preferred prevention formats were examined through qualitative content analysis. The mixed-methods design allowed for a comprehensive interpretation of user typologies and their prevention needs.
Results
Seven distinct user clusters with heterogeneous motivational and cognitive profiles were identified. Respondents particularly emphasized digital visibility, authentic testimonials, and continuous education as preferred prevention formats.
Conclusion
This study identified seven distinct user clusters that differed substantially in their attitudes, intentions, and prevention needs, highlighting the necessity of tailored, behaviorally informed prevention strategies to effectively address AAS use in recreational fitness.
在休闲健身中使用合成代谢雄激素类固醇（AAS）已经变得越来越普遍，造成了严重的健康风险，并为预防和减少危害带来了挑战。目的根据休闲健身运动员的态度、意图和风险认知，识别不同的休闲健身运动员群体，并分析其预防需求。方法采用标准化在线调查（N = 772, N = 749， TPB数据完整）对意向、回避、风险感知和风险接受四个心理量表进行评估。这些变量使用分层验证的k-means聚类分析进行分析，这特别适合于识别大型数据集中的异构子组，并提供稳定的解决方案。此外，通过定性内容分析，对来自同一样本的关于使用动机、信息需求和首选预防形式的开放式回答（n≈600）进行了检查。混合方法的设计允许对用户类型及其预防需求进行全面的解释。结果识别出7个具有不同动机和认知特征的用户群。受访者特别强调数字可见性、真实的证明和持续教育是首选的预防形式。本研究确定了七个不同的用户群，他们在态度、意图和预防需求方面存在很大差异，强调了定制的、行为知情的预防策略的必要性，以有效解决娱乐健身中AAS的使用问题。
{"title":"Doping attitudes and prevention needs in recreational sports: A behavioral cluster analysis based on the theory of planned behavior and risk acceptance","authors":"René Paasch , Gunnar Mau , Oliver Korol","doi":"10.1016/j.peh.2025.100392","DOIUrl":"10.1016/j.peh.2025.100392","url":null,"abstract":"<div><h3>Background</h3><div>The use of anabolic–androgenic steroids (AAS) in recreational fitness has become increasingly widespread, posing serious health risks and creating challenges for prevention and harm reduction.</div></div><div><h3>Objective</h3><div>The aim was to identify distinct groups of recreational fitness athletes based on attitudes, intentions, and risk perception, and to analyze their prevention needs.</div></div><div><h3>Methods</h3><div>A standardized online survey (N = 772; n = 749 with complete TPB data) assessed four psychological scales: intention, avoidance, risk perception, and risk acceptance. These variables were analyzed using a hierarchically validated k-means cluster analysis, which is particularly suited to identifying heterogeneous subgroups in large datasets and provides stable solutions. In addition, open-ended responses (n ≈ 600) from the same sample on motives for use, informational needs, and preferred prevention formats were examined through qualitative content analysis. The mixed-methods design allowed for a comprehensive interpretation of user typologies and their prevention needs.</div></div><div><h3>Results</h3><div>Seven distinct user clusters with heterogeneous motivational and cognitive profiles were identified. Respondents particularly emphasized digital visibility, authentic testimonials, and continuous education as preferred prevention formats.</div></div><div><h3>Conclusion</h3><div>This study identified seven distinct user clusters that differed substantially in their attitudes, intentions, and prevention needs, highlighting the necessity of tailored, behaviorally informed prevention strategies to effectively address AAS use in recreational fitness.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"14 1","pages":"Article 100392"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.peh.2025.100362
Luke A. Turnock , Timothy Piatkowski
Bodybuilders are often at the forefront of experimental forms of drug use and the consumption of novel compounds. One form of enhancement drug use that has received increasing attention in recent years is weight-loss medicine use, including 2,4-dinitrophenol (DNP). However, the market for IPEDs is constantly evolving, with new drugs emerging in digital market spaces. This research focusses on discussions relating to one of these emerging drugs, BAM15, a weight-loss medicine that some bodybuilders perceive as a potentially safer but effective alternative to DNP. We explore the cultural contexts to the navigation of risk in relation to this emergent drug within digital bodybuilding cultures, applying a cultural theory of risk.
The research is based on a netnography of forum threads and YouTube content. Thematic analysis was used to analyse discussions relating to BAM15 on two of the largest bodybuilding forums in the world, in addition to a YouTube instructional on the creation of BAM15 and its comment section.
Our findings reveal that BAM15 is perceived as a promising, low-risk alternative to traditional weight-loss drugs like DNP. The video’s accessibility and step-by-step synthesis guide contributed to the normalisation of risk-taking behaviours. Comments from viewers indicated a high level of engagement, with many expressing intent to self-experiment with BAM15 despite limited clinical evidence.
The study highlights the need for harm reduction frameworks to consider the cultural and digital dimensions of risk. We argue for more contextually informed, peer-led harm reduction interventions that address both material risks and cultural practices surrounding drug use.
{"title":"“The new DNP”: Discussion of the experimental ‘fat burner’ BAM15 on bodybuilding forums and YouTube","authors":"Luke A. Turnock , Timothy Piatkowski","doi":"10.1016/j.peh.2025.100362","DOIUrl":"10.1016/j.peh.2025.100362","url":null,"abstract":"<div><div>Bodybuilders are often at the forefront of experimental forms of drug use and the consumption of novel compounds. One form of enhancement drug use that has received increasing attention in recent years is weight-loss medicine use, including 2,4-dinitrophenol (DNP). However, the market for IPEDs is constantly evolving, with new drugs emerging in digital market spaces. This research focusses on discussions relating to one of these emerging drugs, BAM15, a weight-loss medicine that some bodybuilders perceive as a potentially safer but effective alternative to DNP. We explore the cultural contexts to the navigation of risk in relation to this emergent drug within digital bodybuilding cultures, applying a cultural theory of risk.</div><div>The research is based on a netnography of forum threads and YouTube content. Thematic analysis was used to analyse discussions relating to BAM15 on two of the largest bodybuilding forums in the world, in addition to a YouTube instructional on the creation of BAM15 and its comment section.</div><div>Our findings reveal that BAM15 is perceived as a promising, low-risk alternative to traditional weight-loss drugs like DNP. The video’s accessibility and step-by-step synthesis guide contributed to the normalisation of risk-taking behaviours. Comments from viewers indicated a high level of engagement, with many expressing intent to self-experiment with BAM15 despite limited clinical evidence.</div><div>The study highlights the need for harm reduction frameworks to consider the cultural and digital dimensions of risk. We argue for more contextually informed, peer-led harm reduction interventions that address both material risks and cultural practices surrounding drug use.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"14 1","pages":"Article 100362"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.peh.2025.100389
Jason C․ Y․ Mak , Derwin K․ C․ Chan , Martin L․ T․ Chan , Patrick S․ H․ Yung , Michael T․ Y․ Ong
Background
Despite stigma being commonly identified as a deterrent in doping in sports, a high prevalence of doping is reported amongst competitive bodybuilders, which may be related to social validation. This study aims to explore the doping experience of competitive bodybuilders, specifically under the influences of stigmatization and social validation.
Methods
: Twelve bodybuilders with lived doping experience engaged in individual, face-to-face, semi-structured interviews in Hong Kong from January to March 2023. The interviews were audiotaped, transcribed verbatim and analyzed using an Interpretative Phenomenological Analysis approach.
Results: The following themes were constructed
1) the insignificance of stigma to prevent doping; 2) reinforcement of doping through social validation; 3) doping as a cultural norm in competitive bodybuilding; and 4) insufficient deterrence from anti-doping policy.
Conclusion
: This study provides important insight, as stigmatization and social validation interact, especially under the influence of a doping culture and anti-doping policy. The experiences of competitive bodybuilders provide insight into effective anti-doping strategies by addressing moral disengagement with culturally sensitive approaches.
{"title":"Why does stigmatization fail to prevent elite athletes from doping? A qualitative study among competitive bodybuilders","authors":"Jason C․ Y․ Mak , Derwin K․ C․ Chan , Martin L․ T․ Chan , Patrick S․ H․ Yung , Michael T․ Y․ Ong","doi":"10.1016/j.peh.2025.100389","DOIUrl":"10.1016/j.peh.2025.100389","url":null,"abstract":"<div><h3>Background</h3><div>Despite stigma being commonly identified as a deterrent in doping in sports, a high prevalence of doping is reported amongst competitive bodybuilders, which may be related to social validation. This study aims to explore the doping experience of competitive bodybuilders, specifically under the influences of stigmatization and social validation.</div></div><div><h3>Methods</h3><div><em>:</em> Twelve bodybuilders with lived doping experience engaged in individual, face-to-face, semi-structured interviews in Hong Kong from January to March 2023. The interviews were audiotaped, transcribed verbatim and analyzed using an Interpretative Phenomenological Analysis approach.</div></div><div><h3>Results: The following themes were constructed</h3><div>1) the insignificance of stigma to prevent doping; 2) reinforcement of doping through social validation; 3) doping as a cultural norm in competitive bodybuilding; and 4) insufficient deterrence from anti-doping policy.</div></div><div><h3>Conclusion</h3><div><em>:</em> This study provides important insight, as stigmatization and social validation interact, especially under the influence of a doping culture and anti-doping policy. The experiences of competitive bodybuilders provide insight into effective anti-doping strategies by addressing moral disengagement with culturally sensitive approaches.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"14 1","pages":"Article 100389"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.peh.2025.100391
Luke Cox , Tim Piatkowski
Clenbuterol is a β2-adrenergic agonist that is not approved for human use in the United States but is widely used by bodybuilders and athletes for its fat-reducing effects. Within image- and performance-enhancing drug (IPED) communities, it is commonly referred to as “Clen” and is typically incorporated into a bodybuilder’s drug “cycle” during the “cutting” phase of competition preparation. While well-established within bodybuilding subcultures, clenbuterol use is associated with significant health risks, including tremors, hyperthermia, tachycardia, cardiac palpitations, and, in severe cases, death. Increasingly, concerns have been raised about the diffusion of clenbuterol use into broader fitness communities. This study employs digital ethnography to examine the role of social media in this diffusion process. Drawing on the normalisation perspective (Parker et al., 1998), it highlights how social media platforms shape perceptions and practices related to clenbuterol. Specifically, social media facilitates access and availability, reframes perceptions of risk, enables cultural and social accommodation, and contributes to identity formation among this population. Through the overt promotion, advertising, and discussion of clenbuterol, social media plays a critical role in fostering its acceptability within wider fitness communities. In light of these developments, this paper argues for stronger governmental engagement to mitigate health risks and protect individuals participating in increasingly diverse and evolving IPED communities.
克伦特罗是一种β2-肾上腺素能激动剂，在美国尚未被批准用于人类，但由于其减脂效果，健美运动员和运动员广泛使用。在提高形象和成绩的药物（IPED）社区，它通常被称为“清洁”，通常被纳入健美运动员在比赛准备的“切割”阶段的药物“循环”中。虽然瘦肉精在健美亚文化中得到了广泛的应用，但它的使用与重大的健康风险有关，包括震颤、高热、心动过速、心悸，在严重的情况下，还会导致死亡。越来越多的人担心瘦肉精的使用会扩散到更广泛的健身社区。本研究采用数字民族志来考察社交媒体在这一传播过程中的作用。从正常化的角度来看（Parker et al., 1998），它强调了社交媒体平台如何塑造与瘦肉精相关的认知和实践。具体而言，社交媒体促进了获取和可用性，重塑了对风险的认知，促进了文化和社会的适应，并有助于这一人群的身份形成。通过对瘦肉精的公开宣传、广告和讨论，社交媒体在促进其在更广泛的健身社区中的接受度方面发挥了关键作用。鉴于这些发展，本文主张加强政府参与，以减轻健康风险，并保护参与日益多样化和不断发展的IPED社区的个人。
{"title":"Eat clen? The normalisation of harmful clenbuterol use within digital fitness cultures","authors":"Luke Cox , Tim Piatkowski","doi":"10.1016/j.peh.2025.100391","DOIUrl":"10.1016/j.peh.2025.100391","url":null,"abstract":"<div><div>Clenbuterol is a β2-adrenergic agonist that is not approved for human use in the United States but is widely used by bodybuilders and athletes for its fat-reducing effects. Within image- and performance-enhancing drug (IPED) communities, it is commonly referred to as “Clen” and is typically incorporated into a bodybuilder’s drug “cycle” during the “cutting” phase of competition preparation. While well-established within bodybuilding subcultures, clenbuterol use is associated with significant health risks, including tremors, hyperthermia, tachycardia, cardiac palpitations, and, in severe cases, death. Increasingly, concerns have been raised about the diffusion of clenbuterol use into broader fitness communities. This study employs digital ethnography to examine the role of social media in this diffusion process. Drawing on the normalisation perspective (Parker et al., 1998), it highlights how social media platforms shape perceptions and practices related to clenbuterol. Specifically, social media facilitates access and availability, reframes perceptions of risk, enables cultural and social accommodation, and contributes to identity formation among this population. Through the overt promotion, advertising, and discussion of clenbuterol, social media plays a critical role in fostering its acceptability within wider fitness communities. In light of these developments, this paper argues for stronger governmental engagement to mitigate health risks and protect individuals participating in increasingly diverse and evolving IPED communities.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"14 1","pages":"Article 100391"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.peh.2025.100385
Elena Efstathiou, Liz Akam, Sarabjit Mastana
Objectives
Genetic testing is gaining attention in elite sport, including football, despite limited supporting evidence. This study explores the attitudes of professional footballers and sports nutritionists toward its use for personalised nutrition.
Design
A cross-sectional, anonymous online survey was conducted to assess participants’ willingness to engage with genetic testing and perceptions of its role in dietary advice.
Methods
81 professional footballers and 54 registered sports nutritionists completed a structured questionnaire. The survey explored openness towards genetic testing, willingness to share results, and views on ethical considerations, including talent identification.
Results
Footballers demonstrated greater openness towards genetic testing for personalised nutrition, with many indicating greater willingness if linked to career opportunities. Nutritionists were generally supportive but cautious, reflecting awareness of the current limitations in evidence. Both groups were less open to using genetic information for selection eligibility and talent scouting.
Conclusions
Findings highlight the need for greater education around genetic testing among both athletes and practitioners and emphasise the urgency of developing ethical guidelines to safeguard against misuse of genetic information in professional sport.
{"title":"Opinions and attitudes on genetic testing for personalised nutrition among professional footballers and sports nutritionists","authors":"Elena Efstathiou, Liz Akam, Sarabjit Mastana","doi":"10.1016/j.peh.2025.100385","DOIUrl":"10.1016/j.peh.2025.100385","url":null,"abstract":"<div><h3>Objectives</h3><div>Genetic testing is gaining attention in elite sport, including football, despite limited supporting evidence. This study explores the attitudes of professional footballers and sports nutritionists toward its use for personalised nutrition.</div></div><div><h3>Design</h3><div>A cross-sectional, anonymous online survey was conducted to assess participants’ willingness to engage with genetic testing and perceptions of its role in dietary advice.</div></div><div><h3>Methods</h3><div>81 professional footballers and 54 registered sports nutritionists completed a structured questionnaire. The survey explored openness towards genetic testing, willingness to share results, and views on ethical considerations, including talent identification.</div></div><div><h3>Results</h3><div>Footballers demonstrated greater openness towards genetic testing for personalised nutrition, with many indicating greater willingness if linked to career opportunities. Nutritionists were generally supportive but cautious, reflecting awareness of the current limitations in evidence. Both groups were less open to using genetic information for selection eligibility and talent scouting.</div></div><div><h3>Conclusions</h3><div>Findings highlight the need for greater education around genetic testing among both athletes and practitioners and emphasise the urgency of developing ethical guidelines to safeguard against misuse of genetic information in professional sport.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"14 1","pages":"Article 100385"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.peh.2025.100388
Harrison G. Pope , James I. Hudson , Gen Kanayama , Kristin N. Javaras , Marc J. Kaufman
Background
Impulsivity is associated with many forms of substance use, but few studies have assessed impulsivity in users of anabolic-androgenic steroids (AAS). Also, if an AAS-impulsivity association exists, it remains unclear whether impulsivity might be a cause of AAS use, an effect of AAS use, or a consequence of confounding variables. We sought to assess the magnitude and nature of this association.
Methods
We administered the Barratt Impulsiveness Scale (BIS) to 55 male AAS-using weightlifters (of whom 33 were currently taking AAS and 22 were off-drug at the time of evaluation) and 26 male weightlifters reporting no lifetime AAS use.
Results
AAS users reported significantly higher scores than non-users on the total BIS and its three subscales (especially the Non-Planning subscale). However, current AAS users differed little from off-drug users on these measures. Among AAS users, age of onset of use, lifetime duration of use, and recency of last use (among the off-drug users) showed no significant associations with BIS measures. Causal analysis indicated that impulsivity likely represents a causal factor for AAS use and that the association of impulsivity with AAS use cannot reasonably be explained by confounding variables.
Conclusions
Impulsivity, especially non-planning impulsivity, appears to contribute substantially to the development of AAS use, possibly because impulsive individuals are more prone to seek the reward of rapidly increased muscularity without concern for the potential long-term health consequences of AAS use. Clinicians encountering current or potential AAS users should be sensitive to the possible role of impulsivity.
{"title":"The role of impulsivity in anabolic-androgenic steroid use","authors":"Harrison G. Pope , James I. Hudson , Gen Kanayama , Kristin N. Javaras , Marc J. Kaufman","doi":"10.1016/j.peh.2025.100388","DOIUrl":"10.1016/j.peh.2025.100388","url":null,"abstract":"<div><h3>Background</h3><div>Impulsivity is associated with many forms of substance use, but few studies have assessed impulsivity in users of anabolic-androgenic steroids (AAS). Also, if an AAS-impulsivity association exists, it remains unclear whether impulsivity might be a cause of AAS use, an effect of AAS use, or a consequence of confounding variables. We sought to assess the magnitude and nature of this association.</div></div><div><h3>Methods</h3><div>We administered the Barratt Impulsiveness Scale (BIS) to 55 male AAS-using weightlifters (of whom 33 were currently taking AAS and 22 were off-drug at the time of evaluation) and 26 male weightlifters reporting no lifetime AAS use.</div></div><div><h3>Results</h3><div>AAS users reported significantly higher scores than non-users on the total BIS and its three subscales (especially the Non-Planning subscale). However, current AAS users differed little from off-drug users on these measures. Among AAS users, age of onset of use, lifetime duration of use, and recency of last use (among the off-drug users) showed no significant associations with BIS measures. Causal analysis indicated that impulsivity likely represents a causal factor for AAS use and that the association of impulsivity with AAS use cannot reasonably be explained by confounding variables.</div></div><div><h3>Conclusions</h3><div>Impulsivity, especially non-planning impulsivity, appears to contribute substantially to the development of AAS use, possibly because impulsive individuals are more prone to seek the reward of rapidly increased muscularity without concern for the potential long-term health consequences of AAS use. Clinicians encountering current or potential AAS users should be sensitive to the possible role of impulsivity.</div></div>","PeriodicalId":19886,"journal":{"name":"Performance enhancement and health","volume":"14 1","pages":"Article 100388"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号