The most common desired outcome for the use of Image and Performance Enhancing drugs is that of cosmetic improvement, with performance enhancing properties being a lesser motivation for use. The 2016 national survey into IPEDs found 56% of surveyed users ranked its effects on body image the most important motivation(31).
Body dysmorphia or body dysmorphic disorder (BDD) was first characterised more than 100 years ago. Still poorly understood, it is defined in the DSM-V as a preoccupation with one or more perceived defects or flaws in physical appearance leading to distress(34). There is a subsection of BDD that refers to muscle dysmorphia: preoccupation that the physical build is not muscular enough.
A 2018 study showed 88% of those aged between 18-29 are active on social networking sites such as Instagram and Facebook(35). Users of these sites post content that has been heavily self-scrutinised, meaning viewers only see the best presentations of individuals. Regular viewing of this content has been shown to cultivate body image dissatisfaction and lead to increased rates of body dysmorphic disorders(36).
The association between the world of fashion and body dysmorphia is well known. A similar negative relationship exists in the fitness world where gym-goers have high levels of body dysmorphia connected partly to social-media usage. One study described the culture of constant self-improvement and social media competition with peers as an explanation for the high levels of BDD in gym-goers(37).
IPEDs are seen in many cases as an easily accessible way to cope with BDD. By allowing rapid muscle tissue hypertrophy and stimulating fat metabolism, they make the ‘perfect body’ perpetuated by social media more easily achievable.