Get big or die trying: social media is driving men’s use of steroids. Here’s how to mitigate the risks

Men have cared about their appearance throughout the centuries, and ideals of masculinity and “manliness” are ancient – with strong emphasis put on physical fitness and virility. In ancient Greece, the ideal male body was considered strong, symmetrical and athletic.

Now, with easier access to performance and image enhancing drugs (PIEDs) and their promotion on social media, ideals of masculinity and muscularity have taken on a whole new level.

PIEDs are a class of drugs that some people use to enhance physical appearance or athletic performance. They include anabolic-androgenic steroids, human growth hormone, and other medicines used “off-label” such as insulin.

Social media platforms such as Instagram and TikTok flood us with images and videos promoting steroid use as a “quick fix” to achieve big muscles.

Other influencers promote muscularity by “natural” means, but are then found out as liars who were using steroids all along. For those following, especially impressionable young men, the fallout is real. What once seemed like a natural achievement is exposed as chemically enhanced, pushing young men to wonder whether steroids are the only way to keep up.

A growing and harmful trend

Recent studies show that muscle-building behaviours such as steroid use are rising among young men. But why is this happening?

The answer lies partly in a societal obsession with hypermasculine ideals. Images of sculpted bodies, amplified by social media influencers with millions of followers, set unattainable standards of physical perfection. Fitness influencer content often normalises extreme body ideals. It is no longer just about fitness, it is about shaping an identity around an ideal male body.

It is not a harmless trend. The use of steroids carries significant health risks. For instance, beyond the well-known risks of heart disease and liver damage, steroid use can also lead to psychiatric issues such as mood disorders, aggression and depression.

Tragically, some fitness influencers and bodybuilders who use PIEDs have died unexpectedly. Australian fitness influencer Jaxon Tippet, who openly admitted to using steroids in the past, died at 30 from a heart attack – a known risk linked to anabolic steroids.

Towards ‘safer use’

Many fitness influencers actively engage in online fitness coaching, a booming industry.

This involves providing guidance on training, diet and supplementation. Some of this extends into drug coaching: providing guidance on how to use steroids and other enhancement drugs within a “safer use” model that’s informed by harm reduction approaches.

While these approaches don’t encourage drug use, they do offer strategies to reduce and mitigate known harms.

Some elite bodybuilders actively champion transparency over steroid use. In recent years, athletes and coaches have partnered with scholars on numerous podcasts to discuss prioritising health and health monitoring behaviours such as blood testing.

Regular blood testing is framed as a key strategy to mitigate risks associated with steroid use, often conducted at specific intervals.

However, the absence of formal regulation means not all advice is created equal. Some influencers may still encourage practices that are dangerous and potentially life-threatening.

While these trends are concerning, the solution doesn’t lie in finger-pointing at influencers or shaming young men for their choices. Instead, we advocate for a more positive, educational approach.

A better way forward

Asking people to “just say no” to drug use has never worked. Instead, we must shift the narrative by educating, supporting and collaborating with the people who drive the trend – PIED consumers.

By partnering with trusted community figures and influencers, we can spread awareness about the dangers of steroid use while offering accurate, evidence-based information about health and wellbeing.

An example of this approach is Vigorous Steve, a well-known figure in the fitness world. He has used his platform to share important research on the harms of steroids.

Steve’s work on social media, with millions of views, is a model for how harm reduction education can reach a large, engaged audience, help normalise safer use discussions and expand access to information.

With this in mind, the Queensland Injectors Voice for Advocacy and Action (QuIVAA) has recently launched the Steroid QNECT program (one of us, Tim Piatkowski, is the vice president of QuIVAA). The program provides support to people using steroids, offering peer education and resources via online platforms.

Since its inception in January this year, the program has already engaged with and provided harm reduction information to hundreds of Australians who use steroids, helping to bridge critical gaps in education.

As the muscle building trend continues, peers, policymakers, researchers and health professionals across Australia must collaborate to provide accurate, balanced education about the risks of steroids – especially for young men.