How Widespread Is Steroid Use?
Takeaway Points:
Steroids use is widespread, but certainly not total.
Steroid use carries significant health risks.
Different pressures will lead to different levels of adoption - relevance to your sport, legality, and economic incentives all have an impact on how willing people are to use steroids, and how likely they are to be willing to discuss their usage.
Still, this should not impact your personal decision-making too much - regardless of whether or not someone else is using, this doesn’t impact what you need to do to make progress in your own training.
(Disclaimer - This article is largely based on personal opinion as a lifter and coach of 17+ years of experience. This should not ever be construed as an endorsement of steroid use.)
Steroid use in the fitness industry and in sports is, unfortunately, very widespread.
Recently, a client asked me to guess how widespread it was, and I had a chance to think about it for the first time in quite a while. During the discussion, here are some thoughts that came to mind, based on my experience as a coach and my engagement with the fitness industry over 17+ years.
It’s definitely widespread
Behind closed doors, lots of folks are willing to be more honest about steroid use. I’ve heard a lot of folks talk frankly about it, and many people (even those without world-class performance or physiques) are willing to take at least something at some point in their lives - even when there’s not necessarily money or fame on the line.
In particular, in recent years TRT (testosterone replacement therapy) has become more popular. This is a semi-popular legal alternative in which, if you find that your testosterone levels are a bit low, you can potentially get a subscription from a doctor to get a replacement level of testosterone. This is effectively equivalent to using a low dose of steroids as a way to feel better and perform a bit better in the gym, while generally avoiding the associated health risks with megadosing steroids for performance. However, this is still essentially steroid use, even if in a very minimal form.
The relative use of PED’s also has a lot to do with what’s on the line. When it comes down to money and fame, people are much more willing to take PED’s to compete at higher levels of sport, especially if they perceive that others are probably doing it as well, and they need to engage in PED use in order to be competitive.
It’s not complete
That said, I’d hesitate to argue that PED usage is complete and total at the highest level of sport. In discussion with folks behind the scenes, it’s also true that some people will honestly admit that they don’t do steroids, even when others might think that they do. The reality is that in some cases, there are just genuine genetic monsters who have such good genetics, that they can compete at world-class (or near-world-class) levels of sport without needing to take PED’s. Some people truly are just incredibly gifted.
Steroid use depends highly on what you get out of it
A while back, Greg Nuckols had a great series of articles on the topic, where he analyzed the data on steroid use and found that while steroids can have a huge impact on how much muscle you build (up to 2x the amount of muscle built compared to a nonuser), but a smaller impact on how much strength you can build (only about 10% when you factor in the weight changes associated with building so much muscle). We have studies that show that people who do steroids but NO lifting initially gain more muscle than people who don’t do steroids, but lift (though admittedly not nearly as much as people who both lift and use steroids).
The reality is that steroids are really great at building muscle mass, but that muscle mass (on its own) is not necessarily a huge advantage, depending on the sport.
For example, in bodybuilding, where more muscle mass is (almost) the entire goal of the sport, this makes a huge difference. We can look at the massive differences in physiques between traditional and natural bodybuilding, and get a sense of how big of a difference.
But when it comes to something like powerlifting, where you’re only about 10% more competitive, you can imagine that a lot more natty lifters might sneak their way into something close to a world-record performance on the strength of their genetics and hard work alone.
And then it comes to sports with little to no emphasis on muscle or strength - for example, marathon running - and you can imagine that the difference is even smaller. Of course, you can also understand that these sports have their own form of banned performance enhancers (blood doping, for example) that are more helpful for endurance-based activities.
Likewise, you can imagine that prevalence of steroid usage would vary widely sport by sport, based on what goals people train for and what kinds of athletic qualities they need to succeed.
Health effects may be overblown, but are very real
A common viewpoint I saw a lot in fitness forums when I was younger was that steroids were much safer and more effective than fearmongering tv specials tended to make people think.
I would tend to agree with this in a general sense, but I would also push back on the idea that steroid usage is not with serious and significant short and long term risks.
Heavy usage can cause heart and kidney issues, and is associated with changes in mood, libido, and long term hormone balances. Some of these issues can be offset by intelligent usage, but other issues absolutely cannot - the number of lifters who have heart attacks and die nearly instantly at a young age is not something which can be completely overlooked. For every bodybuilder who safely uses steroids for a long time, there are probably just as many who ended up with serious long term health effects or death as a result.
It’s also important to understand that some lifters are on MASSIVE doses - many times what we see in the literature - simply because it would be legally and ethically irresponsible to even consider dosing someone up that high in a study. As a result, past a certain point, steroid usage is truly a wild west - no one really knows what the effects will be unless they try it.
For these reasons above, I’ve always chosen to be lifetime natural - short term performance is ultimately not worth ANY added health risk, in my perspective - I got into exercising as a way to extend my life, not shorten it. Performance is a fun effect of my training and I always believe in putting yourself 100% into any pursuit you follow, but I would not extend that belief to the pursuit of performance at all costs.
Legality and stigma affect willingness to discuss - and how the field has changed in more recent years
PED usage for sport is generally illegal, and this has an obvious effect on how willing people are to be open about their usage. Obviously, people will generally be less willing to talk about steroid use publicly if this could have a negative impact on your life or career.
I think that this has also changed somewhat in recent years. Some users are more willing and able to be open and honest about their usage and the challenges that it presents.
Personally, I think that this has something to do with the rise of social media. In the past, there were often fewer opportunities for people to make a living as a bodybuilder or powerlifter - these were very much sports that you had to do alongside a day job, because there was not significant money except at the very highest levels of sport. The only real way to monetize this as a career, would be to become a sponsored athlete from a supplement company.
Supplement companies have a vested interest in presenting your results as not coming from steroids, but instead from their supplements. I remember vividly how even just 15-20 years ago, fitness magazines were filled end-to-end with adverts of Mr. Olympia level bodybuilders claiming that the latest protein powder was the reason for their physiques.
But that’s changed, quite a bit since the rise of social media. Now, bodybuilders and powerlifters with exceptional physiques can develop independent followings online, and more easily pivot this into selling their own products or otherwise developing an independent source of income. As a result, I feel like this has contributed to the willingness to share about PED usage - so long as an influencer is open and honest about it, followers will often respect this honesty. Of course, this can also backfire if you’re NOT honest about it, as events like the Liver King’s recent controversy have shown.
How many people are actually using?
A common gut reaction is for people to spend a lot of time speculating on who is and isn’t using, the classic “natty or not”. This tends to lead to this obsession with who is and isn’t using, and the classic “everyone who’s doing worse than me sucks, everyone who’s doing better than me is on steroids” mentality.
This reaction is, I think, misguided.
Ultimately, I think that this leads to a lot of wasted time. In most cases, you cannot actually predict who’s using and who isn’t unless they’re willing to talk about it honestly, and many people aren’t.
There are plenty of people with terrible physiques who are using, and plenty of people with incredible physiques who aren’t. Certainly, at high levels we can assume that many or most are using, but that doesn’t say anything about individual lifters in individual sports, and it certainly doesn’t say much about lower level participants in any given sport.
For the sake of sanity, it is safest not to get too obsessed with the drama of it, and just accept that you don’t necessarily have control over other people’s physiques and performances, but you can certainly continue to improve and iterate on your own processes and continue to make gains over time, regardless of what results another person will get on steroids. Ultimately, whether or not someone else is using, does not change what YOU need to do to see gains.
About Adam Fisher
Adam is an experienced fitness coach and blogger who's been blogging and coaching since 2012, and lifting since 2006. He's written for numerous major health publications, including Personal Trainer Development Center, T-Nation, Bodybuilding.com, Fitocracy, and Juggernaut Training Systems.
During that time he has coached hundreds of individuals of all levels of fitness, including competitive powerlifters and older exercisers regaining the strength to walk up a flight of stairs. His own training revolves around bodybuilding and powerlifting, in which he’s competed.
Adam writes about fitness, health, science, philosophy, personal finance, self-improvement, productivity, the good life, and everything else that interests him. When he's not writing or lifting, he's usually hanging out with his cats or feeding his video game addiction.
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