Performing well and looking good – on drugs

Andrew J. Bloodworth
Swansea University

This is an excellent book. It provides new and valuable insights into image and performance enhancing drug use. As the introduction indicates, the book strives to extend beyond common dualities that we often see in doping research. For example, divides are often made between sport doping and fitness doping. Even elite athletes, however, are not completely sealed off from society, and encountering fitness doping or those engaged in doping for image purposes, is a distinct possibility. Overall, I found the book to be informative, expanding my knowledge of the types of Image and Performance Enhancing Drug (IPED) use that occurs and the contexts that it occurs in. It also helped me to develop awareness of how knowledge of IPEDs is acquired, via online forums for example. And how we might view the transfer of knowledge critically, for example where males tend to dominate the conversation about doping. This book has certainly shifted my view on how best to undertake anti-doping research, and I would encourage all those with an interest in the area to read it. I will now offer a brief chapter by chapter review of the book. I exclude a chapter that I contributed to (Chapter 9, The WADA Code, Recreational Athletes and Ethical Concerns), alongside my colleagues Luke Cox and Mike McNamee.

The first chapter focuses on anti-doping policy and begins with Dasgputa’s critique of the World Anti-Doping Agency’s failure to properly attend to athlete rights. Dasgupta cites a lack of athlete representation or input into anti-doping policy, and the dominance of sports administrators in making decisions. While Dasgupta does cite the Athletes Anti-Doping Rights Act, the chapter concludes by raising a number of issues that athletes have faced with anti-doping policy. The case of Shayna Jack is used to illustrate the difficult position that non-deliberate dopers find themselves in, often facing lengthy bans.

Indeed, the book has encouraged me to reflect upon my own work and consider how at times it has been affected by a narrow way of construing doping behaviour.

In the second chapter Helen Lenskyj is critical of the sporting resolution body the Court of Arbitration for Sport (CAS). She begins by making the observation that CAS arbitrate more doping cases than disputes of any other form. She notes that CAS does not work on the basis of precedent, and offers the illuminating insight that while athletes often come to this process with no awareness of it, the parties who repeatedly come to CAS, FIFA, the IOC and WADA have an advantage in that they know the process well. Indeed, WADA is described as having a high success rate in cases it brings to CAS. The chapter cites the costs of taking cases to CAS for an athlete, citing Shayna Jack’s personally costly process to challenge the decision against her, and finishes with highlighting a consistency problem with case decisions, demonstrated by the discussion of certain cases that have come before CAS.

Gatterer and Blank explore anti-doping education in their chapter, citing obstacles to values-based education, the form of anti-doping education often recommended. Do people know what values-based education is? And can they afford to fund it? They indicate the financial investment required, and the need for properly trained educators. This is indeed an important point, in a study that we conducted on anti-doping education in Kenya, it was found the education was not always delivered in the first language of the recipients (Juma, Woolf and Bloodworth 2022).

In the second section of the book, exploring health issues and risks associated with IPED use, McVeigh et al. begin by asking whether the use of anabolic androgenic steroids is best categorised as a public health issue. They eventually conclude that it is – but cite a limited evidence base on effective responses to this form of drug use. Dunn follows with a systematic review of the experiences of healthcare professionals with IPED users, and the experiences of IPED consumers with healthcare professionals. He indicates a continued reluctance of users to talk to GPs, with online communities more trusted. This avenue is explored further later in the book. Dunn indicates that quantitative studies dominate this sphere of research, and that this leaves a certain sort of question unanswered. So there is certainly scope for further research here.

In the next chapter Mair Underwood asks if trenbolone (a steroid) does such harm, why do people use it? The aim of the chapter is to examine the lived experience of risky behaviours such as trenbolone use. Trenbolone has been described as the ‘God of All Steroids’ the chapter states, but also appears to come with significant cost, including psychological side effects. The chapter concludes by saying we need more research into how bodybuilders model risk.

Next Fincoeur and Rullo examine steroid use among inmates in Belgian prisons. With the body providing the individual with some sort of capital in prison, the authors detail how prisoners are reluctant to openly discuss their steroid use.   The authors conclude that we need more research into the side effects of AAS use for prisoners.

Turnock and Townshend examine digital fitness forums, and how they effect use of IPEDs, access and harm reduction behaviours. The chapter details how forums can act effectively as a means of harm reducing, there is after all a lot of expertise available via this means. Processes where contents of drugs are checked, reducing poor quality product on the market, are described.  Advice from members of the forum not to start drug use, or to minimise dosage are described. But the forum is also described as a place in which unevidenced or contradictory claims may be made. We also see the long-held idea that doctors are not reliable in this sphere, and that it is better to keep IPED use from them.

In the final part of the book gender and doping is examined. In a much under-researched area these chapters offer insights into the experiences of women around drug use and bodybuilding. Henning and Andreasson document cultural manspreading in this arena. They have documented how in online forums, women’s attempts to discuss their bodies, drug use and experiences often came to be dominated by men.  They advocate for policies that protect spaces for women to freely discuss these issues, and allow the development of a women centred ethno-pharmacological subculture.

McLean goes on to document her own experiences in the bodybuilding domain, describing being left with a disordered attitude toward eating, and significantly affected body image. McLean also describes some striking male judgements of female bodybuilders, mainly based on sex appeal. The knowledge of male coaches is also described as being tied to masculinity and sometimes questionable or harmful.

In the final chapter Teetzel details a lack of thought toward gender in the creation of anti-doping policies, and interestingly states that gender specific drug education is warranted. She describes female doping as a threat to the natural order and details the criticism of women’s bodies that do not conform to expectations.

Doping in Sport and Fitness is a book that challenges commonly held perceptions regarding doping, and dualities that have appeared regularly in anti-doping research. Indeed, the book has encouraged me to reflect upon my own work and consider how at times it has been affected by a narrow way of construing doping behaviour. In its four parts, Anti-Doping Policy, Health and Risks, Doping Arenas and Communities and Gendering Doping, the book covers a great deal of ground. It also offers interesting new ways to conceive of IPED use. From my own perspective the second half of the book in particular encouraged me to reflect on aspects of IPED use I had previously given little thought. Overall, I found this an informative and interesting read, and would highly recommend it to those with an interest in this field.

Copyright © Andrew J. Bloodworth 2024

Reference

Juma, Byron O., Jules Woolf, and Andrew Bloodworth. “The challenges of anti-doping education implementation in Kenya: perspectives from athletes and anti-doping educators.” Performance Enhancement & Health 10.3 (2022): 100228.