Becoming and unbecoming a fitness doper

Anders Schmidt Vinther
Department of Public Health, Aarhus University.

Jesper Andreasson & Thomas Johansson
Fitness Doping: Trajectories, Gender, Bodies and Health
217 pages, paperback.
London: Palgrave Macmillan 2020
ISBN 978-3-030-22107-2

Being male and lifting weights in a gym or fitness centre are strong predictors of doping. In fact, male gym members are almost 8 times more likely to use illicit performance and image-enhancing drugs (PIEDs) than their female counterparts, in particular anabolic androgenic steroids (AAS). This is one of the most consistent findings within the doping research literature. Researchers have identified numerous other demographic, psychosocial, and behavioural variables in an attempt to understand the aetiology of PIED use. In addition, various psychological models have been developed to explain this behaviour. However, because of their quantitative nature, such studies do not capture the lived experience and personal stories of PIED users. These aspects have been explored in a number of qualitative investigations since Alan Klein published his landmark ethnographic study of Californian bodybuilders in 1993. This is also what the Swedish scholars Jesper Andreasson and Thomas Johansson set out to do in their most recent book, Fitness Doping: Trajectories, Gender, Bodies and Health. As indicated by the subtitle, the book also aims to explore how fitness dopers understand, negotiate, and sometimes challenge established gender norms, and how they understand and manage the health risks associated with their drug use. They present five research questions which illustrate the fairly broad, and perhaps too broad, scope of their study:

      1. In what ways can different fitness doping trajectories and the processes of becoming and unbecoming a fitness doper be understood?
      2. In what ways are the processes and cultural patterns of socialization and learning regarding fitness doping affected by demographic variables, such as gender, lifestyle, and age?
      3. In what ways is fitness doping discussed, negotiated, and legitimized/normalized in the context of online communication and communities?
      4. What kinds of perspectives on health, physical training, the body, and lifestyles do fitness dopers adopt, and how are drug use practices related to these perspectives?
      5. What does a changing fitness doping demography entail as regards future challenges and implications in the research and in relation to existing anti-doping work and prevention strategies? (p. 7).

To address these aims and research questions, Andreasson and Johansson draw upon an extensive material collected through multiple sources, including (1) qualitative interviews with both male and female PIED users and ex-users from Sweden, (2) field observations from training sessions in the gym and conversations in the locker room, and (3) doping-related inquiries posted by members of an online discussion board.

Andreasson and Johansson also seem to be well aware that individual stories can help us understand the more universal patterns and mechanisms of social life.

The book consists of 4 parts divided into 10 chapters. Part 1 serves to introduce the study and place the phenomenon of fitness doping in a historical and cultural context. After describing the study aims, research questions, terminological considerations, and their methodological approach in chapter 1, Andreasson and Johansson move on to trace the historical origin and development of the modern bodybuilding and fitness movement in chapter 2. As they clearly demonstrate, this history is inextricably linked with the history of PIED use. Here they also prepare the reader for what is to come by discussing women’s entry into the world of bodybuilding and the way these hypermuscular females were, and still are, regarded as a threat to the dominating (and traditional) gender order. Chapter 3 presents a comparative analysis of the national and local policies and interventions that have been developed in the US and Sweden to address fitness doping, including how the different approaches taken in these countries are experienced in PIED-using communities. Whilst the analysis provides key insights into Swedish doping legislation, policy making processes, and prevention efforts, this section appears thematically a bit out of place given that the reader has not yet been introduced to participants’ perspectives on their own PIED use.

In the second and in my opinion most interesting part, Andreasson and Johansson describe the socialisation processes and cultural influences through which individuals gradually transition into, and away from, PIED use. To illustrate the variation and complexity in individual fitness doping trajectories, they begin by presenting four narratives or ‘images’ of current and previous PIED users who reflect on their personal experiences with PIEDs and their motivations for use (chapter 4). Although it works well, this approach is not new. It has recently been used by Christiansen (2020) to describe the diversity in rationales for using AAS amongst Danish gym users (who also presents exactly four narratives). Andreasson and Johansson also seem to be well aware that individual stories can help us understand the more universal patterns and mechanisms of social life. In the next chapter (5) they therefore identify common themes related to the initiation and cessation of PIED use. With its focus on general features of PIEDs use (e.g., the impact of the gym environment and the muscular ideal), this chapter also has much in common with the work of Christiansen (2020). However, instead of modelling these features in a typology, Andreasson and Johansson analyse them through the lens of various sociological concepts. This works well. For example, they use the concept of the ideology of the dissatisfied to describe the endless pursuit of the perfect body amongst PIED users and the emotional consequences of this endeavour. As noted by one of their female informants:

The more I exercise, the more I become fixated with my looks. In the beginning I was quite satisfied with my body. But now I just find flaws and defects everywhere (p. 98).

Part 2 ends with an examination of how PIED use is discussed in the Swedish online community Flashback, and the social dynamics of these conversations (chapter 6). The data presented here have been collected through online ethnography (known as ‘netnography’), which makes chapter 6 one of the more original parts of the book. Netnography is interesting from a methodological perspective because this method circumvents the classical issue within ethnography of potentially influencing what one’s informants report and how they behave when studying cultures in situ.

An explicit goal of the book is to ‘problematize and possibly challenge the gender politics that have traditionally been attached to fitness doping’ (p. 6). Andreasson and Johansson has dedicated the third part of the book to this undertaking although it is unclear exactly what they mean by the term ‘gender politics’. This is also where they move away from a descriptive, analytic approach towards a more normative, opinionated approach. They discuss both how gender and notions of masculinity and manhood is expressed by male PIED users (chapter 7), and how female PIED users experience their role as ‘gender benders’ in these highly male-dominated environments (chapter 8). Although these chapters contain plenty of insightful observations and analytic points, this is also where some of the book’s arguments become less convincing. For instance when they attempt to explain the well-established sex difference in drug preferences amongst PIED users. Using a variety of cultural studies and feministic writings as their theoretical point of departure, they argue that gender norms are social constructions:

… the notions of masculinity and femininity, indeed the heterosexual order, are social and cultural constructions […] Transvestites, female bodybuilders, bisexuals, and other positions viewed as “deviant” in the public discourse reveal the extent to which gender is a game, an act, and how everything is based on a well-developed dramaturgy (p. 165).

Following this social constructivist line of thinking, they further argue that:

Due to the historical association between muscles and masculinity, women are also more likely to use supplements considered less “masculine” […] as opposed to muscle-enhancing supplements such as steroids (p. 164).

It goes without saying that culture matters, and the authors do a good job in disentangling how cultural and societal forces affect individual perceptions of the ideal body. But if gender and masculinity, as they contend, are pure social constructions, there are a number of observations that are difficult to explain scientifically. For instance that perceptions of the ideal body size and shape are relatively uniform across cultures when socioeconomic status is held constant, and that when it comes to male bodies, women generally prefer an athletic body. Andreasson and Johansson seem to overlook (or chose to ignore) the role that evolution has played in shaping our mating preferences and beauty standards mainly through sexual selection, and the implications this has for understanding male (and female) PIED use, as recently shown by Christiansen (2020).

Andreasson and Johansson seem to overlook (or chose to ignore) the role that evolution has played in shaping our mating preferences and beauty standards mainly through sexual selection, and the implications this has for understanding male (and female) PIED use, as recently shown by Christiansen (2020).

Thus, to claim that culture alone can explain the relationship between muscles and masculinity and the fact that AAS are almost exclusively used by male PIED users is to put blind faith in their cultural sociological approach. Apparently, they don’t feel the need to seek other potential explanations, such as those provided by evolutionary psychology, and critically appraise their plausibility which, as famously noted by Karl Popper, is the hallmark of scientific inquiry. The irony is that they later on, in an attempt to embrace complexity, emphasise how: ‘… fitness doping is not a matter of either-or, but rather both-and’ (p. 194).

In the final part, the authors conclude the study by summarising the themes addressed throughout the book. However, for some reason they leave the research question concerning the implications of their findings for anti-doping work and prevention strategies (RQ5) largely unanswered. All they have to say on this is that:

In order for anti-doping work to continue, it will probably be necessary to elaborate new arguments in relation to (public) health, and to defend, for example, the intrinsic values of sport and the ethical ideas of natural bodybuilding. (p. 193)

With such stepmotherly treatment of a pivotal question, one must infer that either the study do not really have any implications for anti-doping and prevention or the authors did not spend much time reflecting on this question. In any case, readers who look for advice on how to address PIED use in interventions will be very disappointed. Like many other scholars, Andreasson and Johansson also cannot resist the temptation to claim that fitness doping is a normalised and growing phenomenon (p. 190) despite that general population studies consistently report prevalence estimates in the range between and 1 and 2%. Moreover, there is no evidence from longitudinal studies to suggest that these numbers have increased over time, or is currently on the rise. For a book that has the ambition to be research-based, postulates like these are a shame.

Since many of the key points presented in Fitness Doping can be found elsewhere, including in the authors’ own writings, chances are that readers who are familiar with previous research on this topic will regard the book as old wine in new bottles. To be fair, it does contain novel aspects such as those presented in the policy analysis and in the ‘netnographic’ investigation. Unfortunately, these chapters are in my opinion overshadowed by sections that largely describe what is already known. For that reason I believe the book will serve best as an introduction to the fitness doping phenomenon for people with little or no prior knowledge on the topic

Copyright © Anders Schmidt Vinther 2021


Christiansen, A. V. (2020). Gym culture, identity, and performance-enhancing drugs: Tracing a typology of steroid use. New York: Routledge.
Klein, A. M. (1993). Little big men: Bodybuilding, subculture and gender construction. Albany: SUNY Press.
Ntoumanis, N., Ng, J. Y. Y., Barkoukis, V., & Backhouse, S. (2014). Personal and Psychosocial Predictors of Doping Use in Physical Activity Settings: A Meta-Analysis. Sports Medicine, 44(11), 1603–1624.
Popper, K. (1973). Kritisk Rationalisme: Udvalgte essays om videnskab og samfund. København: Nyt Nordisk Forlag Arnold Busck.
Vinther, A. S., & Christiansen, A. V. (2017, April). Mythbusting: There is no steroid “epidemic.” ScienceNordic. Retrieved from–culture/mythbusting-there-is-no-steroid-epidemic/1443875
Print Friendly, PDF & Email


Please enter your comment!
Please enter your name here

This site uses Akismet to reduce spam. Learn how your comment data is processed.