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As for the features of the relationship between AAS use and somatoform and/or eating disorders, Pope and Katz [54] showed that 18.2% of 88 male weightlifters who abused AASs reported a history of muscle dysmorphia, compared to none of the 68 male weightlifters who did not use AASs (controls). Blouin and Goldfield [105] examined the relationship between body image disturbances, eating attitudes, and AAS use in 43 male bodybuilders vs. 48 runners and 48 martial artists of the same sex, all recruited from fitness centers. Bodybuilders showed significantly greater body dissatisfaction, with a high tendency to bulk and thinness, and increased inclinations towards bulimia than the other two groups. Additionally, they reported higher perfectionism and ineffectiveness, as well as lower self-esteem. They also consumed more AASs and had freer attitudes towards AAS use. The main reason for taking AASs, according to AAS users, was physical improvement: AAS users reported a stronger drive to put on muscle mass in the form of bulk, more maturity fears, and greater tendencies towards bulimia than AAS nonusers. Thus, male bodybuilders seem to be at risk for body image disturbances and the associated psychopathological characteristics that have been commonly observed in patients with eating disorders. These psycho-pathological characteristics also appear to predict AAS use in this group of men.




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