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Anything but androgens: How image and performance enhancing drug consumers manage body composition and health through off-label use of medicines

Timothy Piatkowski Orcid Logo, Kim Akrigg, Luke Cox Orcid Logo, Adam Bradshaw, Steve Vigorous

Performance Enhancement & Health, Volume: 13, Issue: 2, Start page: 100329

Swansea University Author: Luke Cox Orcid Logo

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DOI (Published version): 10.1016/j.peh.2025.100329

Abstract

IntroductionThis exploratory study investigates the diverse behavioural practices surrounding the use of non-androgenic image and performance enhancing drugs (IPEDs) among individuals who seek to optimise their body composition. Participants engaged in stacking various substances, often leading to p...

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Published in: Performance Enhancement & Health
ISSN: 2211-2669
Published: Elsevier BV 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa70010
first_indexed 2025-07-21T14:24:33Z
last_indexed 2025-09-03T05:19:12Z
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spelling 2025-09-02T16:57:55.5913335 v2 70010 2025-07-21 Anything but androgens: How image and performance enhancing drug consumers manage body composition and health through off-label use of medicines 9811ac84cad867903c385bf7086dfd2d 0000-0001-7625-4603 Luke Cox Luke Cox true false 2025-07-21 EAAS IntroductionThis exploratory study investigates the diverse behavioural practices surrounding the use of non-androgenic image and performance enhancing drugs (IPEDs) among individuals who seek to optimise their body composition. Participants engaged in stacking various substances, often leading to polypharmacy, which complicates the (im)balance between achieving desired physical attributes and maintaining health.MethodsSemi-structured interviews were conducted with 14 participants, predominantly men (n = 13) and one woman, aged 25–45 years (M = 33.34, SD = 6.27). The interviews explored their experiences with non-androgenic substances such as human growth hormone (HGH), insulin, and metformin, focusing on the strategic integration of these drugs into their routines and their motivations for use. Iterative categorisation was employed to identify key themes, including risk management, perceptions of efficacy, and the role of peer networks in shaping usage practices.ResultsThe research highlights how participants employed these non-androgenic substances to manage calorie intake and enhance insulin sensitivity. The cohort reported that this facilitated a more controlled approach to body composition while mitigating the physiological stress associated with high androgen use.DiscussionThe study highlights ethnopharmacology's significance within the IPED community, showing how people navigate drug regimens based on experiential knowledge. While participants noted potential benefits, they also expressed challenges relating to medication access, underscoring the need for improved availability through legitimate channels. This research ultimately advocates for and reinforces the need to recognise people who use IPEDs as knowledgeable agents in health management, informing more effective harm reduction strategies tailored to the complexities of IPED use. Journal Article Performance Enhancement &amp; Health 13 2 100329 Elsevier BV 2211-2669 Anabolic-androgenic steroids; Harm reduction; Human growth hormone; Insulin; Weight loss 1 6 2025 2025-06-01 10.1016/j.peh.2025.100329 COLLEGE NANME Engineering and Applied Sciences School COLLEGE CODE EAAS Swansea University Another institution paid the OA fee None to declare. 2025-09-02T16:57:55.5913335 2025-07-21T15:21:19.4198841 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Timothy Piatkowski 0000-0002-6177-0266 1 Kim Akrigg 2 Luke Cox 0000-0001-7625-4603 3 Adam Bradshaw 4 Steve Vigorous 5 70010__34812__fe3a69a434c84b9ca829f017fc36ab1a.pdf 70010.pdf 2025-07-21T15:24:27.1346883 Output 485271 application/pdf Version of Record true © 2025 The Author(s). This is an open access article under the CC BY license. true eng http://creativecommons.org/licenses/by/4.0/
title Anything but androgens: How image and performance enhancing drug consumers manage body composition and health through off-label use of medicines
spellingShingle Anything but androgens: How image and performance enhancing drug consumers manage body composition and health through off-label use of medicines
Luke Cox
title_short Anything but androgens: How image and performance enhancing drug consumers manage body composition and health through off-label use of medicines
title_full Anything but androgens: How image and performance enhancing drug consumers manage body composition and health through off-label use of medicines
title_fullStr Anything but androgens: How image and performance enhancing drug consumers manage body composition and health through off-label use of medicines
title_full_unstemmed Anything but androgens: How image and performance enhancing drug consumers manage body composition and health through off-label use of medicines
title_sort Anything but androgens: How image and performance enhancing drug consumers manage body composition and health through off-label use of medicines
author_id_str_mv 9811ac84cad867903c385bf7086dfd2d
author_id_fullname_str_mv 9811ac84cad867903c385bf7086dfd2d_***_Luke Cox
author Luke Cox
author2 Timothy Piatkowski
Kim Akrigg
Luke Cox
Adam Bradshaw
Steve Vigorous
format Journal article
container_title Performance Enhancement &amp; Health
container_volume 13
container_issue 2
container_start_page 100329
publishDate 2025
institution Swansea University
issn 2211-2669
doi_str_mv 10.1016/j.peh.2025.100329
publisher Elsevier BV
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
document_store_str 1
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description IntroductionThis exploratory study investigates the diverse behavioural practices surrounding the use of non-androgenic image and performance enhancing drugs (IPEDs) among individuals who seek to optimise their body composition. Participants engaged in stacking various substances, often leading to polypharmacy, which complicates the (im)balance between achieving desired physical attributes and maintaining health.MethodsSemi-structured interviews were conducted with 14 participants, predominantly men (n = 13) and one woman, aged 25–45 years (M = 33.34, SD = 6.27). The interviews explored their experiences with non-androgenic substances such as human growth hormone (HGH), insulin, and metformin, focusing on the strategic integration of these drugs into their routines and their motivations for use. Iterative categorisation was employed to identify key themes, including risk management, perceptions of efficacy, and the role of peer networks in shaping usage practices.ResultsThe research highlights how participants employed these non-androgenic substances to manage calorie intake and enhance insulin sensitivity. The cohort reported that this facilitated a more controlled approach to body composition while mitigating the physiological stress associated with high androgen use.DiscussionThe study highlights ethnopharmacology's significance within the IPED community, showing how people navigate drug regimens based on experiential knowledge. While participants noted potential benefits, they also expressed challenges relating to medication access, underscoring the need for improved availability through legitimate channels. This research ultimately advocates for and reinforces the need to recognise people who use IPEDs as knowledgeable agents in health management, informing more effective harm reduction strategies tailored to the complexities of IPED use.
published_date 2025-06-01T05:31:42Z
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