Body Image and Drug Use
All chapters in this book focus on aspects of body image. In recent years, there has been a noticeable increase in academic and popular interest in psychological factors related to body image and appearance concern (Cash 2012). Researchers have also become increasingly interested in peopleās experiences of embodiment and drug use, and the impact of body image and appearance on drug use (e.g. Hildebrandt and Alfano 2012; Grogan et al. 2009; McCabe and Ricciardelli 2003; Yager and OāDea 2014). The significant rise in the use of drugs designed to make men and women more muscular and thinner has inspired researchers to try to understand motivations behind these behaviours, and more general experiences of embodiment that may be impacted by drug use.
The earliest published definition of body image was, āThe picture of our own body which we form in our mind, that is to say, the way in which the body appears to ourselvesā (Schilder 1950, p. 11). Since 1950, researchers have taken body image to mean many different things, and have moved beyond Schilderās focus on perceptual factors to consider a wide range of issues such as weight satisfaction, size perception accuracy, appearance satisfaction, body satisfaction, appearance evaluation, appearance orientation, body concern, body esteem, body schema, and body percept (Thompson 2012). In an attempt to incorporate the key elements, Grogan (2008) used the definition, āA personās perceptions, thoughts, and feelings about his or her bodyā (p. 3). This definition can be taken to include psychological concepts such as perception and attitudes towards the body as well as experiences of embodiment. Perceptual body image is usually measured by investigating accuracy of body size estimation relative to actual size. Attitudinal body image is assessed using measures of four components: global subjective satisfaction (evaluation of the body), affect (feelings associated with the body), cognitions (investment in appearance, beliefs about the body), and behaviours (such as avoidance of situations where the body will be exposed). Psychological measures of body image assess one or more of these components (Thompson 2012).
To understand body image fully, it needs to be investigated from a range of psychological viewpoints; we need to look not only at individualsā experiences in relation to their bodies, but also at the cultural settings in which people live and the ways that they make sense of how their bodies look within different kinds of social contexts. This text will present work on links between drug use and body image from a number of perspectives, to try to understand both individual and societal factors relating to body image and drug use. Recent evidence has shown that males and females of all ages use various drugs to try to change the looks of their bodies, usually to find ways to be thinner for women and girls, and slender and muscular for men and boys. Drug use may also be impacted by other kinds of appearance concerns, such as the desire to look young and wrinkle-free (Grogan et al. 2010a), and these issues will also be addressed later in this text.
Drugs to Reduce Weight
In spite of cultural awareness of the need to reduce objectification of womenās bodies, there remains significant sociocultural pressure on women to be slender and toned (Frith 2012; Tiggemann and Andrew 2012), and many women of all ages are dissatisfied with aspects of their bodies and most want to be slimmer (Grogan et al. 2013; Tiggemann and McCourt 2013). Men are also under some cultural pressure to be slender as well as muscular, and although most research on menās body image has focused on the desire for larger and more defined muscles (Fawkner 2012; Hale and Smith 2012; McCreary 2012), there is good evidence that most men and adolescent boys desire to look lean as well as muscular (Grogan and Richards 2002; Ricciardelli 2012). Body builders are also increasingly seeking drugs that will reduce body fat in addition to those that will build muscle (Hall et al. 2014; Magkos and Kavouras 2004).
The use of diet pills is a major health issue, linked with anxiety, restlessness, and insomnia, with high and sustained use being linked to increased risk of myocardial infarction and stroke (Calfee and Fadale 2006; Medicinenet.com 2015). The use of caffeine to control weight is an important area of new research, and heavy caffeine use has been implicated in serious health problems in women who use heavy doses to control their weight (Ramacciotti et al. 2016). Prescription substances such as stimulants designed to treat attention deficit disorder also suppress appetite, and there is now some evidence that people are using them for weight loss rather than their intended purpose (Jeffers and Benotsch 2014). Also, substances such as clenbuterol, ephedrine, recombinant human growth hormone, thyroxine, and orlistat can cause serious long-term problems if used for appearance reasons and without medical supervision (Baker et al. 2016). Recently the role of cigarette smoking among young women to control weight has been investigated, and has been found to represent a serious health concern (Grogan 2012). Also, both male and female smokers tend to have lower body satisfaction than never-smokers, and may be concerned about stopping smoking because of the likely impact on their weight after quitting (Grogan et al. 2009, 2010b).
Drugs to Increase Muscularity
Men are under increasing pressure to become more muscular (Hildebrandt and Alfano 2012; Thompson and Cafri 2007), and may resort to drugs to enable them to increase muscularity. The rise in the use of appearance- and performance-enhancing drugs such as anabolic steroids, used by men and some women (Grogan et al. 2006), presents significant health risks, including increased risk of heart attacks and strokes (NHS 2015). These drugs may be particularly common in those with muscle dysmorphia (Hildebrandt and Alfano 2012), although their use is becoming increasingly widespread across broader populations (KimergƄrd and McVeigh 2014). This has led to serious health concerns about needle use and the health impacts of the anabolic steroids themselves, particularly when taken in heavy doses recommended by some online information sites (Grogan et al. 2006).
Growth hormone is now widely available for non-medicinal use, and can cause health problems if taken, without medical support, by those wanting to produce appearance-related changes (Graham et al. 2016). Substances such as synthol, which are injected into desired muscles in order to make those muscles appear bigger, are also widely available on the Internet (Hall et al. 2015) and may carry a wide range of health risks including destroying the injected muscle (Ghandourah et al. 2012).
Summary of Book Content
In this book we investigate both prescription and non-prescription drugs, focusing on their impact on appearance, and the psychological and health-related factors linked with their use. In the first section, we focus on some of the differential aspects of drug use within males and females, and also review use of appearance-related drugs by those with body dysmorphic disorder. Chapter 2 investigates use of drugs to change appearance in boys and male adolescents, focusing on links between drug use and the desire to become more muscular, gain body size and weight, and increase body strength. Links are made with use of appearance- and performance-enhancing drugs such as anabolic-androgenic steroids, food supplements, creatine, ephedrine, and adrenal hormones. This is followed by a consideration of body dysmorphic disorder in Chap. 3, investigating links between muscle dysmorphia and drug use, including use of anabolic steroids and treatment issues. Chapter 4 will consider use of drugs to change appeara...
