The battle of the bulge

Michael, who is unemployed, goes to the gym every day. While heaving a 31kg barbell over his head, he tells me he once trained for eight hours straight. He watches himself in the mirror, his thick biceps accentuated by a skimpy white vest. But Michael’s dramatic physical transformation isn’t just the result of intensive gym sessions. He is one of a growing number of young men regularly taking steroids to achieve their ideal body shape. His compulsion to use them, part of a trend sometimes considered the inverse of anorexia, has a name: bigorexia.

Steroids entered mainstream awareness through stories of professional sportsmen using them as performance enhancers. Mimicking the effects of the male hormone testosterone, steroids increase muscle mass and decrease fat, giving athletes a competitive (and controversial) edge. Now these drugs have emerged from the locker rooms of professionals into common use. They are especially popular among young men.

“It’s difficult to even guess at the number of people using steroids,” says Jim McVeigh, acting director of the Centre for Public Health at Liverpool John Moores University, who has been researching steroid use for more than 20 years. Because steroids are a controlled Class C substance available legally by prescription only (possession isn’t illegal, but supplying them is), it is difficult to find accurate figures for their usage. A conservative estimate by the National Institute for Health and Clinical Excellence (Nice), a healthcare body that advises the NHS, suggests that almost 60,000 people aged 16 to 59 used anabolic steroids in England and Wales in 2013. McVeigh believes the real figure to be in the hundreds of thousands — “far more than heroin addicts”.

Last year, the charity Crime Reduction Initiative reported a 645% increase in steroid users at its needle exchanges in England, up from 290 in 2010 to 2,161 in 2013 — many more buy their needles and syringes online. In South Wales, experts have warned of an epidemic: police seized steroids every 36 minutes, on average, in 2012-2013 — a 30% hike on the previous year.

Kim Davies has worked as the needle exchange coordinator at Sands Cymru, a government-funded charity providing services for drug users in Swansea, since November 2012. She sits behind a two-metre high counter in a tiny cubicle. All day, people trail in and out to collect clean needles from her, which she dispenses for free, without judgment. I spent a week with Kim. I was startled by the number of clean-cut young guys who’d pop in to pick up needles. Kim thinks the people they see could just be the tip of the iceberg: yet more users buy needles online, at a pharmacy or from their dealer.

Since she started at Sands, Kim has noticed escalating numbers of 18- to 24-year-olds coming in for clean needles to use with steroids and other performance-enhancing drugs. “It used to be the case that a typical steroid user was a big guy in his thirties to fifties,” she says. “They were professional bodybuilders and they had a very structured fitness and nutrition routine, of which steroids were almost an extension.” Now Kim sees more young, inexperienced guys. “They’re not doing the fitness or the nutrition. They’re coming in with McDonald’s bags. It’s almost as if they want a quick fix for the summer holidays. They’re completely desensitised. They order needles like they’re ordering a coffee.”

Sands Cymru was where I first met Michael. He had managed to gain 2½st naturally in a year, but peaked. “That’s why I started [taking steroids],” he says — at first in tablet form. “I thought I’d never inject because I hate needles.” He bought 100 pills for £25 from some boys in the gym, and took two a day. The headaches started almost immediately. They lasted three weeks. “The pain had become so bad I couldn’t stand it any more,” Michael says. His blood pressure rose to such an extent that when he loaded 100kg onto a thigh-adductor machine and squeezed, his nose “exploded” with blood.

Is that the moment he stopped?

“No, I carried on. It’s only a bit of blood.”

When Michael eventually tried to stop taking steroids, the bulk he’d gained rapidly fell off and he couldn’t lift as much. “You try doing it and you just can’t. It pisses you off.”

He is now taking a steroid called Testobolin, usually prescribed for use in hormone-replacement therapy, rejuvenation therapy, panhypopituitarism and female breast cancer. He’ll inject 1ml twice a week for a month, then 2ml twice a week for six weeks. The course costs him £80. “I’m gonna see if it has an effect on me. If not, I’ll move onto something stronger,” he says.

Michael gets his mate to jab him, leaning over the sofa, in the front room of his house. He knows there are side effects. “It’s the hair loss I’m worried about,” he grins. “Because of my age, apparently, my bones might fuse together. Like, who cares about that? If they fuse, they can undo it, can’t they?”

I don’t know. Can they? Is it worth the risk? “For me, yeah. I don’t care about side effects,” he says. “No one’s going to get killed or die taking steroids.”

Michael’s wrong, of course. McVeigh tells me there is growing evidence that steroid users risk long-term cardiovascular damage. In 2012, Mohammed Belkhair, a 19-year-old from Manchester who had dreamt of becoming a doctor, died from acute heart failure brought on by a cocktail of anabolic steroids and heavy exercise. Last year, Oli Cooney, a 20-year-old steroid user, suffered two heart attacks and three strokes before he stopped taking steroids, then ignored the doctor’s warnings and returned to training three or four times a week. The inquest into his death concluded that he had died from “massive” steroid abuse.

The side effects associated with steroids in men include baldness, breast development, splayed teeth, an overgrowth of the forehead giving an Incredible Hulk look, and severe acne; and those are just the cosmetic effects. Psychosis, abrupt mood swings and irritability (known as “roid rage”) are also on the list. The killers Raoul Moat and Anders Breivik were both steroid users.

Other risks include infertility, reduced sperm count, shrunken testicles and prostate cancer. An underlying issue, McVeigh points out, is that “because virtually all steroids are illicitly manufactured, no one knows what they’re using”.

Most users I spoke to bought them from friends, gym buddies, or online — a quick Google search presents dozens of outlets selling them. Injecting steroids carries the risk of infection from blood-borne diseases. Users who share needles are vulnerable to HIV and hepatitis. “There is strong evidence now that the prevalence of HIV in steroid users is the same as among those using heroin,” McVeigh says.

“I’ve heard horror stories,” Kim adds, “of four guys lined up in the changing rooms and one guy with one needle — jab, jab, jab, jab.” In addition, the effect on the libido makes users an especially sexually active group.

“A real problem,” says McVeigh, “is that this group do not consider themselves drug users, so they don’t see these issues as affecting them.”

Michael was waiting to pick up sterile needles at the Sands Cymru exchange alongside heroin addicts when I asked him if he thought of steroids as drugs. “Steroids are totally different,” he said. “They don’t make you look ill. They make you look better. When you’re injecting steroids you’re going to the gym, getting hungry, eating. It’s healthy.”

But it’s not real.

“No, it’s fake... but it looks good. It’s to do with appearance more than anything. You just want to be bigger.”

We think of vanity as a woman’s curse, but men, too, are bombarded with aspirational body images. David Beckham’s underwear ads; Men’s Health covers; film and even reality-TV stars with six-packs. Experts on male eating disorders say that even the action figures boys play with are influential in creating an unrealistic male body shape, in much the same way that Barbie is for girls. A muscle-bound 21-year-old rugby player I met at Sands Cymru told me he wanted to look like “some of the wrestlers, like Randy Orton; some of the movie stars, like Chris Hemsworth in Thor, or Chris Evans from Captain America.” Could he get that look without steroids? “Yeah, but it would take 10 years, whereas I can do it in two. By the time you’re 40, half your life’s over. I want to look like that now.”

Colin Tyrie, a public-health adviser at the Manchester Mental Health NHS trust, sees this trend as part of a wider crisis of masculinity: “The male role in society has become quite damaged. It’s not sure what it is any more. Men don’t have an identity like our fathers did, so there’s this sense that we’re trying to fulfil that. There’s quite a strong prevalence of this among white, working-class males. It’s a quick way to get prestige to say, ‘Yes, I’m big.’ ”

Professor Bruce Davies of the University of Glamorgan, who has conducted detailed studies into steroid use in rural Wales, thinks this is particularly true in the Welsh valleys. “Miners were brave and proud, they had nothing to prove about their masculinity, they worked in a dangerous situation and were respected by everybody. Now young men are bored — they seem to think if they look big and manly, they are big and manly, and people will see them like that.”

I go to meet Kyle, a 23-year-old Welshman with a baby face and enormous frame, whose grandfather worked as an electrician down the mines. Kyle has been injecting steroids for over a year, and has gained more than 2st. He comes to the gym each day for one hour. “It’s just for size,” he says. “It’s made a huge difference. The bigger you are in the gym, the more respect you get: I don’t do it for the girls, I do it for the men.” Even so, he adds, “you get more girls when you’re more muscly than when you’re skinny.”

His ex-girlfriend left him “for a bigger boy”. Being more muscular, “gives you the confidence. You can be the least confident person in the world, but if you’ve got muscles, it’s easy with girls,” he says. Yet he couldn’t hold down a relationship. He tried for three weeks, but it interfered with his training. “And what’s more important? This.”

When Kyle talks about steroids he talks not just about looks, but how they make him feel. “This gives me the confidence to go out and wear the tighter clothes,” he says. He doesn’t drink when he goes out. He sticks to Red Bull. Why bother? “Just to stand there and look good. That’s it.” Kyle took his first dose of steroids in September 2013; he bought them from friends in the gym. Within three weeks he’d noticed his arms were larger, his chest had swelled, his back was broader.

Since then he’s tried different types of steroids, researching online, talking to people in forums, asking friends and working through “trial and error”. This cycle is his fourth batch — Sustanon 250, a compound of different testosterones that adds mass quickly. “I gained 6lb in about 10 days.”It costs him £120 a course.

He takes out his phone and shows me photos of his body, which he takes to monitor his progress. In the pictures, he’s posing, clenching, showing off his back, his chest, the definition of his arms. He, like Michael, keeps a photograph of what he used to look like: a skinny boy waving scrawny arms, and also wearing — for the same, unfathomable lads’-night-out reasons — women’s clothes.

After a mammoth, free-weights session, he ends on an assisted-dip machine where he loads two fat, medieval chains around himself, weighing 23kg each, and a belt weighing 15kg; he lifts the lot along with his own body weight. Most people would need two or three days to recover. Because of the steroids, Kyle doesn’t. He says if he doesn’t train for a day he feels like his weight has dropped. “It’s all up here,” he says, pointing to his head. “When I quit for two months, I looked like a child. I’m in the mirror every day, looking at myself thinking, ‘I feel skinny.’ I’m looking at my body getting smaller all the time.”

Kyle does not exercise his lower half. Like many steroid users he has a distinctive top-heavy look. He avoids cardio in case he loses weight. “I won’t walk anywhere. I try to drive as much as I can.”

A few weeks ago, Kyle had an attack of breathlessness in the gym. His blood pressure was so high, his resting heart rate was 120 bpm. If he moved it hit 180. “I was a bit apprehensive because I couldn’t walk upstairs. I couldn’t breathe because my heart was just pumping all the time. I was very tired, very sweaty.” As he talks I notice his shortness of breath. “When I’m off steroids, it’s fine. My heart rate lowers over time.”

The acne has only appeared in the last fortnight, he says. “The sleep and sweating is in the first two weeks, the breathlessness in the first week.”

Doesn’t that put him off?

“No. I keep taking it. I took the full cycle.”

His doctor has advised him to stop.

“I do abuse it to a level,” he says, “but if I become ill with it, then I’ll stop.”

But you have become ill, I say.

“If I have a heart attack, I’ll stop,” he says. Then reconsiders: “I wouldn’t mind if I had a heart attack in the gym. Because I was big.”