The Use of Image and Performance Enhancing Drugs During the Covid-19 Lockdown: a Cross-Cultural Study on Potential Users and Associated Risks

Image and performance-enhancing drugs (IPEDs), or lifestyle drugs, are a wide range of products presented as having the potential to improve mental and physical function and health. Little is known about IPEDs consumption during the COVID-19 lockdown. The present study aimed to profile IPEDs during this period characterised by physical distancing, isolation, gym closures, and other altered lifestyle habits. A cross-sectional observational study investigating the type of IPEDs consumed and purchasing methods was disseminated via a web-based questionnaire in eight countries (United Kingdom, Italy, Lithuania, Hungary, Portugal, Spain, Brazil, and Japan) between April and May 2020. This included the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), and the Self-Compassion Scale (SCS). A total of 736 IPEDs users were included in the survey. The mean age of the sample was 33.05 years (SD =10.06), with females rate of 64.2%. Among IPEDs users, 6.8% were at risk of exercise addiction (EAI >24), 27.6% presented high levels of appearance anxiety and 24.9% revealed low levels of self-compassion and emotional self-regulation. Most participants (55.6%) purchased IPEDs through pharmacies/specialised shops, while 41.3% purchased IPEDs on the Internet. Online shoppers of IPEDs were mainly men who reported higher scores on the Exercise Addiction Inventory. One or more IPEDs classifiable as “potentially at-risk” were used by 66.3% of the sample. Users of “potentially at-risk IPEDs” were younger and mostly males. They showed higher scores both at Exercise Addiction Inventory and Appearance Anxiety Inventory. This study profiled users of IPEDs during the peak of lockdown policies due to the COVID-19 breakdown. Both purchasing methods and types of IPEDs consumed were associated with distinct socio-demographic aspects and psychopathological traits. Some relevant cross-cultural differences were highlighted. Longitudinal studies will be needed to determine the impact of the COVID-19 lockdown on IPEDs consumption.