Association between social media use and intentions to use anabolic-androgenic steroids: the role of body comparisons

Background Social media frequently exposes boys and men to idealized muscular and lean bodies, linked to increased intentions to use anabolic-androgenic steroids (AAS). However, mechanisms linking social media use to AAS intentions among non‑consumers are underexplored. Methods Data were drawn from The Study of Boys and Men, an online survey of 1515 males aged 15 to 35 years from Canada and the United States who reported no lifetime AAS use. Participants reported their daily social media use, frequency of social media body comparisons, and intentions to use AAS. Linear regression models estimated associations between social media use and AAS intentions, progressively adjusting for sociodemographic variables and social media body comparisons. The Karlson-Holm-Breen (KHB) method quantified the attenuation of the association due to social media body comparisons. Results Greater time spent on social media was significantly associated with higher intentions to use AAS across unadjusted and adjusted models. Social media body comparisons attenuated this association by 39.8% ( p < .001). Conclusions Social media body comparisons attenuate the association between social media use and AAS intentions, representing an important area for future investigation to better understand the mechanisms underlying this association.