Steroid use is down among teenagers, but experts warn that young people are replacing it with a potentially dangerous booster.
Researchers from the University of Michigan found that while anabolic steroid use among teens has significantly decreased over the past two decades, creatine use is surging.
“I did this study given the rise in social media trends that glorify toxic gym culture, along with the rise in ‘looksmaxxers,’” said study author Philip Veliz.
“Looksmaxxing” is when young men take extreme measures to improve their appearance.
Influencers like Kareem Shami (@syrianpsycho), dubbed the “godfather of looksmaxxing,” have built large followings of young men looking to change their appearance in pursuit of higher status, success and “sexual market value.”
Though often framed as self-improvement, research suggests these online spaces can also foster toxic masculinity, body shaming and humiliation.
Published in Annals of Epidemiology, the study, which included 874,931 adolescents with a mean age of 16, explored trends in steroid use, creatine use and attitudes about steroids.
“What surprised me was that steroid use did not increase over the past five years among adolescents,” Veliz said.
“This is a positive finding, but additional research is needed,” he added.
In this national sample of adolescents, past-year steroid use decreased substantially between 2001 and 2024. However, past-year creatine use nearly doubled between 2019 and 2024.
Creatine is a naturally occurring chemical found in muscle cells and foods such as red meat, fish and poultry. Many athletes take creatine supplements because they are purported to increase muscle mass, enhance power output and boost performance.
It’s offered in various forms: pills, powders, chews and even gummies.
Experts are concerned about the rapid increase in creatine use among adolescents, as there is not enough evidence to thoroughly know its safety profile.
Indeed, NBA hopeful Darryn Peterson, 19, recently revealed that “loading” creatine left him with debilitating symptoms that sidelined his game and made him fear for his life.
While steroid use is down among teens, study authors believe that emerging trends and increasingly accepting attitudes could still lead to future use, as the study shows that the perceived harmfulness and disapproval of steroids declined even as use fell.
“These trends suggest that social norms around muscularity-oriented enhancement may be shifting toward greater acceptance of both ‘legal’ supplements and, potentially, steroids,” said study authors.
The decline in perceived harmfulness of steroids was greater among boys, which may indicate increased risk.
Meanwhile, Veliz believes that the sharp increase in creatine use is partly due to social media influencers like Shami, who promote supplement use as a means of looksmaxxing.
He notes that the study found that girls’ creatine use increased 168%, compared with a 90% increase among boys.
While looksmaxxing typically attracts boys and men, Veliz reports that aesthetic pressures affect boys and girls equally.
“There is a big emphasis on body image regardless of sex, particularly for girls,” he said. “Further, many adolescent girls lift weights and try to increase muscularity in gendered ways — for instance, lifting to target leg muscles to increase size or definition.”
Veliz shared that teen creatine use is not an immediate red flag but could potentially lead to riskier, related behavior, including supplements and steroids.
“The fact that steroid use is down while creatine use is up points to a shift in the importance of muscularity and fitness among teens,” said Veliz.
“What is yet to be determined is whether this will eventually translate into steroid use as they age into young adulthood.”
