For the past fifteen years, gay men have been flocking to gyms to work out and bulk up. It is simplistic to equate this current trend with so-called “body fascism,” a term used by gay social critics. It is very complex how and why this focus on bodybuilding emerged. In the 1970s, there were very few well-built muscle men. This began to change in the 1980s, as AIDS ravaged the gay community, and people with HIV wasted away and all too frequently looked gravely ill. It is no coincidence that gay men became interested in bulking up during this time period.

In an effort to stem AIDS-related weight loss and wasting, physicians began to prescribe steroids, testosterone and human growth hormones. The onset of combination antiviral drugs brought countless people with AIDS back from the brink of death. Weight training in combination with the above-mentioned drugs changed the way many people with AIDS looked. People who had once been very gaunt developed into imposing hunks.

In addition to helping some men combat the physical side-effects of HIV and medications, working out can also help some men cope with the external oppression of unsympathetic and overtly hostile segments of society. This is one tangible way gay men can regain control of their bodies and feel powerful. Additionally, for the ever-growing numbers of healthy people with HIV, the ability to do strenuous aerobic exercise and lift weights is another reminder that they are not ill. A lot of uninfected gay men also keep fit as a way of announcing to the world that they are not sick.

There are also several emotional and physical benefits of working out and bulking up that have little to do with HIV. Many gay men, regardless of HIV status, remember being skinny and awkward kids, and cite numerous benefits of regular exercise and lifting weights. Physical exercise can increase your confidence, decrease your stress, and contribute to a overall feeling of balance. In many ways, being buff has also become the standard for being physically attractive and sexually desirable.

At times, however, keeping fit can become an unhealthy obsession that is facilitated by a distorted body image, regardless of what was the driving force behind the focus on fitness to begin with. Today, numerous men inject themselves with anabolic steroids, gain a degree of muscle impossible without this chemical assistance, and become huge. Physicians prescribe some steroids, while a majority of people purchase illicit drugs from personal trainers or dealers. For men who never seem to be satisfied with how big they become, there are cultural pressures that have led to such practices becoming a misguided and exaggerated variant of a healthy way of coping.

Bob Bergeron, CSW, a psychotherapist in New York, NY, works with clients examining their use of steroids. In his work, Bergeron has found that individuals who have a “problematic relationship” with steroid use almost always suffer from a distorted body image. Indications of this are when people are not satisfied with the way their body looks, or the size of the muscles they have developed, even after several years of steroid usage and bodybuilding. Additionally, once they stop a cycle of steroids, they feel that their body is considerably and dramatically reduced in size — and that their workouts are not as powerful when they are taking steroids. Bergeron has clients who the minute they are done with one cycle immediately feel they have to begin another one.

An obvious danger of using illicit steroids is the lack of quality controls regarding the purity of the drugs. It is after experiencing an understandably frightening and negative physical and psychological reaction to poor quality steroids that some men seek out therapists for help. Bergeron takes a “harm reduction” approach. Rather than trying to convince his clients to stop using steroids, he helps them figure out what the physical and psychological rewards are, to help clients develop strategies for replacing steroid use with something else.

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