Some experts believe illegal AAS usage is linked with a body image disorder called muscle dysmorphia. Affecting mostly males, people with muscle dysmorphia feel ashamed of looking too small when they're actually big. For this reason, it is often referred to as "reverse anorexia" because it is the opposite of the mostly female disease of anorexia nervosa, in which patients believe they are always too fat, sometimes despite extreme weight loss.

According to Dr. Arnold Andersen, M.D. of the University of Iowa, seven out of 10 males are dissatisfied with their bodies. Half of those want to bulk up, while the other half want to lose weight. Another indicator that men are increasingly concerned about their body image is the dramatic increase in cosmetic surgery. In 1992, men underwent 6,000 liposuction procedures to surgically remove excess fat; five years later that figure has jumped to 24,000. Other...