Table 4 Qualitative studies presenting AAS users’ history prior to use

Anorexia and reverse anorexia

Fudala [25]; Pope [44]

Complacent trainer(s)

Maycock [34, 35]

Long-term exposure to muscle magazines

Petrocelli [42]

Low self-efficacy

Fudala [25]; Joubert [7]

Male sex work

Scull [47]

Negative body image

Fudala [25]; Khorrami [30]; Kusserow [32]; Maycock [34, 35]; Petrocelli [42]; Pope [44]; Walker [10]; Joubert [7]

Other drug(s) use

Gruber [27]; Hegazy [28]; Joubert [7]; Kusserow [32]; Nøkleby [38]; Rashid [14]

Other sports (athletics, cycling, hockey, football etc.)

Bardick [20]; Boyadjiev [22]; Fudala [25]; Joubert [7]; Khorrami [30]; Kusserow [32]; Nøkleby [38]; Pappa [41]; Skårberg [49]; Tallon [11]; Vassalo [52]

Poor self-esteem

Fudala [25]; Walker [10]; Joubert [7]

Power sports (bodybuilding, powerlifting, weightlifting)

Annitto [19]; Bardick [20]; Bilard [21]; Boyadjiev [22]; Fudala [25]; Grogan [26]; Joubert [7]; Katz [29]; Khorrami [30]; Kimergård [8]; Korkia [12]; Kusserow [32]; Malone [33]; Maycock [34, 35]; Olrich [40]; Petrocelli [42]; Pope [43]; Pope [44, 45]; Skårberg [49]; Tallon [11]; Todd [51]; Wilson-Fearon [53]

Psychological disorder

Fudala [25]; Gruber [27]; Hegazy [28]; Pope [44, 45]; Rashid [14]

Troubled background (bullying, divorce, rape etc.)

Fudala [25]; Gruber [27]; Hegazy [28]; Rashid [14]; Skårberg [48–50]; Joubert [7]