OBJECTIVE. We examined the prevalence, persistence, secular and longitudinal trends, and predictors of steroid use in a diverse sample of adolescents.

PARTICIPANTS AND METHODS. Data are from Project EAT-II (Eating Among Teens), a 5-year longitudinal study of eating, activity, weight, and related variables in 2516 middle and high school students. Data were collected in 1999 (time 1) and 2004 (time 2).

RESULTS. Approximately 1.5% of adolescents reported steroid use at time 2. Use differed by ethnicity but not socioeconomic status. Steroid use was not stable across time, although the risk of use at time 2 was higher for girls and (marginally) for boys who used steroids at time 1. No secular trends were noted in middle adolescents’ steroid use between 1999 and 2004. Developmentally, steroid use decreased as adolescents grew older. Predictors of use for male adolescents included wanting to weigh more and reporting higher use of healthy weight-control behaviors. Female time 2 steroid users had higher BMIs and were less satisfied with their weight, had poorer nutrition knowledge and concern for health, and were marginally more likely to have participated in weight-related sports at time 1.

CONCLUSIONS. The prevalence of steroid use in adolescents was low but of concern. Although use was not persistent over 5 years, time 1 use was a risk factor for time 2 use in female adolescents. There was no change in the prevalence of steroid use by middle adolescents between 1999 and 2004 despite a great deal of public interest in steroids during this time period. Steroid use decreased as adolescents grew older. Weight-related variables predicted adolescents’ steroid use 5 years later, and health and nutrition knowledge and concern and (marginally) participation in weight-related sports further predicted use in female adolescents. These findings suggest that early preventive efforts may be most useful.

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