How many gym-goers actually use performance drugs?

Short answer

At the gym, about 1 in 10. Asked anonymously, 8 to 13% said they had used, and up to 19.5% in one survey, higher than the global average of 3.3%. Asked directly, use hid behind a 0.4% figure, and users had 3 times the risk of death.

How many gym-goers actually use performance drugs?
'All the big guys are on gear' vs 'Only a tiny few' — what do the numbers say?
You'll hear that everyone with a great physique is on drugs, and also that drug use is a tiny-minority thing. We checked survey numbers on how many people have actually used drugs like steroids.
Start with the global average
3% have used at least once in their life
An analysis that pooled 187 studies found that 3.3% of people had used steroids (testosterone-type drugs) at least once in their life. The rate was 6.4% for men and 1.6% for women, 4 times higher in men. Studies that surveyed people who play sports found higher numbers.
Step inside the gym
1 to 2 in 10 said they had used
In Germany, 1,802 questionnaires were handed out at 113 gyms, and 13.5% said they had used muscle-building drugs. In a survey of 415 people at 24 gyms in Saudi Arabia, 19.5% said they had used steroids or muscle-building drugs.
But people hide it when asked directly
4% became 8.2% with an anonymous method
When 718 members of 92 Dutch gyms were asked directly, 0.4% said they used drugs. Asked again with a method that made it impossible to tell who answered 'yes,' the figure rose 20-fold to 8.2%. The most common drugs weren't steroids but stimulants used to lose weight.
Anonymous surveys still topped 10%
500 people at German gyms: 12.5%
Using the same anonymous method with 500 people at 49 German gyms, 12.5% had used banned drugs. That was close to the 13.5% in the earlier German survey. Inside the gym, about 1 in 10 people had used drugs.
Women are no exception
8% of female bodybuilders
A 2024 analysis that pooled 18 studies of women found that 4% overall had used steroids. The rate was 1.4% in women in general, 4.4% in women who play sports or go to the gym, and 16.8% in female bodybuilders. The closer to physique competition, the higher the number.
The cost for those who used
3 times the risk of death, 8.9 times the risk of cardiomyopathy
545 people who tested positive in Danish gym checks had 3 times the risk of death of 5,450 non-users, and visited hospitals 0.81 times a year versus 0.36. A study that followed 1,189 users for 11 years found 3 times the risk of heart attack and 8.9 times the risk of cardiomyopathy, where the heart muscle breaks down.
Bottom line: about 1 in 10 at the gym
Not 'everyone' and not 'a tiny few'
The global average is 3.3%, but gym-goers asked anonymously said 8 to 13% had used, and up to 19.5% in one survey. Asked directly, use hid behind a 0.4% figure. Users had 3 times the risk of death. Most gym-goers don't use drugs, but it's not rare either.