U-M study shows a concerning rise in creatine use among US adolescents despite declining steroid usage. Experts warn of potential health risks.

Recent trends in past-year steroid and creatine use among U.S. adolescents have been the focus of a new University of Michigan study published in Annals of Epidemiology. The research, conducted by Philip Veliz, highlights a notable shift in teen attitudes towards muscle-enhancing products, with a significant increase in creatine usage.

The study, which examined data from 2001 to 2024, found that while steroid use among teens has declined over the past two decades, creatine use has risen rapidly. This rapid rise is particularly concerning given the limited evidence on safety and efficacy of creatine supplements for youth, according to Veliz.

Veliz, a research associate professor at the U-M School of Nursing and Institute for Social Research, the growth in creatine use may be linked to social media trends glorifying gym culture. He explained, "I did this study given the rise in social media trends that glorify toxic gym culture, along with the rise in 'looksmaxxers,' who focus on maximizing physical attractiveness through extreme measures."

The findings suggest a growing acceptance of muscle-enhancing products among teens. Veliz observed, "What surprised me was that steroid use did not increase over the past five years among adolescents. This is a positive finding, but additional research is needed."

However, he emphasized the potential risks associated with creatine use. "While creatine is legal, its rise may be accompanied by other pre- and post-workout routines that can be harmful for teens, including highly caffeinated pre-workout mixes or energy drinks," Veliz warned.

The study also noted a decline in perceptions of steroid harm and slightly softer disapproval of their use among adolescents. This shift could increase the risk of future use, particularly among boys who showed greater declines in perceived harm compared to girls.

Veliz attributed the rise in creatine use to social media influencers promoting muscle-building routines and supplements. "There is a big emphasis on body image regardless of sex, particularly for girls," he added. "Further, many adolescent girls lift weights and try to increase muscularity in gendered ways—such as lifting to target leg muscles to increase size or definition."

The research underscores the need for further investigation into the long-term effects of creatine use among teens. Veliz concluded, "What is yet to be determined is whether this will eventually translate into steroid use as they age into young adulthood."

Experts caution that while creatine may have potential benefits for body and mind, its safety in youth remains uncertain. The study highlights a complex interplay between social media trends, body image pressures, and changing attitudes towards muscularity among teens.