The Physique Shortcut Tax: Steroids, SARMs, Peptides, and Tanning

Anabolic steroids: the upside is real

Steroids are the most intellectually useful place to start because pretending they do not work destroys credibility.

Anabolic-androgenic steroids can substantially increase muscle mass and strength.

That is why athletes use them.

That is why bodybuilding looks different in enhanced divisions.

And that is why simply telling someone, "Steroids are cheating and you don't need them," is not a serious cost-benefit analysis.

The question is whether their incremental benefit is worth the health trade for the person considering them.

The upside is real

For someone who has trained and eaten properly for years, natural progress eventually becomes slow.

At sufficiently advanced levels, an enhanced athlete may be able to:

• accumulate more muscle;
• maintain more lean mass at very low body fat;
• recover from more training volume;
• progress faster;
• and exceed their likely natural muscular ceiling.

If someone's only objective were maximum muscularity, ignoring every other variable, the decision would be straightforward.

But that is almost nobody's actual objective.

Most recreational lifters want some combination of:

muscularity + strength + attractiveness + health + longevity + fertility + quality of life

That is a multi-variable optimization problem.

The downside is not theoretical

A 2025 Circulation study followed 1,189 identified male anabolic-androgenic steroid users and 59,450 matched controls for roughly 11 years.

Adjusted hazard ratios were about 3 for myocardial infarction, above 2 for venous thromboembolism and arrhythmia, 3.6 for heart failure and 8.9 for cardiomyopathy.

These are relative associations, not a user's absolute chance of an event. The identified users were men sanctioned through a Danish antidoping program. This observational study cannot establish the individual risk caused by a particular drug, dose or user.

The FDA also warns about steroid-containing bodybuilding products, including serious liver injury and cardiovascular, hormonal and reproductive harms.

I do not need to claim that every steroid user will experience these outcomes.

They will not.

That is not how risk works.

The relevant point is that a recreational physique decision can increase exposure to outcomes that matter far more than another inch of arm circumference.

"But people use them safely for decades"

Some people have no apparent harm for decades. That does not establish that their exposure was safe.

A person can smoke for decades without developing lung cancer.

Someone can drive without a seatbelt for 30 years and never crash.

The absence of an observed bad outcome in one person does not tell you whether the probability distribution changed.

This is especially important in bodybuilding because survivors are visible.

The healthy 50-year-old enhanced lifter still training at your gym can become evidence for safety.

Someone who stopped because of health problems, fertility issues, psychiatric effects, or changing priorities is much less visible.

The correct question is not:

"Can someone use steroids and remain healthy?"

Clearly, some can.

It is:

"Does the expected incremental physique benefit justify increasing my exposure to serious health outcomes when my livelihood does not depend on that physique?"

For most recreational trainees, I think the answer is no.

The natural alternative is unusually good

A person with favorable genetics, years of intelligent training, appropriate nutrition and consistency can build an impressive physique by normal-population standards. The enhanced ceiling is higher; the natural ceiling is not therefore low.

Another 10 pounds of lean tissue may be enormously valuable to a competitive bodybuilder and nearly irrelevant to someone else's quality of life. PASS for most recreational lifters: the added muscularity does not justify that health trade for my goals.

SARMs: the supposed middle ground

Selective androgen receptor modulators became popular partly because the pitch sounds perfect.

You want anabolic effects.

You do not want "steroids."

So use something supposedly more selective.

Muscle benefits, fewer androgenic effects, easier recovery, less suppression.

That story is extremely marketable.

It is not a risk profile I would bet my health on.

SARMs are not approved bodybuilding supplements

The FDA states that SARMs marketed for bodybuilding are unapproved drugs, not legal dietary supplements.

The agency has linked SARM-containing products to serious or potentially life-threatening problems including liver injury and acute liver failure, possible increased risk of heart attack or stroke, sexual dysfunction, infertility and testicular shrinkage.

That creates an odd trade.

With traditional anabolic steroids, at least decades of human use have created a substantial body of observational and clinical knowledge about what these compounds do.

SARMs are frequently marketed as the safer innovation while offering less long-term human outcome data.

That is not obviously progress.

"More selective" does not mean "safe"

This is a recurring mistake in performance enhancement.

People hear a mechanistic description:

"It selectively targets the androgen receptor."

Then mentally translate it into:

"It gives me the muscle part without the bad part."

Biology is rarely that cooperative.

Receptor selectivity does not automatically eliminate hepatic, endocrine, cardiovascular or reproductive consequences.

And even if a compound eventually proves safer than some traditional anabolic drugs in some dimensions, that does not answer the decision question.

It still has to beat:

optimized natural training

on total expected utility.

Product uncertainty makes the trade worse

Another problem is that many SARMs are sold through online channels using language such as "research use only."

Now the user is not merely accepting uncertainty about the pharmacology.

They may also be accepting uncertainty about what was manufactured, how consistently it was manufactured and whether the product matches its marketing.

That is the opposite of what I want when the thing I am optimizing is my health.

PASS. Receptor selectivity is not evidence that a recreational product beats optimized natural training after known risks, unknowns and product quality are counted.

"Peptides" is too broad to be a useful category

Peptide describes a class of molecules. It does not establish approval, effectiveness, safety, manufacturing quality or suitability for your condition. Legitimate peptide medicines and experimental compounds sold for recreational enhancement need separate judgments.

BPC-157 is the perfect example of the evidence gap

BPC-157 is often discussed as if it were an established injury-recovery therapy.

Its reputation online is enormous relative to the human evidence.

FDA's safety materials state that it has identified no or only limited safety-related information for proposed routes of administration and lacks sufficient information to know whether BPC-157 would cause harm in humans. FDA also highlights possible immunogenicity and peptide-impurity concerns.

The human safety evidence is too limited to make this a confident recovery choice.

That distinction is important.

People frequently invert uncertainty:

"Nobody has proven this is dangerous."

But when I am injecting something into myself for a nonessential benefit, that is backward.

The burden is not on researchers to prove catastrophe.

The burden is on the intervention to earn enough confidence to justify exposure.

TB-500 has a similar problem

FDA says it has not identified human exposure data adequate to characterize the safety of TB-500 and notes potential concerns involving immunogenicity, aggregation and peptide-related impurities.

That uncertainty belongs in the cost of the decision, especially when the promised benefit is faster recovery from an ordinary training setback.

If my alternative is physical therapy, intelligent load management, time, sleep, nutrition, diagnostic workup when appropriate and established medical treatment, an experimental injectable has to produce substantial evidence before it becomes an attractive trade.

A rat recovering faster does not clear that threshold.

CJC-1295 and ipamorelin illustrate the same problem

FDA has identified limited clinical data and potential serious safety concerns with several growth-hormone-related peptides.

For CJC-1295, FDA notes limited clinical data and reports of serious adverse events including increased heart rate and systemic vasodilatory reactions.

For ipamorelin, FDA cites insufficient information for several routes of administration and potential issues involving immunogenicity and peptide-related impurities.

That is a very different evidence base from:

"Everyone at my anti-aging clinic uses it."

A white coat does not substitute for outcome data.

"My peptide came from a compounding pharmacy"

Compounded drugs are not FDA approved. FDA does not verify their safety, effectiveness or quality before marketing.

Compounding can meet legitimate medical needs. It does not supply missing human outcome evidence for a molecule promoted for recreational enhancement. A pharmacy source and a favorable risk-benefit case are different questions.

PASS until the evidence improves materially. For an injury, diagnosis, rehabilitation, load management and established treatment are better starting points than an injectable whose human benefit and safety remain poorly established.

Melanotan II adds another experimental exposure

Melanotan II deserves separate mention because it can combine two bad optimization instincts.

Someone wants darker skin without spending as much time tanning.

So instead of using a cosmetic sunless tanner, they introduce an unapproved peptide intended to alter pigmentation.

FDA's compounding safety information notes published case reports involving serious adverse events associated with Melanotan II, including melanoma, posterior reversible encephalopathy syndrome, sympathomimetic toxidrome and priapism. Case reports do not establish that Melanotan II caused every reported outcome, but they are hardly the evidence base I would accept for a nonessential cosmetic intervention.

The underlying question is devastatingly simple:

Why introduce systemic pharmacologic uncertainty to change skin color when a topical cosmetic substitute exists?

Conclusion

PASS.

Intentional UV tanning has a cosmetic substitute

Tanning is different because there is little ambiguity about whether the mechanism works.

UV exposure causes skin pigmentation.

It also damages the skin.

This is not merely "sunlight might be unhealthy."

The International Agency for Research on Cancer classifies UV-emitting tanning devices as carcinogenic to humans, Group 1.

The National Cancer Institute identifies ultraviolet exposure from sunlight, sunlamps and tanning beds as a skin-cancer risk factor and states that UV exposure causes skin damage that can lead to cancer and premature aging.

Risk depends on dose, skin type, genetics and exposure pattern. The avoidable exposure I am questioning is tanning for a darker appearance.

Outdoor activity itself has substantial benefits.

The relevant behavior here is deliberately accumulating UV exposure for cosmetic pigmentation.

A non-UV cosmetic alternative

Suppose the objective is:

"I think I look better with darker skin."

Fine.

Now compare the options.

Option A: UV tanning

Produces pigmentation while adding:

• cumulative UV damage;
• accelerated photoaging;
• increased skin-cancer risk;
• and potentially eye damage depending on exposure.

Option B: sunless tanning

Produces temporary cosmetic pigmentation without needing UV radiation to damage skin DNA.

FDA guidance on sunless tanners distinguishes topical use from exposure to eyes, mucous membranes or inhalation. Use a topical product as directed; do not treat inhaling spray mist as equivalent. A self-tanner does not provide sun protection unless it includes labeled sunscreen.

The aesthetic result may not be perfectly identical.

It does not need to be.

If the safer substitute captures most of the visual benefit while deleting the major irreversible downside, the remaining aesthetic difference has to justify carcinogenic exposure.

For me, it comes nowhere close.

Mr ROI verdict: tanning beds

PASS. Hard.

Intentional outdoor tanning

Also PASS as a cosmetic strategy.

Being outdoors is good.

Seeking progressive UV exposure specifically to make skin darker is not the same thing.

Enjoy the outdoors. Protect the skin. If the goal is the color, use the substitute designed to create the color.

Medical treatment is a different decision

A treatment that addresses a diagnosed problem deserves its own benefit-risk assessment. “Natural” alone tells me very little about whether a choice is worthwhile.

Testosterone replacement is not a bodybuilding cycle

Testosterone prescribed to someone with appropriately diagnosed pathological hypogonadism is addressing a medical deficiency.

Nonmedical supraphysiologic androgen use to exceed normal physiology is pursuing a different objective.

The compound may overlap.

The decision does not.

Dose, indication, treatment target, monitoring, baseline physiology and expected benefit all change the risk-benefit calculation.

Approved medicines can be worthwhile shortcuts

This is the same principle behind my view of GLP-1 medications.

Rejecting an evidence-based treatment merely because someone could theoretically accomplish the goal through more willpower is not automatically rational.

If a medication has:

• substantial human evidence;
• known manufacturing standards;
• a legitimate indication;
• meaningful expected benefit;
• defined contraindications;
• and appropriate medical oversight,

then it deserves evaluation on its actual merits.

That is almost the opposite of buying an unapproved research compound because people on social media report that it "feels amazing."

The framework is not:

natural versus unnatural.

It is:

evidence, expected benefit, expected harm, alternatives, and uncertainty.

Uncertainty costs more when the goal is cosmetic

Poorly characterized long-term effects may be a reasonable trade for treating an otherwise fatal disease. The same uncertainty is much harder to justify for slightly faster recovery or another few pounds of muscle. Risk tolerance should scale with the importance of the problem being solved.

The Instagram comparison is structurally unfair

There is another reason enhanced physiques distort decision-making.

You are not necessarily comparing:

natural you versus enhanced you.

You may be comparing yourself with someone who has:

• better genetics;
• more muscle insertions favorable to bodybuilding;
• a decade more training;
• professional lighting;
• a pump;
• dehydration;
• photo editing;
• posing experience;
• lower body fat;
• performance-enhancing drugs;
• and an income stream that rewards staying extremely lean and muscular.

Then you conclude:

"My program must be missing something."

Maybe it is.

But the comparison itself may be invalid.

The appropriate benchmark is not the most impressive human being the algorithm can place on your screen.

It is:

What can I build from my genetics, lifestyle and goals while retaining the rest of the life I care about?

That is a much better optimization target.

Do not let sunk cost move the goalposts

There is a progression I see in many optimization cultures.

First:

"I just want to look athletic."

Then:

"I want visible abs."

Then:

"I want to reach my natural potential."

Then:

"Maybe TRT would optimize me."

Then:

"A small cycle isn't really that much."

Then the enhanced physique becomes the new baseline.

The same thing can happen with tanning, cosmetic procedures, stimulants, nootropics or any intervention whose benefit becomes psychologically normalized.

The initial improvement stops feeling exceptional.

Now maintaining it feels necessary.

This creates a hidden form of lifestyle inflation.

Except instead of needing a more expensive car every few years, you may need continued pharmacology just to feel normal relative to your new reference point.

That deserves to be counted in the price.

Bloodwork is a safeguard, not an exemption

Monitoring is useful.

It is not magic.

A person who chooses to use medications or performance-enhancing substances is better served by appropriate medical monitoring than by ignorance.

But testing does not eliminate the underlying exposure.

A normal snapshot does not prove that cumulative risk is zero.

Not every relevant harm has a convenient early biomarker.

Not every future outcome is perfectly predicted by today's blood panel.

And some risks develop through cumulative exposure rather than an immediately abnormal number.

Monitoring can reduce uncertainty.

It cannot transform a poor expected-value intervention into a good one automatically.

"I'll only do one cycle"

Maybe.

But this deserves the same skepticism I apply to introductory pricing in consumer products.

The first decision changes the reference point.

Suppose an enhanced period produces:

• significantly more muscle;
• better gym performance;
• faster progress;
• and a physique you strongly prefer.

Returning to a lower-performance state may feel like losing something rather than simply returning to baseline physiology.

That creates a retention problem.

I would not assume that my future preferences will remain identical after experiencing the upside.

A reversible-looking experiment can therefore create behavioral lock-in even if the drug itself is discontinued.

That is part of the shortcut tax too.

Professional bodybuilding changes the payoff

Someone will reasonably object:

"What about someone trying to become Mr. Olympia?"

That is not the same utility calculation.

At the elite level, maximum muscularity is not merely cosmetic.

It is the product.

A professional athlete may rationally accept risks that would make no sense for me because the marginal performance has:

• competitive value;
• career value;
• sponsorship value;
• and potentially substantial financial value.

The expected-value equation changes.

The biology does not.

Calling the decision understandable is not the same as calling it safe.

My hierarchy for physique optimization

Use The Fitness 80/20 to address training quality, nutrition, fatigue, sleep and consistency. Solve actual medical problems with qualified care. Then recognize that slower progress may mean you have already captured most of the available value.

I want substantial muscle, strength and a reasonably lean physique. I also want cardiovascular capacity, fertility, healthy skin and the ability to keep training decades from now. Those goals can compete at the margin.

For recreational physique goals, I stop before experimental or high-risk enhancement. Not because there is no additional benefit, but because the remaining benefit has stopped paying for the risk.

The mistake is evaluating the shortcut only by what it gives you. Always price what it takes away.