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If drugs were to disappear from the bodybuilding scene, in what state would this leave the sport? How would the inevitable "down-sizing" of competitors' affect the marketability of what is essentially a pursuit of extremes?

Competitors and the paying public alike have increasingly puzzled over this dilemma as the sport has evolved into a quest to out-size the next guy, an activity where winning at all costs has become the main aim. In fact, never in the history of sport in general and bodybuilding in particular has there been a more contentious issue: drug use among the elite.

In many respects the lay public and, more disturbingly, the media, even tend to associate bodybuilding, and bodybuilders with drug use, like the two are somehow inextricably connected. The truth is, there are two definite camps on the issue: one that considers a drug-free approach the best option for all concerned, and those who support the individual's right to use every advantage to win.

While some feel that a drug-free stance would sanitise the sport to where it is more publicly accepted, thus helping to remove the sideshow status it is often encumbered with, others feel any professional sport has its risks and that all advantages must be taken to win at the highest level. And although anabolic drugs such as anabolic/androgenic steroids, insulin and Human Growth Hormone do help the bodybuilder to achieve their full potential as athletes, reported drawbacks to the use of such substances are sometimes thought to offset their beneficial effects.

For example, possible side effects including liver, cardiovascular and reproductive damage are thought to occur in some users of AA steroids, although compared to other harmful activities such as smoking and drinking the risk is said to be minimal.

Many even use various anabolic drugs for many years without experiencing any discernable adverse effects. On the other hand, there have been cases where pro bodybuilders have died relatively young. In such instances, drugs are inevitably cited as being the primary cause of death.

The jury is still open on both cases. One thing is for certain though: whether anabolic drugs do pose a major concern or whether they are relatively harmless if used sensibly, their health and ethical implications will be discussed and debated for years to come.