Short abstract
Channel 4, 12 August at 9 pm
Rating: ★★★★
Tabloid science; the randomised controlled trial meets reality television; or Big Brother goes sporty? Take 24 volunteers, give one group anabolic steroids (testosterone enanthate) and placebo to the other, train them hard, monitor their performance, create a mini Olympics, and film the study. The personalities, the environment, the competition, the slightly eccentric scientist, and over-hyped athletes: these are all the components of a television drama. And yet, from what we see, the science is good: a double blind randomised controlled trial, a scientific setting, with proper informed consent, medical monitoring, outcomes measurement, and uncertainty about the result. As an insight into competition, the dynamics of a training camp, athletes' concerns about anabolic steroids, and their side effects, this programme made compelling viewing for those with even a passing interest in sport.
Figure 1.
On their marks for the world's first televised trial of anabolic steroids
In the lead up to the Olympic Games, the big stories are more about who will miss their big day in Athens because of drug related bans than about the wonder of the event. Twenty British athletes, the programme told us, have had a positive drug test in the last 12 months. Why take the risk? Superlative performances will inevitably be tainted by suspicion. Instead of what a performance, we will say what are they on. Are they wind assisted or drug assisted? And what about the side effects?
Athletes believe, however, that drugs help both training and performance, and while there may be few high quality randomised controlled trials to date, it would be foolish not to believe the chat at the track. Led by Dr Robert Weatherby of Southern Cross University, New South Wales, Australia, the research group behind the trial featured in this programme is one of the few that has previously published in the field, and a quick Medline search identifies some of their key papers. In Cheating at Athens—which claimed to be the world's first televised trial of anabolic steroids—they looked at both training and performance improvements, and recorded side effects and personality changes in particular. Even the athletes tried to guess who was on the steroids, based not just on their physical performance but on psychological changes. Was it the hothouse atmosphere and training camp niggles, or was it “roid rage,” the term used by athletes to describe the gym familiar effects of increased irritability and aggression?
The programme claimed to show that taking testosterone enhanced performance, in particular increasing the body's strength and power. But Dr Weatherby also said that his team was able to show that androgenic anabolic steroids “have a seriously detrimental effect on a specific part of the human body's immune system.”
The doses given in the six week trial—3.5mg per kilogram of body weight per week—were 50 times lower than those commonly taken by steroid users. Yet even at these low doses, Dr Weatherby said that “the body's ability to defend itself against viruses and cancers is likely to be significantly lessened.” While the programme was explicit about the potential side effects, it was perhaps guilty of sexing up the presentation as athletes were asked about the size of their testicles, to record their libido, and count their erections.
The programme showed the average viewer what was required in a proper randomised controlled trial—the importance of blinding, informed consent, close measuring, and monitoring. Those who have ever undertaken research would have empathised with the scientists and their difficulties with withdrawals from the trial, injury, illness, and human variability.
Television likes pain and suffering and doctors may yawn at the fuss about injections, athletes fainting at the sight of blood, and complaints about sore buttocks. To be fair, the needle did look rather large, although probably necessary for the viscous anabolic steroid. Traditionalists who feel scientific experiments should be out of the public eye, buried in anonymous laboratories, clothed in secrecy, and published only in dusty journals may have found this programme difficult viewing, but it was well done and science benefits from this exposure. Allowing a little for the dramatic music, close needle shots, and flowery commentary, it was good to see a well conducted experiment on prime time television.