The main motivation for people using steroids and other similar drugs in the UK is to enhance their image, a survey has shown.
More than 680 people who use image and performance-enhancing drugs took part in the National IPEDinfo survey.
It found that although motivations for use of those drugs were complex, 56% used them for aesthetic purposes.
Public Health Wales, which led the project, said a "pragmatic health-focussed approach" was needed.
In recent years, concerns have specifically been raised about the use of steroids in Welsh grassroots and semi-professional rugby.
Last year, Wales' Public Health Minister Rebecca Evans said sports players taking performance-enhancing drugs faced a closer watch under a new three-year plan to tackle substance misuse.
Those who took part in the survey ranged in age from 17 to 74, with the average person using image and performance-enhancing drugs (Ipeds) in the UK likely to be a white British male in their 30s.
Most of those used a mixture of injectable and oral anabolic steroids and typically injected their Ipeds into their muscles. Most had started using before the age of 30, with some reporting they started as young as 14 or 15.
As well as steroids, substances taken included peptides and growth hormones, and drugs designed for weight loss, fat loss, diuretic effects and tanning.
Josie Smith, head of substance misuse for Public Health Wales, said use was widespread, adding: "The findings of the latest survey evidence a further shift in the motivations for use of Ipeds."
"Changes in our cultural and social expectations relating to physique, along with the availability of a wide range of substances to modify or facilitate image and performance enhancement mean that a pragmatic health-focussed approach is required."
Public Health Wales worked on the survey with the Public Health Institute at Liverpool John Moores University, NHS Scotland and Public Health England.
Prof Vivian Hope, from the Public Health Institute, said: "There are considerable risks in the use of any drugs sourced from the illicit market, such as issues with contamination and incorrectly described content and dosage.
"Evidence of the potential long-term harm caused by the use of anabolic steroids and other Ipeds is growing.
"There are also concerns about the transmission of infections, including blood-borne viruses such as HIV among those using Ipeds."
Other motivations included sporting or athletic performance, occupational performance, competitive and non-competitive body building, increasing sex drive and retaining or regaining a youthful appearance.