Background: The use of dietary supplements and drugs to improve performance and physical appearance has recently increased among professional and recreational athletes. Literature shows that bodybuilders, more than other athletes use supplements and drugs. Objectives: This study aims to predict the use of supplements and drugs by muscle dysmorphia and social physique anxiety variables among Hamedan bodybuilders. Methods: This cross-sectional investigation was conducted with 438 bodybuilders in Hamedan province. For collecting data, we used a demographic questionnaire, muscle dysmorphia scale, and social physique anxiety scale. Results:The results showed that 79.2% of the subjects used supplements, and vitamins (22.1%) and protein powders (21.9%) had the highest rates of use among supplements. Moreover, 145 subjects (33.1%) used drugs, and steroid derivatives (16.2%) and peptide hormones and growth factors (12.6%) had the highest rates of use among drugs. The results of t-test showed that muscle dysmorphia and social physique anxiety were significantly higher in the subjects who used supplements and drugs than those who did not. Additionally, the results of logistic regression indicated that muscle dysmorphia and social physique anxiety can predict the likelihood of drug abuse. Conclusions:The present study provides novel findings of the effect of social physique anxiety and muscle dysmorphia on nutritional supplement and drugs use among bodybuilders.