Even teens who are not athletes are using performance-enhancing supplements in an attempt to enhance their appearance, the American Academy of Pediatrics warns in a new report.

The supplements, which include steroids, diet pills and protein powders, are risky and unregulated, the group says. “Doctors think of performance-enhancing substance use as an athlete problem, but many non-athletes are using these substances for appearance enhancement,” said report co-author Dr. Michele LaBotz.

Boys are most likely to use protein supplements, caffeine, steroids and creatine, HealthDay reports. Girls are most likely to use nonprescription weight-loss supplements.

LaBotz noted many over-the-counter supplements are contaminated with steroids, stimulants, or toxic heavy metals, such as lead and mercury. Supplements spiked with stimulants put teens at higher risk for cardiovascular problems. “If you are one of the many teens already on stimulants for ADHD, you’re compounding the risk of heart problems,” she said.

She warned teens against using steroids. “A lot of the effects of steroids are irreversible, including stunted growth and the growth of male breasts — gynecomastia. These don’t go away when you stop putting steroids in your body,” she said.

LaBotz said studies have found using performance-enhancing supplements may lead to drug and alcohol use, as well as other risky behaviors.

The report, published in the journal Pediatrics, urges doctors to educate teens and parents about the dangers of supplements. “Often, doctors avoid talking about supplements with kids because it’s something they don’t know a lot about,” LaBotz said. She added that parents should also play a role. “They have a lot of influence and they should know what their teens are taking and should discourage the use of these supplements,” she said.