Situated within a framework of a globalized gym and fitness culture, this paper aims to investigate and compare how fitness doping can be understood in relation to, and how it is affected by, different national and local contexts. Representing different forms of welfare state regimes, the comparative analysis focuses on policy, practice, and prevention in the United States and Sweden. The findings indicate, among other things, how national level policy and implementation reflect local priorities, understandings, and values. Sweden’s choices form a pattern reflecting the priority of protecting the collective good over individual pursuits. Conversely, that the U.S. does not police outside formally governed competitions in sports or in criminal contexts. Further, U.S. bodybuilders do not feel targeted for their appearance in the same ways, illustrating the priority of individual choice. Further, the paper discusses how each country implements anti-doping in ways consistent with global policies, but are also informed by various local understandings and values. This interplay between the supranational structures and locally diverse implementation is not only complex, but can seem contradictory as each locality partly remains within a global system of anti-doping in sport, and partly operates outside this context. We suggest glocal fitness doping needs to be understood as a process through which global ideals, organisations, and more contribute to influencing local and national prevention policies and cultures, and vice versa.