Researchers say most young men with eating disorders are trying to build muscle, not lose weight.
Historically, much of the research on eating disorders has focused on girls and women.
But in recent years, researchers have increasingly explored the ways disordered eating and body image concerns can affect boys and men as well.
While women are often pressured to strive for thinness, men are often pushed to emulate an idealized male body that’s muscular and lean.
In an effort to build muscle, some teenage boys and young men engage in activities that are detrimental to their health.
According to a new study published in the International Journal of Eating Disorders, 22 percent of young men between the ages of 18 and 24 exhibit what the authors call muscularity-oriented disordered eating behaviors.
Those behaviors include doing one or more of the following to gain weight or bulk up: eating more or different foods than usual, taking dietary supplements, or using androgenic anabolic steroids.
“Muscularity-oriented disordered eating may develop when a boy becomes preoccupied with his appearance, body size, weight, food, or exercise in a way that worsens his quality of life,” Dr. Jason Nagata, MSc, lead author of the study and an assistant adjunct professor in the school of medicine at the University of California, San Francisco, told Healthline.
“In moderation, some behaviors to build muscle or bulk up may not be ‘disordered,’” he continued. “However, engaging in muscle-building or bulking behaviors may put young people at greater risk for developing an eating disorder or muscle dysmorphia.”
This study adds to a relatively small but growing body of research on disordered eating behaviors in boys and men.
“Males have been traditionally under-recognized in the fields of eating disorders and in research on disordered eating more generally, so any studies that are addressing this topic are helpful,” Jason Lavender, PhD, an assistant researcher in the school of health sciences at the University of California, San Diego, told Healthline
“In terms of the methods, I think this type of study is especially valuable, both because it’s longitudinal and because it’s in a nationally representative sample,” he continued.
To conduct the study, Nagata and colleagues used data from the National Longitudinal Study of Adolescent to Adult Health.
They followed a nationally representative cohort of 14,891 young adults in the United States over a period of seven years.
Participants who said they were trying to gain weight were asked about some of the strategies they had used to do so, including dietary changes, supplement use, and steroid use.
Young men were more likely than young women to say they were trying to gain weight. They were also more likely to report that they had changed their diets or used supplements or steroids to bulk up.
While 22 percent of young men reported engaging in one or more of those behaviors, 5 percent of young women reported doing so.
Black youth were more likely than others to engage in such behaviors.
Not all efforts to gain weight or build muscle are disordered.
But when those efforts interfere with someone’s health, quality of life, or ability to take part in their usual work or social activities, it may be a sign that they’ve developed an eating disorder.
Muscularity-oriented disordered eating behaviors are also linked to muscle dysmorphia.
“Muscle dysmorphia is a type of body dysmorphic disorder in which people are preoccupied with nonexistent or slight flaws in their appearance to the point that it causes them clinically significant distress or impairment in functioning — usually both,” Dr. Katharine Phillips, a professor of psychiatry in the department of psychiatry at NewYork-Presbyterian Hospital and Weill Cornell Medical College at Cornell University in New York, told Healthline.
“In the case of muscle dysmorphia, the appearance concerns focus on thinking that one’s body build is too small or insufficiently muscular. In reality, these men look normal or are even very muscular due to working out excessively and/or taking muscle-building, often risky, drugs,” she added.
When Phillips and her colleagues studied muscle dysmorphia, they estimated that more than 20 percent of men with this condition met the criteria for an eating disorder.
She also notes a significant portion of men with muscle dysmorphia use anabolic steroids.
Muscularity-oriented disordered eating behaviors and muscle dysmorphia can put people at risk for serious physical and mental health problems.
For example, eating an overly restricted diet can raise the risk of malnutrition.
Excessive exercise can cause injuries that may be disabling. It can also contribute to social isolation if a person’s workout schedule makes it difficult for them to maintain their social life.
Anabolic steroid use increases the risk of many health conditions, including stroke, heart attack, liver damage, and kidney damage. Using needles to inject steroids raises the risk of infection, too.
Supplement use might also pose dangers to a person’s health, many of which may be hard to predict or study due to the lack of regulatory oversight and transparency in the supplement industry.
In addition to such physical risks, muscularity-oriented disordered eating behaviors and muscle dysmorphia can also impair a person’s mood, self-esteem, and overall mental health.
If you suspect that you or someone you care about is experiencing muscularity-oriented disordered eating behaviors or muscle dysmorphia, Phillips recommends seeking professional help.
“Muscle dysmorphia and muscularity-oriented disordered eating are distressing, impairing, and potentially even life-threatening, and they often improve with the right treatment,” Phillips said.
“Two-thirds of people with body dysmorphic disorder have onset of the disorder before age 18, so it’s especially important to be aware of it during childhood and adolescence,” she added.
To treat muscularity-oriented disordered eating or muscle dysmorphia, healthcare professionals may use many of the same strategies used to treat other types of disordered eating or body dysmorphic disorders.
“Although muscularity-oriented disordered eating involves some different behaviors than traditional disordered eating, often it’s driven by similar concerns and the same sort of underlying issues,” Lavender said.
“So, what’s being done currently is, [experts are] taking traditional eating disorder prevention and treatment programs and adapting those,” he continued.
Depending on a person’s specific behaviors and symptoms, they might benefit from treatment with certain types of medication, counseling, or other types of support.
To learn more about treatment options and access other support resources, Lavender suggests people may find it helpful to connect with the National Eating Disorders Association.