A muscle-building obsession in boys: What to know and do

Boys are surrounded by Marvel action heroes with huge, protruding muscles and rock-hard abs by the time they are eight or ten years old. They are overloaded with social media feeds of masculine bodies that have bulked up by adolescence.

Many boys worry about how they measure up and are concerned about the underlying signals about power and worth. Sometimes, negative ideas and worries may get in the way of day-to-day activities; this is a mental health condition called body dysmorphic disorder, or body dysmorphia. In boys, muscular dysmorphia is the most prevalent type of condition.

What is muscle dysmorphia?

Muscle dysmorphia is characterized by an obsession with having a slender, muscular body. Although just a tiny proportion of boys and young men exhibit the more severe behaviors that characterize this condition, it may influence the thinking of many more.

Approximately 25% of boys and young men participate in activities related to muscular growth. “Approximately 60% of young boys in the United States mention altering their diet to gain more muscle,” says Dr. Gabriela Vargas, who oversees Boston Children’s Hospital’s Young Men’s Health website. “While that may not meet the diagnostic criteria of muscle dysmorphia disorder, it’s impacting a lot of young men.”

“There’s a social norm that equates muscularity with masculinity,” says Dr. Vargas. Even four and five-year-old boys’ Halloween costumes now feature padding designed to resemble six-pack abs. They are continuously told that this is how their bodies should appear.”

Does body dysmorphic disorder differ in boys and girls?

Body dysmorphia, long associated with girls, can manifest as eating disorders like bulimia or anorexia. Muscle dysmorphia is not considered an eating disorder in theory. However, it is far more subtle and common among men.

“The common notion is that body dysmorphia just affects girls and isn’t a male issue,” explains Dr. Vargas. “Because of that, these unhealthy behaviors in boys often go overlooked.”

What are the health dangers of muscle dysmorphia in boys?

Extreme actions can be harmful to one’s bodily and emotional well-being.

For instance, males who use uncontrolled protein powders and supplements in the expectation of rapidly gaining muscle mass may be using stimulants or perhaps anabolic steroids. “With that comes an increased risk of stroke, heart palpitations, high blood pressure, and liver injury,” says Dr. Vargas.

Boys who follow a “bulk and cut” plan, which alternates periods of intense calorie restriction with rapid weight growth, also try to build muscle. This may have an impact on long-term bone and muscle development, as well as reduced testosterone levels and irregular heartbeat.

“Even in a best-case scenario, eating too much protein can lead to a lot of intestinal distress, such as diarrhea, or to kidney injury, since our kidneys are not meant to filter out excessive amounts of protein,” explains Dr. Vargas.

Significant psychological effects are also possible. Males who severely restrict their calorie intake or skip out on entire food groups may become malnourished, which increases their risk of depression and suicide ideation. In addition, individuals could have persistent feelings of inadequacy as they strive to live up to false expectations.

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