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Fifth of young men who exercise engage in 'disordered eating' to gain muscle, study finds

Use of anabolic steroids may be a warning sign of muscle dysmorphia

Katie O'Malley
Thursday 20 June 2019 16:10 BST
Man working out in the gym
Man working out in the gym (iStock)

A fifth of young men who exercise to gain muscle may be at risk of so-called muscularity-orientated disordered eating behaviours, a new research finds.

The study, conducted by researchers at the UCSF Benioff Children’s Hospital in San Francisco, found that 22 per cent of males aged 18-24 who work out to bulk up exhibit these disordered eating behaviours.

Meanwhile, five per cent of women in the same age category show similar characteristics.

The behaviours are defined as including at least one of the following: eating more or differently to gain weight or bulk up, and use of dietary supplements or anabolic steroids to achieve the same goal.

The study’s researchers say that such behaviours, if left unchecked, may develop into muscle dysmorphia, which is characterised by a strict diet, obsessive over-exercising, and an extreme preoccupation with physique.

“Some eating disorders can be challenging to diagnose,” said the study’s first author Jason Nagata, MD, of the UCSF Division of Adolescent and Young Adult Medicine.

“Unlike anorexia nervosa, which may be easily identified by parents or paediatricians, disordered eating to increase bulk may masquerade as healthy habits and because of this, it tends to go unnoticed.”

Body dysmorphic disorder (BDD), or body dysmorphia, is a mental health condition where a person spends a lot of time worrying about flaws in their appearance, the NHS states. These flaws, as they view them, are often unnoticeable to others.

In the case of muscle mass, the dysmorphic disorder is also known as “bigorexia” – an anxiety disorder which causes someone to see themselves as small, despite actually being big and muscular.

The research, published in the International Journal of Eating Disorders, involved researchers analysing the behaviour of 14,891 young adults from the US.

Man lifting weight (Getty Images)

The analysts wanted to find out if their early data, when the participants’ average age was 15, showed something about their perceptions and habits that may serve as warning signs of disordered eating.

Their findings showed that young men who exercised specifically to gain weight had 142 per cent higher odds of this type of eating. Meanwhile, the odds increased by 248 per cent for young women.

Male participants who perceived themselves as being underweight also had 56 per cent higher odds of developing the behaviours linked to muscularity-orientated disordered food consumption, while in women the odds were 271 per cent higher.

Smoking and alcohol use in men, and smoking in women, increased odds moderately.

When it came to the intake of supplements to gain weight or build muscle, 6.9 per cent of the men reported they had take something to increase this, with 2.8 per cent saying they used anabolic steroids.

Use by women was significantly lower at 0.7 per cent and 0.4 per cent, respectively.

“Supplements are a black box, since they are not regulated,” stated Nagata.

“In extreme cases, supplements can cause liver and kidney damage. Anabolic steroids can cause both long-term and short-term health issues, including shrunken testicles, stunted growth and heart disease.”

The NHS states that anabolic steroids are prescription-only medicines that are sometimes taken without medical advice to increase muscle mass and improve athletic performance.

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However, when taken without medical permission, they can cause serious side effects and addiction.

Nagata continued, explaining that visible signs that could indicate behaviours may be developing into muscle dysmorphia include a highly restrictive diet that omits fats and carbohydrates, compulsive weighing and checking of appearance, and extensive time dedicated to exercise that may cut into social activities.

At its most extreme, the behaviours can lead to heart failure due to insufficient calories and overexertion, as well as muscle dysmorphia which is linked to social withdrawal and depression.

If you have been affected by any of the issues mentioned in this article, you can contact the following organisations for support:

NHS Moodzone

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