By Yalda Alam
Summertime is finally here! After months of wearing oversized sweaters, knee high boots and the thickest winter coat, the temperatures are finally rising. While most students are finished with their last study activities and are worrying about which sunglasses suit their faces best, summer is not all sunshine for everyone. With modern day beauty standards and advertisements promoting all kinds of ‘skinnytea’ and easy weight-loss supplements, both women and men are facing mounting pressure regarding their appearance. New studies show that we might underestimate the impact it has on men in particular, who are increasingly struggling with body-image dissatisfaction.
During the last decades, the majority of the world depicts the ideal man as a strong and muscular male body. Men are becoming more prone to the influence of these robust male images on the covers of magazines, in movies and commercials, and even in children’s action figures. According to Harrison G. Pope M.D., professor of Psychiatry at Harvard Medical School, the number of men with a preoccupation regarding their body weight and shape is far greater than the current statistics would indicate. Men who have a disorder rarely come forward and at the same time are seldom recognised by healthcare providers because of the sex-specific presentation.[1][2][3] This is supported by a prospective cohort study, the Growing Up Today Study, which showed that 8% of young men in the USA report being very concerned with their lack of muscles and use unhealthy means in pursuit of their desired level of muscularity. These data come from questionnaires sent every 12 to 36 months from 1999 up till 2010 to 5527 young males (12 to 18 years).[4] This obsession with their muscular appearance and leanness can be defined as ‘Muscle dysmorphia’, a subdivision of Body Dysmorphic Disorder. Due to the severity and rising prevalence of this disorder, it has even been included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as an official diagnosis.[5]
Unfortunately, the obsessive dysmorphic behaviour often pushes men to resort to the use of high-protein level dietary supplements and anabolic-androgenic steroids (AASs), especially ‘testosterone boosters’. Several studies have indicated that around 45% of men with muscle dysmorphia utilise such AASs for their entire lives. The use of these supplements often turns into abuse due to combining extremely high doses of AASs with other substances such as human growth hormone, thyroid hormones and insulin to accelerate the process and enhance the mass and visibility of muscularity. Also, the use of AAS on its own is not entirely without health risks. Adverse effects include an increased risk of cardiovascular disorders, a stroke, long-term neurotoxicity and even premature death.[6][7]
Overall, Muscle Dysmorphia has shown to be a dangerous mental illness that is becoming more and more prevalent nowadays. With muscle loaded male images everywhere that tend to link appearance to success, it is understandable why millions of people are unhappy with the way they look. And so, society actually sends a disturbing double message: a man’s self-esteem should be based primarily on his appearance, yet by modern day supermale standards, practically no man is able to measure up.
1. S.B. Murray, S. Griffiths, J.M. Mond. Evolving eating disorder psychopathology: Conceptualizing muscularity-oriented disordered eating. Br J Psychiatry, 208 (2016), pp. 414–415.
2. D. Mitchison, J.M. Mond. Epidemiology of eating disorders, eating disordered behaviour, and body image disturbance in males: A narrative review. J Eat Disord, 3 (2015), p. 20.
3. Pope HG, Jr, Phillips KA, Olivardia R. The Adonis Complex: The Secret Crisis of Male Body Obsession. New York, NY: The Free Press; 2000.
4. Field AE, Sonnenville KR, Crosby RD, Swanson SA, Eddy KT, Camargo CA, et al. Prospective association of concerns about physique and the development of obesity, binge drinking, and drug use among adolescent boys and young adult men. JAMA Pediatrics 2014; 168: 34–9.
5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5®) Arlington, VA: American Psychiatric Association; 2013.
6. Pope HG, Khalsa JH, Bhasin S. Body Image Disorders and Abuse of Anabolic- Androgenic Steroids Among Men. JAMA. 2017;317(1):23-24.
7. Stuart B. Murray, Scott Griffiths, Jonathan M. Mond, Joseph Kean, Aaron J. Blashill. Anabolic steroid use and body image psychopathology in men: Delineating between appearance- versus performance-driven motivations. Drug and Alcohol Dependence, Volume 165, 1 August 2016, Pages 198-202.