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Body image concerns among men—particularly muscularity-oriented eating behaviours, muscle dysmorphia, and exercise addiction—are increasingly recognized but remain understudied in relation to sexual orientation. Existing research suggests that gay men may be more vulnerable to these issues, yet the nature of their interrelationships remains unclear. This study examined the associations among muscularity-oriented eating behaviours, muscle dysmorphia, and exercise addiction in gay and heterosexual men and tested whether sexual orientation moderated these associations. A sample of 168 physically active men (104 heterosexual, 64 gay) completed validated self-report questionnaires. Analyses included independent samples t-tests, multiple regression, and moderation using the PROCESS macro. Gay men reported significantly higher levels of muscularity-oriented eating behaviours (p = .006, d = 0.44), muscle dysmorphia (p < .001, d = 0.66), and exercise addiction (p = .002, d = 0.50) compared to heterosexual men. Regression analyses showed that both muscularity-oriented eating behaviours and muscle dysmorphia were significantly associated with exercise addiction, jointly accounting for 42% of the variance. Moderation analyses further revealed that sexual orientation significantly moderated these associations, with stronger links observed among gay men for both muscularity-oriented eating behaviours and muscle dysmorphia in relation to exercise addiction. These findings reveal important clinical implications for professionals working with male populations experiencing body image concerns. The stronger association between body image concerns and exercise behaviours in gay men highlights the need for targeted assessment strategies that consider sexual orientation as a meaningful factor in clinical presentations. Results support an integrated approach to screening and treatment that addresses these interconnected concerns simultaneously rather than as separate issues. Clinicians should incorporate muscularity-oriented assessment tools when working with men and develop interventions that specifically address the unique manifestations of body image distress in diverse male populations. Future research should explore underlying sociocultural mechanisms using longitudinal and mixed method approaches to further refine these clinical applications. Many men today are concerned about how their bodies look, especially when it comes to being muscular and lean. For some, this can lead to strict eating habits focused on gaining muscle—a condition called muscle dysmorphia (MD)—or to exercising so much that it becomes hard to stop, which researchers refer to as exercise addiction (EA). Previous research has shown that gay men may be especially affected by these concerns. However, we do not yet know how these issues are connected, or how sexual orientation might influence them. In this study, 168 men (104 heterosexual and 64 gay) answered questionnaires about their eating habits, body image concerns, and exercise behaviours. The results showed that gay men reported higher levels of muscle-focused eating behaviours, symptoms of MD, and signs of EA compared to heterosexual men. We also found that the link between body image concerns and compulsive exercise was stronger among gay men. These findings suggest that some men—particularly gay men—may be more likely to struggle with intense concerns about muscularity and exercise. While this study did not examine the underlying reasons, it highlights the need for future research into the social and psychological factors that may contribute to these patterns. These insights may help inform support, prevention, and treatment programs that are sensitive to men’s diverse experiences with body image.
Arey et al. (Tue,) studied this question.