Body Image Concerns, Muscle-Enhancing Behaviors, and Eating Disorders in Males

Body image concerns among adolescents and young adults are prevalent; almost half of adolescent girls report being dissatisfied with theway their bodies look.1 Body dissatisfaction can have seri-ous adverse consequences, including disordered eating behaviors, eatingdisorders, andobesity. Longitudinal studieshave shown that body dissatisfaction does not motivate young people to engage in healthier eating and physical activity behaviors.2 Body dissatisfac-tionhasbeenfoundtobeassociatedwitha lower likelihoodofhealth-promoting behaviors such as physical activity and eating fruits and vegetables.2Becausebodydissatisfactiondoesnotmotivateyoung people to engage in health-promoting behaviors, it is important to helpyoungpeople feelbetter about theirbodies topromoteasense of positive well-being and healthier behaviors. Most research on body dissatisfaction emphasizes weight and shape dissatisfaction (eg, wanting to be thinner) in female popula-tions. More recently realized is the importance of body image in adolescent males and the relevance of muscularity for both adoles-cent males and females.3-5 In a study of 5527 adolescent boys aged 12 to 18 years published in JAMA Pediatrics, Field and colleagues6 showed that adolescent boys have concerns aboutmuscularity and engage in muscle-enhancing behaviors: 17.9 % were highly con-cerned, including 2.4 % who used products to enhance muscularity at some point in the 1999-2011 study period. Muscle-enhancing behaviors, and to a lesser extent, muscle-related concerns, were found to longitudinally predict the onset of binge drinking and drug use. Given these findings, clinicians should address muscularity