Do men have unrealistic ideals for body image?

"I'm worried about my son. He's spending more time in the gym than at college. He thinks he's scrawny but he's not."

"My boyfriend's diet includes four protein shakes and four protein bars every day. Isn't that a bit excessive ... ?"

"I want to be massive ... I want more muscle, less fat."

There's a new syndrome emerging from behind gym doors. It's called muscle dysmorphia. You might notice it in the weight room of your gym.

Some weightlifters have a pathological belief their muscles are too small. They have a poor body image; they are ashamed of, embarrassed by and unhappy with their bodies. They have a passionate desire to not only build muscle, but also to avoid gaining fat.

This preoccupation with building muscles manifests in excessive weight lifting (spending 4+ hours a day at the power gym), excessive attention to diet (consuming protein shakes on a rigid schedule), excessive time spent "body-checking" (looking in mirrors, CDs, window reflections, etc)., excessive weighing of themselves (10 to 20 times per day), too little time spent with family and friends (but who'd want to be with a wimp, anyway???) and not uncommonly, use of anabolic steroids.

Is this overconcern with body size a new obsession? Perhaps. In the past few years, we have been increasingly exposed to half-naked male bodies (i.e., underwear ads for Calvin Klein, shampoo ads with muscular men taking showers). Even brief exposure to these media images can affect a man's view of his body.

In a study of the media's effect on male body image, a group of college men viewed advertisements with muscular men while another group viewed neutral advertisements with no partially-naked male bodies. The men were then given a body image assessment (while unaware of the hypothesis being tested in the study).

The men exposed to the muscular images showed a significantly greater discrepancy between the body they ideally would want to have and their current body size. (Leit, Int'l J Eating Disorders, April '02)

Another study suggests up to a third of teenage boys are trying to gain weight to be stronger, fitter, have a better body image and do better at sports. (J Am Diet Assoc, Jan. '01)

The irony is, while college-age men may believe a larger male body is more attractive to the opposite sex, women report desiring a more normal-sized body. In a study with men from three countries (United States, Austria, France), the subjects were shown a spectrum of body images and then asked to chose

1) The body they felt represented their own body,
2) the body they would ideally like to have,
3) the body of an average man of their age, and
4) the male body they felt was preferred by women.

Men from all three countries chose an ideal male body that was about 28 pounds more muscular then their current bodies. They also reported believing women prefer a male body with 30 pounds more muscle than they currently possessed. Yet, an accompanying study with women indicated women actually preferred an ordinary male body without added muscle. (Pope, Am J Psychiatry, Aug. 2000)

At the Massachusetts Eating Disorders Association's (MEDA) annual conference, Roberto Olivardia shared his research on body image in adolescent boys.

Olivardia is a psychology instructor at Harvard Medical School and co-author of The Adonis Complex. (Adonis is the Greek god who exemplifies ideal masculine beauty and the desire of all women.) Olivardia explained that adolescence is a time for exploring "Who am I?"

Without a doubt, so much of who a teen is is defined by his body. Because today's boys have been exposed from day one to GI Joe dolls, Hulk Hogan, and Nintendo's Duke Nukem, they have relentlessly received very strong messages that muscular bodies are desirable.

Muscularity is commonly associated with masculinity. Compared to ordinary men, muscular men tend to command more respect, are deemed more powerful, more threatening, more sexually virile. Muscular men perceive others as "backing off" and "taking them seriously."

Not surprisingly, men's desire for muscles has manifest in a dramatic increase in cosmetic surgery for muscle (and penile) implants.

Olivardia expressed concern that the "bigger is better" mindset can often lead to the use of anabolic steroids. He cited statistics from a study with 3,400 12th grade high school boys: 6.6% reported having resorted to steroids; more than two-thirds of the boys started before the age of 16. (Buckley, JAMA 260:344, 1988)

Olivardia regrets that steroids are commonly used shamefully, in secrecy. "Men will tell someone they use cocaine before they admit to using juice.'"

Steroids carry with them serious medical concerns: breast enlargement, impotence, acne, mood swings, risk of heart disease, prostate cancer, liver damage and AIDS (from sharing needles) to say nothing of sudden death, if not now perhaps 20 years from now.

"Roid rage," the fierce temper that easily contributes to brutal murders and violence against women, is an immediate danger.

Olivardia reminds us not every male who lifts weights struggles with muscle dysmorphia. Those at risk include boys who have been teased as a child about being too fat or too short. The boys at highest risk are those who base their self-esteem solely on how they look.

What's the solution? According to Olivardia, young men need education about realistic body size so they can correct the distorted thought "if some muscle is good, then more must be better."

They might also need treatment for obsessive-compulsive disorder. The sad part is, most men believe they are the only ones on this planet who have this problem; they take a very long time to admit the need for therapy. And when they do, too few programs exist to help them explore the function this obsession serves in their life: It offers a sense of control. They mistakenly believe control of their bodies equates to control over their lives.

If you are a male struggling with body dysmorphia, certainly you can read The Adonis Complex: The Secret Crisis of Male Body Obsession and other books that are available via

A Web search on "muscle dysmorphia" can also yield hundreds of articles with helpful information. Most importantly, know you are not alone; seek help and find peace.

For help with eating disorders and body image, go to the Massachusetts Eating Disorders Association's Web site: Copyright: Nancy Clark MS, RD 4/03

Sports nutritionist Nancy Clark, MS, RD counsels clients privately at SportsMedicine Associates (617-739-2003) in Brookline, Mass. Her Sports Nutrition Guidebook ($23) and Food Guide for Marathoners: Tips for Everyday Champions ($20) are available via or by sending a check to Sports Nutrition Services, 830 Boylston St #205, Brookline MA 02467.

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