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Updated June 27, 2014.
Tween and teen girls face societal pressure to be thin, but for boys the typical ideal body is big and muscular. That can lead to muscle-building behaviors—some of which are dangerous—among adolescent boys. A study of a large group of teens published in the journal Pediatrics reported that certain "muscle-enhancing" behaviors by teens may be on the rise, particularly among subgroups like athletes and kids who are overweight.
The study's authors expressed concern about this trend.
The researchers used data from a diverse sample of nearly 2,800 adolescents (both boys and girls) from 20 different urban middle schools and high schools. The study looked at the presence and prevalence of five muscle-enhancing behaviors among the subjects. Two are potentially healthy: changed eating and exercise habits. Three are considered unhealthy: overuse of protein and use of steroids or other muscle-building substances.
Among boys:
- More than two-thirds said they changed their eating habits to increase muscle size or tone
- Over 90% added exercise to increase muscle mass or tone
- Over one-third used protein powders or shakes
- Just under 6% used steroids; Asian boys had elevated odds of steroid use compared with whites
- About 10% used some other muscle-enhancing substance
- Almost 12%, especially those who participated in sports, did three or more of these
Among girls:
- A large majority changed eating and exercise habits
- 21% used protein powders or shakes
- 4.6% used steroids
- 5.5% used other substances
- About 6% did three or more of these
Both boys and girls who were overweight or obese were significantly more likely to report these kinds of behaviors
"As with boys, girls who are obese (or overweight, in the case of protein use) had significantly elevated odds of reporting these behaviors than those of average weight," the study states. "Sports team participation was positively associated with changing eating, exercising, and using protein powders/shakes."
Unlike some other research into this area, this study did not find "clustering" of muscle-enhancing behaviors within schools. The researchers suggest that this means that these behaviors are influenced by factors outside of school (instead of, say, being driven by a particular sports team coach). These factors might include media messages.
How Parents and Doctors Can Respond
The authors note that a societal focus on leanness and muscularity means that teens are engaging in these behaviors to boost satisfaction with their bodies (not necessarily for good health). The authors conclude that "health care providers should counsel adolescent patients about appropriate exercise, general nutrition, and the lack of efficacy and potential dangers of muscle-enhancement products."
Also, existing programs designed to improve body image might need to be broadened to address muscularity as well as thinness (this would be a cost-effective strategy). Anytime coaches, parents, and medical professionals encourage physical activity and healthy eating in adolescents, we need to focus on "skill development, fitness, and general health rather than development of a muscular appearance," the authors note.
Source:
Eisenberg ME, Wall M, and Neumark-Sztainer, D. Muscle-enhancing behaviors among adolescent girls and boys. Pediatrics, Vol. 130 No. 6, December 2012.
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