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Male body image and the damage done

18 Feb 2014

Poor body image has been seen primarily as a women’s health issue, but males are not immune to body image concerns.

In fact, it is increasingly recognised that young men are particularly vulnerable, with Mission Australia’s annual National Survey of Young Australians consistently identifying body image as a significant area of concern for both genders.

Unhealthy body image harms mental and physical health, as well as social functioning, and can potentially lead to unhealthy dieting, eating disorders, excessive exercise, substance use and a desire for unnecessary surgical procedures.

Popular media has a significant influence on self-perception and body image, with young people being especially susceptible to social pressure to conform to ideal stereotypes. For men, this often means lean and athletic.

Idealised images promoted in the media can contribute to unrealistic perceptions about an individual’s physical appearance. Australian research has shown that among males, body dissatisfaction can lead to body dysmorphic disorder, which is an excessive concern and preoccupation with physical features. 

Typical approaches to changing physical appearance include highly restrictive diets and excessive amounts of exercise. For females the goal is generally weight loss in order to meet the ‘thin ideal’, while men are likely to want to either gain or lose weight in order to achieve low body fat levels and increased muscle mass, to achieve the idealised V-shaped frame. 

Cultural attitudes mean that excessive exercise in males is often seen as a positive attribute, and may be encouraged.

Combined with the expectation that men should not talk openly about insecurities, including concerns about their physical appearance, this means that the problem may be difficult to identify during a medical consultation.

Achieving the desired V-shaped look can be extremely difficult, so many men will resort to taking various muscle building supplements, have a diet of predominantly low fat protein, and spend hours in the gym. Ultimately, some will resort to steroid use.

Australian research has shown that 68 per cent of steroid users attributed their usage to body image and other appearance-related issues.

The steroid doses used are often much higher than those prescribed for medical conditions that warrant their use.

Due to cost, accessibility, tolerance and a desire to reduce side effects, steroids are often taken intermittently (commonly referred to as ‘cycling’). Users also combine different types of steroids with non-steroidal supplements, with the aim of maximising results (‘staking’).

While steroids do not cause the same high as other drugs, they are reinforcing and can be psychologically addictive. When taking steroids, many users report feeling good about themselves. But extreme mood swings can occur, possibly resulting in paranoid jealousy, extreme irritability, delusions and impaired judgement.

The physical consequences of steroid abuse for men include kidney impairment or failure, liver damage, cardio vascular problems, and the commonly reported testicular atrophy, reduced fertility, gynaecomastia and an increased risk of prostate cancer. For adolescent male users, additional effects may include stunted growth and accelerated puberty.

Despite limited evidence of effectiveness, human growth hormone (HGH) is increasingly being used as a way to enhance athletic performance.

HGH has been shown to reduce body fat and increase lean muscle mass. It may also enhance resistance to injury and facilitate faster recovery from injury and fatigue.

However, some research suggests that the use of HGH may in fact lower stamina and athletic performance.

Despite the lack of a strong consensus on its impact, increasing numbers of males are using HGH to help them achieve their desired ‘look’.

Hormones may be requested from medical practitioners but should, of course, only be prescribed when clinically indicated.

Much more often, hormones and ‘supplements’ are obtained at gyms or over the internet. Anything from these sources is dubious in terms of both content and safety. For example, Dinitrophenol, which is promoted as a fat loss supplement, has caused severe illness and death.

In recent weeks it has been suggested that male body image issues, and the associated steroid abuse, are contributing to alcohol-related violence.

While it is hard to be definitive, research confirms that men, particularly young men, are vulnerable to body image concerns.

Alongside efforts to prevent the development of poor body image among boys, clinicians and educators must be attuned to the needs of teen and young adult males who may be effected by poor body image. 

The AMA’s Position Statement Body Image and Health was last reviewed in 2009.

Given the increasing interest in male body image and more recent research, it is likely that the AMA’s Public Health and Child & Youth Health Committee will undertake a review of the policy in order to expand its reference to male body image. 

I would welcome feedback from members about their views and experiences in relation to male body image, and body image more broadly. 

Published: 18 Feb 2014