Young adults who see themselves as scrawny and who exercise to gain weight may be at risk of muscularity-oriented disordered eating behaviors, according to a new study led by researchers at the University of California- San Francisco (UCSF) Benioff Children’s Hospitals.
These behaviors include one or more of the following: eating more or differently to gain weight or bulk up and/or using dietary supplements or anabolic steroids to achieve the same goal.
The findings, published in the International Journal of Eating Disorders, reveal that 22 percent of young men and 5 percent of young women, ages 18 to 24, exhibit these disordered eating behaviors.
Left untreated, these behaviors may escalate to muscle dysmorphia, characterized by rigid dieting, obsessive over-exercising and extreme preoccupation with physique, say the researchers.
“Some eating disorders can be challenging to diagnose,” said first author Jason Nagata, M.D., of the UCSF Division of Adolescent and Young Adult Medicine.
“Unlike anorexia nervosa, which may be easily identified by parents or pediatricians, disordered eating to increase bulk may masquerade as healthy habits and because of this, it tends to go unnoticed.”
At its most extreme, it can lead to heart failure or overexertion, as well as muscle dysmorphia, which is associated with social withdrawal and depression, Nagata said.
For the study, the researchers evaluated the data of 14,891 young American adults, who had been followed for seven years. The researchers wanted to see if the early data, when the participants’ average age was 15, revealed something about their perceptions and habits that may serve as warning signs.
They found that male teens who exercised specifically to gain weight had 142 percent higher odds of this type of disordered eating; among female teens, the odds were increased by 248 percent. Boys who perceived themselves as being underweight had 56 percent higher odds; in girls the odds were 271 percent higher. Smoking and alcohol use in boys, and smoking in girls, increased odds moderately.
In addition, being African-American boosted the odds by 66 percent in boys and 181 percent in girls. Non-heterosexual identity, which the participants had been asked about when they reached adulthood, was not found to be a risk factor, the researchers said.
In young adulthood, 6.9 percent of males reported supplement use to gain weight or build muscle and 2.8 percent said they used anabolic steroids. Use by young women was significantly lower at 0.7 percent and 0.4 percent respectively.
“Supplements are a black box, since they are not regulated,” said Nagata. “In extreme cases, supplements can cause liver and kidney damage. Anabolic steroids can cause both long-term and short-term health issues, including shrunken testicles, stunted growth and heart disease.”
According to Nagata, some behavioral clues that may indicate muscle dysmorphia risk include a highly restrictive diet that omits fats and carbohydrates, compulsive weighing and checking of appearance, and extensive time dedicated to exercise that may cut into social activities.