Muscle-enhancing behaviors among adolescent girls and boys
Open accessAbstract
OBJECTIVE: Media images of men and women have become increasingly muscular, and muscle-enhancing techniques are available to youth. Identifying populations at risk for unhealthy muscle-enhancingbehaviors is of considerable public health importance. The current study uses a large and diverse population-based sample of adolescents to examine the prevalence of muscle-enhancing behaviors and differences across demographic characteristics, weight status, and sports team involvement. METHODS: Survey data from 2793 diverse adolescents (mean age = 14.4) were collected at 20 urban middle and high schools. Use of 5 muscle-enhancing behaviors was assessed (changing eating, exercising, protein powders, steroids and other muscle-enhancing substances), and a summary score reflecting use of 3 or more behaviors was created. Logistic regression was used to test for differences in each behavior across age group, race/ethnicity, socioeconomic status, BMI category, and sports team participation. RESULTS: Muscle-enhancing behaviors were common in this sample for both boys and girls. For example, 34.7% used protein powders or shakes and 5.9% reported steroid use. Most behaviors were significantly more common among boys. In models mutually adjusted for all covariates, grade level, Asian race, BMI category, and sports team participation were significantly associated with the use of muscle-enhancing behaviors. For example, overweight (odds ratio = 1.45) and obese (odds ratio = 1.90) girls had significantly greater odds of using protein powders or shakes than girls of average BMI. CONCLUSIONS: The use of muscle-enhancing behaviors is substantially higher than has been previously reported and is cause for concern. Pediatricians and other health care providers should ask their adolescent patients about muscle-enhancing behaviors.
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Muscularity-oriented disordered eating behaviors are relatively common among both adolescent boys and girls.
“Clinicians working with adolescent girls should assess for muscularity-oriented disordered eating behaviors, which are relatively common among both adolescent boys and girls (Eisenberg et al., 2012).”
From Incorporating social media and muscular ideal internalization into the tripartite influence model of body image: Towards a modern understanding of adolescent girls’ body dissatisfaction (2022) · cites this paper as Eisenberg et al., 2012
The Results report that changing eating to increase muscle size or tone was common among both boys and girls, and the Conclusions recommend that clinicians ask adolescents about muscle-enhancing behaviors. The paper does not establish that these common behaviors were disordered eating: its Conclusions say that changing eating or exercising may be beneficial, while compulsive or excessive use is cause for concern. No page numbers are available in our copy. (LLM, conf=0.88)
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References 42 · Cited by 197
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- Leit RA, Pope HG Jr, Gray JJ. Cultural expectations of muscularity in men: the evolution of playgirl centerfolds. Int J Eat Disord. 2001;29(1):90-93
- Pope HG Jr, Olivardia R, Gruber A, Borowiecki J. Evolving ideals of male body image as seen through action toys. Int J Eat Disord. 1999;26(1):65-72
- Pope HG Jr, Olivardia R, Borowiecki JJ III, Cohane GH. The growing commercial value of the male body: a longitudinal survey of advertising in women's magazines. Psychother Psychosom. 2001;70(4):189- 192
- Neumark-Sztainer D, Wall M, Larson N, Story M, Fulkerson JA, Eisenberg ME. Sec- ular trends in weight status and weight- related attitudes and behaviors in adoles- cents from 1999-2010. Prev Med. 2012;54 (1):77-81
- Leit RA, Gray JJ, Pope HG Jr. The media' s representation of the ideal male body: a cause for muscle dysmorphia? Int J Eat Disord. 2002;31(3):334-338
- Andrist LC. Media images, body dissatis- faction, and disordered eating in adoles- cent women. MCN Am J Matern Child Nurs. 2003;28(2):119-123
- Hogan MJ, Strasburger VC. Body image, eating disorders, and the media. Adolesc Med State Art Rev. 2008;19(3):521-546, x-xi
- Grogan S. Body Image: Understanding Body Dissatisfaction in Men, Women, and Chil- dren. 2nd ed. London, England: Routledge; 2008
- Gruber AJ. A more muscular female body ideal. In: Thompson JK, Cafri G, eds. The Muscular Ideal Psychological, Social, and Medical Perspectives. Washington, DC: American Psychological Association; 2007: 217-234
- Homan K. Athletic-ideal and thin-ideal in- ternalization as prospective predictors of body dissatisfaction, dieting, and compul- sive exercise. Body Image. 2010;7(3):240- 245
- Associated Press. Barry Bonds indicted. November 15, 2007. Available at: www. sfgate.com/flat/archive/2007/11/15/news/ archive/2007/11/15/state/n141013S18.html. Accessed October 5, 2011
- Metzl JD, Small E, Levine SR, Gershel JC. Creatine use among young athletes. Pedi- atrics. 2001;108(2):421-425
- vandenBerg P, Neumark-Sztainer D, Cafri G, Wall M. Steroid use among adolescents: longitudinal findings from Project EAT. Pe- diatrics. 2007;119(3):476-486
- Irving LM, Wall M, Neumark-Sztainer D, Story M. Steroid use among adolescents: findings from Project EAT. J Adolesc Health. 2002;30(4):243-252
- Vertalino M, Eisenberg ME, Story M, Neumark- Sztainer D. Participation in weight-related sports is associated with higher use of unhealthful weight-control behaviors and steroid use. J Am Diet Assoc. 2007;107(3): 434-440
- McCabe MP, Ricciardelli LA. Body image and body change techniques among young ad- olescent boys. Eur Eat Disord Rev. 2001;9 (5):335-347
- McCabe MP, Ricciardelli LA. Parent, peer, and media influences on body image and strategies to both increase and decrease body size among adolescent boys and girls. Adolescence. 2001;36(142):225-240
- Smolak L, Murnen SK, Thompson JK. So- ciocultural influences and muscle building in adolescent boys. Psychol Men Masc. 2005;6(4):227-239
- Fernandez MMF, Hosey RG. Performance- enhancing drugs snare nonathletes, too. J Fam Pract. 2009;58(1):16-23
- Neumark-Sztainer D, Story M, Hannan PJ, Croll J. Overweight status and eating pat- terns among adolescents: where do youths stand in comparison with the healthy people 2010 objectives? Am J Public Health. 2002;92(5):844-851
- Stice E. Risk and maintenance factors for eating pathology: a meta-analytic review. Psychol Bull. 2002;128(5):825-848
- Stice E, Whitenton K. Risk factors for body dissatisfaction in adolescent girls: a longi- tudinal investigation. Dev Psychol. 2002;38 (5):669-678
- Cafri G, Thompson JK, Ricciardelli L, McCabe M, Smolak L, Yesalis C. Pursuit of the muscular ideal: Physical and psycho- logical consequences and putative risk factors. Clin Psychol Rev. 2005;25(2):215- 239
- Boutelle K, Neumark-Sztainer D, Story M, Resnick M. Weight control behaviors among obese, overweight, and nonover- weight adolescents. J Pediatr Psychol. 2002;27(6):531-540
- Neumark-Sztainer D, Story M, Hannan PJ, Perry CL, Irving LM. Weight-related con- cerns and behaviors among overweight and nonoverweight adolescents: implica- tions for preventing weight-related dis- orders. Arch Pediatr Adolesc Med. 2002;156 (2):171-178
- Authors
- Eisenberg, M. E., Wall, M., & Neumark-Sztainer, D.
- Affiliations
- University of Minnesota (US)
- Columbia University (US)
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota; and
- Corresponding author
- Wall, Melanie
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2012-12-01
- Volume
- 130
- Issue
- 6
- Pages
- 1019-1026
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC3507247
- OpenAlex
- W2108041501
- Cited by
- 197
- References
- 42
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 7 · 2023: 8 · 2022: 29 · 2021: 22 · 2020: 28 · 2019: 17 · 2018: 11 · 2017: 17 · 2016: 12 · 2015: 9 · 2014: 15 · 2013: 8 · 2012: 1
- FWCI
- 34.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- PEDIATRICS (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL084064)
- Topics
- Social Sciences › Sociology and Political Science › Doping in Sports
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Pharmacological Effects and Assays
- Keywords
- adolescents, anabolic steroids, protein powder, weight status, obesity, overweight, sex differences, race and ethnicity, socioeconomic status, dietary habits, physical activity
- MeSH terms
- Adolescent, Adolescent Behavior, Body Image, Dietary Proteins, Drug Utilization, Feeding Behavior, Female, Health Surveys, Humans, Male, Minnesota, Obesity, Powders, Socialization, Somatotypes, Steroids, Health Behavior, Exercise, Muscle, Skeletal, Dietary Supplements, Overweight, Muscle Strength, Performance-Enhancing Substances
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