Supporting positive body image in boys

Being dissatisfied with our bodies is linked to a number of consequences for our mental and physical health. There is very compelling evidence that body dissatisfaction predicts, and is related to depression and anxiety, as well as eating disorders, use of muscle building supplements, misuse of drugs and alcohol, smoking and absences from school.

Just as young girls generally start with the weight change behaviour of dieting, boys generally start with trying to increase the amount of protein in their diet, and are then more likely to use muscle building supplements. These substances, like protein powders, are a huge multimillion dollar industry.

Supplement companies use intensive marketing to promise the gain of lean muscle mass with less effort, and make bold claims about their effectiveness. Muscle building supplements are easily purchased online, or from gyms or specialty supplement stores, and include things like protein powder, pre-workout supplements, mass gainer, and testosterone boosters.

 You might think that doping is just something that elite athletes do, but research shows that it is adolescent boys in more recreational-level sports who use these substances, as there are no legal frameworks prohibiting use for non-athletes.

Muscle building supplements are widely available and have been widely adopted by adolescent boys. In our research on boys aged 14-16 in all boys’ schools in Australia, we found that 49.8 per cent had used protein powder, 8.4 per cent used creatine, and 62 per cent intended to use protein powders in the future.

Boys who are engaged in a higher number of sports, and boys who are engaged in weight lifting, were more likely to be using muscle building supplements. 

In 2000, my colleague and I asked adolescent boys what (if anything), they were trying to do to in order to gain weight. Boys indicated that they were eating more meat, or drinking more milk – a few said they were using protein shakes, but the majority listed food-related mechanisms for weight gain.

In 2012, we repeated the same question, and we were surprised to find that boys were now listing the brand name, or the category of supplements that they were using to gain weight. 

Over that time, the level of body dissatisfaction hadn’t changed that much, but what boys were doing to try to gain muscle had changed dramatically. I wonder what the responses would be now…

Some supplements are fairly safe to use, though they can have some side effects, particularly if not used according to the instructions (and many adolescent boys don’t follow the instructions!).  The two main reasons why supplements are concerning are the lack of regulation, and the potential for the Gateway Effect.

One of the dangers of supplements comes from their lack of regulation; they fall into a grey area within the regulatory bodies. Because they are consumed like a food in powder or shake form, they are classified as a food, rather than as drugs, and they therefore fall under the lightest self-regulated category.

No one is checking that the supplements are safe, and no one is confirming that they are effective. This means that some supplements can contain dangerous substances such as stimulants, synthetic forms of testosterone, or dangerous amounts of otherwise safe substances.

It is hard to know the exact proportion of supplements that are spiked- intentionally or not- with these ingredients, but as an example, one study found that 52 per cent of the brands of one particular herbal supplement were found to contain a stimulant substance that was not related to the herbal ingredient, and had never been tested on humans. There are multiple reports of side effects from weight loss and muscle building supplement use, including heart attacks, liver failure, and sudden death, particularly among consumers who are otherwise safe and healthy.

 The other cause for concern relates to the fact that seemingly benign supplements can lead adolescents to want to take more and more serious substances. Termed the ‘Gateway Effect’, this concept is well established for illicit drug use, and recently confirmed for muscle building supplement use.

The idea is that adolescent boys might start by taking vitamins, and supermarket whey protein powders, but then as these things either do or don’t produce the effects they are after, they are more and more likely to move on to the more serious supplements such as pre-workout formulas and mass gainer products, and on to testosterone derivatives, and eventually steroids.

Boys either like the effect of what they are taking and want more, or they find that what they have tried isn’t as effective as they like, so they step it up a notch. The likely psychological and physical consequences of each supplement also increase along that scale. It’s something to be aware of, particularly in the early stages of boys wanting to use these substances.

It’s important to keep open communication with adolescent boys about their desires to use muscle building supplements. Most boys gather their information about supplements from peers in gyms and weight lifting environments, or online communities of weight lifters – it would be great if you as parents could open up a conversation about this to provide more balanced information about why they feel the need to use these supplements, what they are wanting to use, where they will get it from, and how they know it is safe.

My colleagues and I are mid-way through a trial of a school-based program for boys called Goodform, that aims to increase boys’ body image and reduce their use of supplements.

We have developed a ‘traffic light’ system to help parents to identify what supplements might be ok for their boys to use, and what might be more dangerous. Supplements in the green category will have ingredients that you might recognise, or that look like food. Those in the orange category, that you should be cautious about, will have ingredient lists that look more like chemicals. And supplements in the red or ‘avoid’ category will have a lot of numbers and hyphenated chemical-sounding ingredients. 

ASADA also has a Sport Integrity Australia mobile app – you can download this to see exactly which supplements have been independently tested for safety.

The fact that adolescent boys develop later than girls, are seeking muscularity to establish their masculinity, and desire increased sports performance in order to increase their self-esteem and feelings of success, means that they are in a vulnerable place in terms of feeling dissatisfied with their appearance, and being susceptible to the marketing of muscle building supplements.

By being informed yourself, communicating with boys, and establishing social norms against supplement use, we can help them to more critically evaluate the information and messages that they are receiving, and make more informed choices about what they put into, and do with their bodies.

Dr Zali Yager is an Associate Professor of Health and Physical Education, and the CEO of the Body Confident Collective.

Zali has 16 years’ experience in body image research and the development and evaluation of interventions that might improve body image among children, adolescents, and adults.

The Body Confident Collective (BCC) is a not-for-profit organisation that aims to improve health and wellbeing by promoting evidence-based positive body image content and professional learning programs at the individual, organizational, and cultural level. It works with researchers to communicate the latest evidence and programs from the body image research field to the community.

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