iatrics at Harvard Medical School, Boston.
“Particularly troubling,” Dr. Field said, was the prevalence of muscularity concerns coupled with the reported use of “potentially” unhealthy products (creatine supplements) and “definitely” unhealthy products (growth hormone or steroids). The prevalence grew from approximately 2% among 13- to 15-year-old boys, to about 7% among 16- to 18-year-old boys, to almost 9% among young men aged 19-22.
“A lot of these young men who are using unhealthy products to bulk up won’t be huge – not yet,” said Dr. Field. “These are hard issues to assess, but it will be important for clinicians to probe.”
Adolescent boys commonly want more muscularity, she said, but “we’re talking here about defining yourself around your physique and being willing to take on whatever it takes to achieve that.”
Dr. Field and her coinvestigators used lagged analysis techniques to determine whether these concerns and behaviors led to certain adverse outcomes and risky behaviors.
Boys with thinness concerns, they found, were 2.5 times more likely than their peers without weight concerns to develop a high level of depressive symptoms (the top quartile of the Center for Epidemiologic Studies Depression Scale [CES-D] self-report scale) in the next 1-2 years.
Those with high concerns about both muscularity and thinness were more likely than their peers to start binge drinking frequently (odds ratio, 1.6) and using drugs (OR, 2.5) within the next 1-2 years, as were boys with high muscularity concerns who used supplements and other products to enhance physique (OR, 2.4 and 2, respectively).
The analysis also offers a window into the issue of eating disorders in males. Bulimia nervosa was rare across age groups, as was purging disorder until young adulthood, when the prevalence grew to just under 1% among males aged 23 years and older. The prevalence of meeting partial or full criteria for binge eating disorder (which for this analysis meant binge eating at least monthly), however, was much higher and grew with age, from almost 0.5% among boys aged 9-12, to more than 2% in the 19- to 22-year-old age group.
Research on disordered eating among males is tricky because most scales and other research tools have been validated for females only.
In terms of diagnosis, “the DSM-5 criteria [for eating disorders] have been improved for females, but we may not be capturing the problem for males,” Dr. Field said. More discussion is needed, she said, on the possibility of gender differences.
Dr. Field reported no relevant financial disclosures.
Original article found here.