A new study examines ways teens try to bulk up, including diet and exercise changes as well as steroid use.(Photo: Brian Kersey, AP)
When it comes to body image, large, lean and muscular is in, and it's
"extremely common" for teenagers to turn to diet, exercise, protein
powders or steroids in hopes of bulking up and enhancing muscle
development, a study finds.
Although these techniques are most
often seen among boys, in some cases they are nearly as widespread among
girls, says the study published Monday in Pediatrics.
about methods they have used to increase their muscle size or tone,
2,793 middle school and high school students (average age 14) in
Minneapolis/St. Paul said they:
• Changed eating: 68% boys; 62% of girls
• Exercised more: 91% boys; 81% of girls
• Used protein powders or shakes: 35% boys; 21% girls
• Used steroids: 6% boys; 5% girls
Used other muscle-enhancing substances such as creatine, amino acids,
hydroxyl methylbutyrate (HMB), DHEA, or growth hormones: 11% boys; 6%
Researchers did not collect data indicating whether eating
changes were healthy or unhealthy nor how much or what type of exercise
was adopted. Almost 12% of boys and 6% of girls, however, reported
using three or more of the general muscle-enhancing behaviors,
"indicating a relatively high level of use," says the report.
findings suggest that "increasing muscle strength or mass or tone is an
important piece of body image for both boys and girls," says lead study
author Marla Eisenberg, professor of pediatrics at the University of
Minnesota School of Medicine. "Kids really are seeing that as a goal."
it's not just a behavior isolated to athletes or certain teams, says
Eisenberg. Students who said they did not play sports also reported
these muscle-enhancing efforts.
Teenage interest in re-shaping or
building their physiques is nothing new. What is new, is a social and
cultural emphasis "not just about having a healthy physique," but about
achieving the "perfect" muscular body, she says, which ultimately is
"just one more cultural ideal that young people find hard to achieve."
a result, the many good reasons for teens to be physically active -
skill development, having fun and general health and fitness - run the
risk of being overshadowed by the goal of looking like someone in a
magazine ad or in the sports pages, she says.
And given greater
awareness of performance-enhancing and muscle-building substances,
teens know there are many other ways to bulk up, "ways that are not
recommended and not safe, but may be quite effective," says Eisenberg.
study is a reminder that parents and physicians need to be aware that
these behaviors are going on and that they need to be discussed with
their adolescents, says Joel Brenner, medical director of the Sports
Medicine Program at Children's Hospital of the King's Daughters in
Norfolk, Va., and chair of the American Academy of Pediatrics Council on
Sports Medicine and Fitness.
The use of steroids and other
performance-enhancing substances is clearly dangerous and needs to be
avoided, but inappropriate changes to diet or exercise can also be
hazardous, he says.
Even when teens are involved in supervised
strength and conditioning programs, parents need to stay aware of their
child's goals and make sure their activities remain "part of an overall
fitness program," Brenner says.