Muscularity-oriented disordered eating has joined some of the newer risks of muscle dysmorphia. With this type of disordered eating, teens may feel that heavy physical workouts will help them gain weight or “bulk up,” to overcome a self-image of being skinny or puny. Researchers at the University of California-San Francisco Benioff Children’s Hospitals recently studied 14,891 young adults from throughout the US for seven years, seeking warning signs and causes for this type of disordered eating, which can easily be overlooked and in fact felt to be healthy.
The researchers, led by Jason Nagata, MD, of the UCSF Division of Adolescent and Young Adult Medicine, reported that at its most extreme level, this pattern can lead to heart failure due to too few calories and overexertion, as well as muscle dysmorphia, which is frequently linked to social withdrawal and isolation. Teens with muscularity-related eating disorders may also exercise excessively or swing back and forth between eating excessive amounts of protein and cutting calories or restricting carbohydrates and fats, in order to achieve the body shape they want.
The researchers reported that boys who exercised specifically to gain weight had 142% higher odds of developing this type of disordered eating than boys who did not. The risks were much higher among girls, where the odds of disordered eating increased by 248%. Being African-American increased the odds in males by 61% and by more than twice as much, 181%, among girls. Non-heterosexual identity, which the participants were asked about when they became adults, was not a risk factor. By the time the study participants were 18 to 24 years old, 1 in 20 females and more than 1 in 5 males had one or more symptoms of muscularity-related eating disorders.
Clues to behavior that increases the risk of muscle dysmorphia include a highly restricted diet that omits fats and carbohydrates, compulsive weighing and checking of appearance, and devoting an excessive amount of time to exercise, to the detriment of an individual’s social life.