By the time boys are 8 or 10, they see many superheroes and action figures with massive muscles and perfect abs. As they get older, social media shows them even more images of bulky bodies. These messages can make boys worry about how they look. Sometimes these worries get so strong that they affect daily life. This is a kind of body dysmorphic disorder. In boys, the most common form is called muscle dysmorphia.

What is muscle dysmorphia?
Muscle dysmorphia is when someone is always thinking about having big muscles and being very lean. Only a small number of boys meet the strict definition of this disorder, but many more feel pressure to bulk up. Studies find that nearly 22 out of 100 young men try special muscle-building routines, and about 60 out of 100 boys change their diet to get more muscular. Society often links big muscles with being a “real” man, and even young boys’ costumes now include fake six-pack abs.

Does body dysmorphic disorder differ in boys and girls?
Body dysmorphic disorder was long seen as mostly affecting girls through eating disorders like anorexia or bulimia. Muscle dysmorphia is not an eating disorder, but it shows up far more in boys. Because of this, families and doctors can miss the warning signs in boys.

What are the signs in boys?
Watch for these red flags:
• A sudden jump in workout time, from an hour a day to several hours every day.
• Strict routines for exercise and meals, often focusing only on protein.
• Skipping normal activities or friends’ events to work out.
• Taking many photos of muscles or abs to “see progress.”
• Weighing themselves multiple times a day.
• Wearing tight clothes to show off muscles or baggy clothes to hide a body they feel is not good enough.
The key difference is that these behaviors go on for weeks or months without much change.

What are the health dangers?
Pushing too hard can harm both body and mind. Some boys use unregulated protein powders or steroids, raising the risk of stroke, heart palpitations, high blood pressure, and liver damage. A “bulk and cut” approach—rapid weight gain followed by extreme calorie cutting—can weaken bones, affect muscle growth, cause irregular heartbeat, and lower testosterone. Too much protein can also cause diarrhea or hurt the kidneys. On the mental side, extreme dieting or malnutrition can lead to depression and even suicidal thoughts. Boys may feel they never measure up.

How can parents encourage a healthy body image?
• Eat family meals together. Research shows this supports both physical and mental health.
• Avoid commenting on anyone’s body shape or size, including your own.
• Talk about food and exercise as ways to stay healthy, not as ways to change how you look.
• Ask your son why he wants to exercise more or eat extra protein—does he want to feel stronger, or is he chasing an ideal?
• Don’t buy protein powders or supplements. If your son needs more protein, ask his doctor or a dietitian how to get it from regular foods.