What Parents Need to Know About Body Image and Bigorexia in Teen Boys

How young is too young to worry about muscles? For one boy in Arizona, it started happening at age 11. He became increasingly concerned about his body composition, his mom recalls — mostly, he was on a quest for “more muscles.” 

The tween had fallen into a social media algorithm that served him a never-ending scroll of gym bros, lifting heavy weights and preaching the gospel of eating more protein, while flexing their bulky biceps and displaying their six-pack abs. As an impressionable and growing boy, the message was ingrained: your worth is directly tied to your size — and for boys, bigger is better.

“He would just start asking about food and the types of food we were eating as a family — specifically the protein,” the mom, who spoke to SheKnows on the condition of anonymity, says. “He’d also say things like, ‘I shouldn’t be eating carbs’ or if he ate a cheeseburger and french fries he’d say, ‘I’m off my diet.’”

As a parent of a teenage girl, this mom had always been careful about how the family spoke about food, conscious that they should eat a healthy variety of all kinds of things and not demonize any one food group along the way. She knew her daughter would pick up on troubling signals about diet culture that could quickly spiral into body image issues or even disordered eating. She didn’t anticipate that her son was equally vulnerable.

“He was starting to be more conscious of wanting to ‘build a six-pack’ around 12 years old,” the mother of two says. “He is kind of preconditioned to wanting to look strong, show off his guns, and all of those things. He’s just been wired that way more than his sister.”

Now 13, the boy’s parents have allowed him to take up some light, but not extreme, weightlifting under the supervision of his dad, to supplement his tennis, skiing, and skateboarding. They don’t think his diet or his physical activity have gotten to the point of concern, but they do keep an eye on it so that it doesn’t escalate into unhealthy behaviors.

These parents in Arizona are not alone in their concerns. Gym culture has infiltrated the American boy’s life in a new way, thanks in large part to social media and YouTube. According to Newport Academy, a mental health treatment program for children and teens, 25 percent of adolescent boys are worried about not having enough muscles. A 2021 study published in the Journal of Adolescent Health found that a quarter of 4,489 male participants between the ages of 16 and 25 were also worried that they didn’t have enough muscles, and 11 percent had used products like creatine or anabolic steroids to increase muscle mass.

What is bigorexia and what’s driving it?

Of course, an interest in gym culture — or wanting bigger muscles — isn’t inherently unhealthy. But at its extreme, this kind of muscle dysmorphia is called bigorexia. According to the American Psychiatric Association, it’s a condition in which a person has an obsessive and exaggerated belief that their body is too skinny, too small, or not muscular enough. It can lead to preoccupations with weight, body image, and disordered eating behaviors. 

Erin McTiernan, a pediatric psychologist at Nationwide Children’s Hospital, says that she wishes more parents were aware of the pressures boys are feeling when it comes to their bodies, taking special care to know what they’re looking at on social media and if they’re being bullied at school about fitness routines or diets. (To that end: In a recent SheKnows survey of teen boys, 50 percent of respondents said friends influenced their body image the most, followed by social media at 36 percent.)

Some of the symptoms to watch include whether an adolescent boy becomes distressed if he’s not able to fit in a typical workout, like during a vacation, for example. Or If his meal plan is getting in the way of doing normal activities like eating pizza at a friend’s house. 

“We have seen more teen boys presenting with disordered eating, excessive exercise, steroid use, and body image concerns than we have in the past,” McTiernan says. “However, we know that the stigma among males to share their feelings about these concerns remains high…there are likely many boys who are struggling who may not be getting the help they need.”

Experts like McTiernan say that while social media may be a big contributor to bigorexia and associated body image and eating disorders, boys may also feel the societal expectation for men to look “tough” and “strong” — something one 16-yea-old teen who talked to SheKnows relates to. “I do feel some sort of pressure to be muscular and bigger to show my masculinity and to look the part of being strong and able to not be messed with,” the teen, who requested anonymity, says. “I believe it all stems from boys needing to be bigger and stronger in order to be accepted and to be masculine. Without being masculine, boys are often not valued as much.”

Unfortunately, today’s male adolescents have more opportunities to compare themselves to others through TikTok and other apps. Just like girls, it can create a skewed perception of the perfect body composition. And in either case, young people are often comparing themselves to the adults they see on screen.

John, 18, says now that he’s older, he focuses more on staying fit than building muscle, but when he was younger he got caught up in his appearance. Like many of his peers, he didn’t want to be the “skinny” guy.

“I started seeing a lot of fitness influencers online and YouTubers posting from their gym every day,” he says. “And these guys are just, like, freakishly huge dudes who have been working out for like 20 years to get this body…it’s just this unrealistic expectation.”

Maverick, 19, has noticed the same trends among his friends. “Some had trainers give them plans [to gain muscle], but some do look it up on the Internet and say, ‘Oh, I want to look like this person. What do they do? Let me try this.’”

What can parents do to support boys?

According to the National Alliance for Eating Disorders, people experiencing bigorexia may display behaviors that include:

If caregivers see concerning signs among their boys, McTiernan suggests first meeting them with curiosity about why they’ve become so rigid about their meals and exercise routines. Then, try to find out what’s motivating it.

“Ask about conversations among their friend group about fitness routines or diets,” she says. “Parents can also help educate their sons on the importance of fueling their bodies with a variety of foods and taking rest days to promote recovery.”

“The conversations about it aren’t had enough,” admits Maverick, who says that body image and working out are topics he’s discussed with friends. “But when they are, they tend to be very meaningful and serious. No one’s joking around. [Friends] have said to me that, you know, we can trust each other.”

In addition, just talking through puberty and how this phase of life can bring feelings of discomfort and self-consciousness for everybody can help alleviate some fears and validate the array of feelings they’re experiencing. Boys, just like girls, need to know that what they’re going through is normal — and often uncomfortable.

Caregivers can also keep an eye on the messages boys get at practices, too, if their boys are participating in sports. 

“Coaches also play a key role in creating healthy habits in their athletes,” McTiernan says.

If a boy’s symptoms of body dysmorphia continue, parents should consider making an appointment with their child’s primary care doctor to make sure his body is growing the way it should. McTiernan suggests informing coaches and athletic trainers so that they can keep an eye on the situation. A therapist and dietitian who specialize in treating eating disorders can also help.

As for the mom in Arizona, her son is firmly entrenched in a skateboarding phase now. The after-school weightlifting sessions he used to attend with his friends have been replaced by hours at the skatepark. Though he still occasionally thinks about his protein intake, he isn’t quite as obsessed with his body composition as he once was.

Nonetheless, his mom is glad she’s more aware of the issues and pressures that boys like her son are feeling, so that she can help him make healthy choices for his long-term health.

“I tell him that what he’s feeling is natural and that we all go through it,” she says. “We help him not go to the extremes in any one thing, whether it’s diet or weightlifting or whatever. We just continue to monitor it and just let him be a kid.”