Excessive workout supplement use: An emerging eating disorder in men?

While the pressure for both men and women to be thinner and slimmer has been well documented as a driving force behind a variety of eating disorders, the desire to pursue a masculine body image ideal - being both lean and muscular - has often remain unaccounted for as a driving factor for eating disorders, according to research led by Richard Achiro, PhD, from Alliant International University.

The study, presented at the American Psychological Association's annual convention, suggests that in an effort to build better bodies, more men are turning not to illegal anabolic steroids, but to legal over-the-counter bodybuilding supplements - to the point where it may qualify as an eating disorder.

"These products have become an almost ubiquitous fixture in the pantries of young men … and can seemingly be purchased anywhere and everywhere," said Achiro. "The marketing efforts, which are tailored to addressing underlying insecurities associated with masculinity, position these products perfectly as a 'solution' by which to fill a void felt by so many men in our culture."

Indeed, Achiro and his colleagues found that a large proportion of gym-going men are increasingly taking supplements – with a small but significant group of people indicating that they have been hospitalised through use of supplements or had a medical advice to reduce supplement usage.

"Body-conscious men who are driven by psychological factors to attain a level of physical or masculine 'perfection' are prone to use these supplements and drugs in a manner that is excessive and which was demonstrated in this study to be a variant of disordered eating," said Achiro.

"As legal supplements become increasingly prevalent around the globe, it is all the more important to assess and treat the psychological causes and effects of excessive use of these drugs and supplements."

"The most critical implication for these findings is to put risky/excessive legal supplement use on the map as an issue facing a significant number of men," he added.

Research details

In their study, Achiro and his team recruited 195 men aged between 18 and 65 who had consumed legal appearance- or performance-enhancing supplements (including whey protein, creatine, L-cartinine) in the past 30 days and had stated that they work out for fitness or appearance-related reasons a minimum of two times a week.

Participants completed an online survey asking questions about a variety of subjects, including supplement use, self-esteem, body image, eating habits and gender role conflicts.

The researchers found that more than 40% of participants indicated that their use of supplements had increased over time and 22% indicated that they replaced regular meals with dietary supplements not intended to be meal replacements.

Most alarming, said Achiro, is that 29% said they were concerned about their own use of supplements.

The study also revealed that 8% of participants had been told by a physician to cut back on or stop using supplements due to actual or potential adverse health side effects, while 3% had been hospitalised for kidney or liver problems that were related to the use of supplements.

Driving this risky misuse of legal workout supplements appears to be a combination of factors, including body dissatisfaction, low self-esteem and gender role conflict, in which an individual perceives that he is not living up to the strict limitations of masculinity dictated by modern culture, said Achiro.

“Overall, the current findings suggest that excessive legal appearance and performance-enhancing drugs (APEDs) use may represent a variant of disordered eating that threatens the health of gym-active men,” said the authors.