Increased Depression Risk and Steroid Use for Boys Who Perceive Themselves as Underweight

Sullen Tween BoyAlthough the problems of teenage body image and weight issues have primarily focused on girls, a new study published in Psychology of Men & Masculinity, the journal of the American Psychological Association, has found that teenage boys who are a healthy weight but consider themselves underweight are at an increased risk for depression and steroid use. Furthermore, boys who perceive themselves as underweight are at a greater risk than boys who perceive themselves as overweight.

Researchers led by Aaron Blashill, staff psychologist at Massachusetts General Hospital and faculty member at Harvard Medical School, recently performed a set of studies that focused on teenaged boys. The first study examined body image distortions, weight, and depression. The second study examined steroid use among teenage males.

In the first study, the researchers examined data from 2,139 teen boys who were 16-years-old in 1996 and who were followed for 13 years. The researchers surveyed the boys three times at six-year intervals to evaluate depressive symptoms, body image perceptions, and body mass index (BMI).

Boys who identified themselves as underweight — but were either a healthy weight or overweight — displayed the highest levels of depressive symptoms.

Blashill comments on the findings, stating that these results indicate the importance of addressing body image issues in girls and boys: “These studies highlight the often underreported issue of distorted body image among adolescent boys. Teenage girls tend to internalize and strive for a thin appearance, whereas teenage boys tend to emphasize a more muscular body type.”

In the second study, the researchers examined data from a 2009 survey of 8,065 high school boys in the United States.

Four percent of the boys reported using steroids while three percent identified themselves as underweight. The boys who considered themselves underweight were more likely to have been bullied and reported more depressive symptoms, both of which predicted steroid use.

In other words, boys who identify as underweight are more likely to take drastic measures such as using steroids to improve their body image.

Blashill comments on the findings, “We found that some of these boys who feel they are unable to achieve that often unattainable image are suffering and may be taking drastic measures.”

Additionally, teenage boys need to be made aware of the risks of steroid use. As Blashill explains:

“Unfortunately, there is little evidence-based research on effective therapies for steroid use among adolescent boys. However, cognitive-behavioral therapy has proven to be effective for body image concerns and could be helpful for boys considering using or already using steroids.”

Together, the two studies indicate that teenage boys who identify themselves as underweight are more likely to be depressed and more like likely to use steroids.


Body Image Distortions, Weight, and Depression in Adolescent Boys: Longitudinal Trajectories into Adulthood:
A Dual Pathway Model of Steroid Use Among Adolescent Boys: Results from a Nationally Representative Sample:
Higher Depression Risk in Boys Who Think They Are Underweight:

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