30/08/2017 09:05 BST | Updated 30/08/2017 09:05 BST

A Boy's Need For Massiveness - Adolescent Bigorexia

With a growing gym culture in adolescent boys, getting 'tonked,' 'jacked up' and 'mahoosive' is an integral part of the lives of an increasing number of my peers. Whilst a healthier lifestyle is certainly desirable, if it potentially comes at the expense of psychological wellbeing and physical health, could this "largeness-mania" be doing more harm than good?

Bigorexia, also known as muscle dysmorphia, is a psychological illness under the category of body dysmorphic disorder. Defined by Oxford Dictionaries as 'a psychological disorder marked by a negative body image and an obsessive desire to have a muscular physique,' a BBC Newsbeat documentary indicated that it affects 1 in 10 gym-goers. With an increasing youth presence in the gym, these statistics are concerning.

So why has this obsession with 'gyming' grown? In my opinion, contrary to the common belief that it stems from trying to emulate the physique of aspirational celebrities, it more often begins with the simple need to fit in with one's peers. Now that an increasing number of boys are bulking up, the physical norm is to appear more muscular; and as 'fitting in' is arguably pivotal to one's enjoyment of school, this inevitably encourages others to follow suit.

I have seen boys follow strict rituals of 'cutting and bulking' (dieting and calorie restriction,) whilst others have turned to steroids and supplements (including anabolic steroids, pro-hormones and ephedrine.) Adolescents abusing steroids risk hair loss, increased acne, reduced sperm count and impotence. Furthermore, the long term risks of steroid use include potential damage to liver, heart, muscles and raised cholesterol levels. Thus, in some respects, taking such pride in one's appearance could be very damaging.

Perhaps the most concerning aspect of this desire to increase muscle mass and definition is the impact on adolescents' mental health. The incidence of muscle dysmorphia is rising. Large scale surveys have shown that male body dissatisfaction has risen from 15% to 43% over the last 30 years, with most young men wishing to be larger and more muscular. Whilst individuals suffering from the psychological disorder may appear superficially healthy, they may be suffering from underlying issues of low self-esteem, anxiety or depressive symptoms and mood swings.

Adolescents generally turn a blind-eye to the theoretical limitations that genetics - something completely out of an individual's control - play in muscularity. A paper in Scientific American outlining the role of genes in athletic prowess highlighted the importance of the IGF-1 gene in producing myostatin protein. The variant of this gene that an individual possesses may influence the ease of increasing muscle mass. Thus, when their peers with different genetic profiles appear to be bulking up with less effort, the individual will spend a greater amount of time in the gym to try and catch-up. This often-losing battle may result in some turning to anabolic steroids and other substances to try and circumvent their genetic make-up and natural body shape.

Other studies have looked at the effect of advertising and media on muscle dysmorphia. Leit et al.'s study suggested that when young men viewed advertising images with male muscular bodies, it immediately warped their perception of their own body image. The desire for a muscular physique could also unwittingly be introduced at a much earlier age. Many young boys play with action figures. The anatomical dimensions of these have changed over the last couple of decades (Pope et al. 1999,) with GI Joe, Batman and Wolverine changing from figurines with relatively minimal muscular dimensions to extraordinarily bulky muscular proportions. With the prominence of video games in the lives of youths, the physique of PlayStation characters, such as the assassins in 'Assassin's Creed,' perhaps plays an important role over an even longer period.

How can we tackle bigorexia? I believe that increased awareness is the way forward, particularly within primary healthcare and schools. Open discussions in school on healthy body image should be a part of PSHE lessons. These initially focus on anti-bullying and good citizenship, resulting in us learning to be kinder. Later, discussions usually move to sex education and recreational drug abuse, however, body image should not be overlooked. Adolescents need to be better educated on the risks of unhealthy diets and the dangers of steroid abuse.

Bigorexia exists and is on the rise. Whilst it may presently impact a relatively small group of adolescents, it needs to be tackled; and it needs to be tackled now.