Teenage boys who think they're too skinny
when they are actually a healthy weight are at greater risk of being depressed
as teens and as adults when compared to other boys, even those who think they
are too heavy, according to findings published by the American Psychological
Boys who inaccurately see themselves as
overweight are also more likely to be depressed than boys who think they are of
average weight, but their risk is not as significant as the boys who think they
are very underweight, according to a study published online in the APA journal
Psychology of Men & Masculinity.
Read: Childhood stress linked to overweight
Teenage boys who feel they are underweight
and report being the victim of bullying are also more likely to use steroids
and feel depressed than other boys their age, according to another study
published in the same journal.
"These studies highlight the often
underreported issue of distorted body image among adolescent boys," said
Aaron Blashill, PhD, staff psychologist at Massachusetts General Hospital and
faculty member at Harvard Medical School, who led both studies.
about teen girls?
"Teenage girls tend to internalise and
strive for a thin appearance, whereas teenage boys tend to emphasise a more
muscular body type. We found that some of these boys who feel they are unable
to achieve that often unattainable image are suffering and may be taking
Blashill's research was based on two large,
nationally representative samples of teenage boys in the US. The first sample
included 2 139 boys who were about 16 years old in 1996 at the beginning of the
study and were followed for 13 years.
Boys who perceived themselves as very
underweight, but actually were average weight or higher, reported the highest
level of depressive symptoms. These findings remained constant across the span
of the study, which ended when the participants were close to 30 years old.
Read: Why kids get overweight?
Researchers surveyed the participants three
times about six years apart to assess depressive symptoms, body image
perceptions and the participants' body mass index. To measure body image
perceptions, the researchers asked the boys to rate their current weight,
ranging from "very underweight" to "very overweight." They
then compared those ratings with the participants' BMI.
There were 1 433 white participants, 513
black and 235 Hispanic. The rest of the sample identified themselves as
Asian/Pacific Islander, Native American or "other."
In Blashill's other study, he also found
boys who perceived themselves as underweight were more likely to feel depressed
than their peers who were average or overweight, which may be one of the
reasons they turned to steroids, he said. The data came from a 2009 nationally
representative survey of 8,065 ninth- through 12th –grade boys in the US.
Overall, 4% of the participants in the
second study reported ever using steroids and 3% reported they were very
underweight. Boys who perceived themselves as underweight were more likely to
be victims of bullying and report more depressive symptoms which, in turn,
predicted steroid use.
Clinicians working with depressed teenage
boys, particularly those who think they are underweight and/or bullied based on
their appearance, should be mindful of the possibility of steroid use, Blashill
"Unfortunately, there is little
evidence-based research on effective therapies for steroid use among adolescent
boys," he said. "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."
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