A study recently published in the journal Pediatrics reported that an alarming number of middle-school and high-school boys appear to be taking unhealthy measures to try to achieve Charles Atlas bodies that only genetics can truly confer. Many of these boys spend long hours in the gym and supplement their diet with unapproved or even risky illegal steroids, all in search of the perfect body. 

In the study, more than 40 percent of boys in middle school and high school said they regularly exercise with the goal of increasing muscle mass. It is not just girls these days who are consumed by an unattainable body image. This national phenomenon is affecting teenage boys—whose goal is simply to add muscle—as well. Attitudes toward male body image have changed dramatically over the past 30 years. The idolization of fat-free, chiseled men by the media appears to dominate teenage male thinking.

This trend is alarming because these boys, who chase an illusory image of manhood, run the risk of stunting their development, particularly when they turn to unproven supplements or illegal steroids.

Even sophisticated teenagers will have a hard time evaluating the various bodybuilding supplements on the market because none are FDA approved, and the content of these supplements is often unknown. From a urologic standpoint there is reason for significant concern.  If, per chance, a supplement contains an anabolic steroid, the results on developing testicular tissue can be devastating. The anabolic steroids pose a special danger to developing bodies because when taken indiscriminately, these supplements can reduce or eliminate the production of testosterone and can lead to testicular atrophy.

To compound the problem, the media depictions of men with a perfectly chiseled six-pack are widely available for viewing, and teenagers communicate freely online in bodybuilding forums. On Tumblr and Facebook, boys barely out of puberty share weight-lifting regimens and body-fat percentages to be judged by each other. Teenagers post images of elite athletes under the heading “fitspo” or “fitspiraton,” which are short for “fitness inspiration.” The tags are spinoffs of “thinspo” and “thinspiration” pictures and videos, which have been banned from many sites for promoting anorexia in girls.

Some boys exercise vigorously to become stronger and more conditioned for sports, and that’s okay, but the increasing number of teenagers who exercise solely to change their body type is worrisome.

I am not discouraging a lifestyle that includes healthy exercise, particularly when compared with a sedentary lifestyle as a couch potato. The goal is to promote exercise in a healthy, drug-free manner in order to both get and stay in shape.

As a general rule, lifting weights to build muscle mass may be beneficial for developing a more athletic body, but in teenagers, whose muscle and bone structures are developing, bodybuilding can prove to be tricky at best and dangerous at worst. Nevertheless, many coaches and peers encourage weight lifting in the quest for victory on the field. This environment is not good.

Steroid use among adolescents is not just a myth. A recent New York Times article reports that the The National Gym Association has indicated that weight lifting among adolescents is depleting the number of contestants in teenage bodybuilding contests because many of these children cannot pass a drug test. There are fewer teenage bodybuilders because “a lot of these kids are juiced, so they’re not entering natural shows,” said Andrew Bostinto, president of the association. “You get these kids now, they’re 5 feet 6 inches, 5 feet 7 inches, weighing 265 pounds with two percent body fat,” Mr. Bostinto said. “Give me a break. You can’t put on 30 pounds in a month.”

In the end, physical fitness, aerobic exercise, and cardiovascular conditioning are all good. But weight lifting should be approached with caution, supplements used judiciously, and steroids avoided entirely.

Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).

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