A study presented at the recent annual meeting of the American Psychological Association (APA) suggests that a growing number of men — many of them young — are overusing legal performance- and appearance-enhancing supplements such as protein powders and bars, creatine and glutamine in order to bulk up in muscle and get very lean.
There’s comparatively little research about body image and disordered eating in men, and even less on the men who overuse these supplements. So these findings may point to an emerging and worrisome trend. Richard Achiro, PhD, a graduate student at the California School of Professional Psychology at Alliant International University, in Alhambra, California, who led the study, sees this as an emerging field as more men seek the same physical ideal they see in the media, just as many women have for years.
Dr. Achiro says he first became interested in the topic of excessive workout supplement use among men after seeing more guys working out longer at the gym and frequently using these products. “Body-conscious men who are driven by psychological factors to attain a level of physical or masculine ‘perfection’ … 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,” wrote Achiro in the paper he delivered at the APA meeting.
Achiro says that although excessive use of supplements isn’t recognized as an addiction, eating disorders do share similarities with addiction, particularly because people with disorders like anorexia, bulimia and binge eating syndrome find it very difficult to stop the problem behaviors on their own.
Performance-enhancing products fall under the category of dietary supplements, which means that while they are regulated by the Food and Drug Administration they don’t have to be proven safe or effective to be sold. And these products do appear to be safe when used as directed. According to MayoClinic.org, overuse of creatine, one of the most widely-used supplements, can draw water into muscle tissue and away from other parts of the body, putting exercisers at risk for dehydration. In high doses creatine can potentially damage the kidneys and liver.
Workout Supplements: How Much is Too Much?
For the study, Achiro developed a scale to determine excessive use of legal “appearance- and performance enhancing drugs” (APEDs) and used a survey to gather responses from study participants at gyms in California. His survey included 195 men between the ages of 18 and 65 who regularly used products that included L-cartinine, creatine and whey protein powder — all legal supplements that are widely sold in retail stores and online.
“By ‘excessive’ we mean that the supplement use has begun to interfere in some way with one’s ability to live or work in a fulfilling way, such as being obsessed with taking supplements at specific times and [experiencing] significant emotional distress when a planned supplementation time is interrupted,” explains Achiro. “This is a scenario in which one can easily see a person being distracted from relating meaningfully with others or from doing their work to their fullest potential.” Excessive” use also relates to taking so many supplements, or replacing so much real food with supplements, that the body is being adversely affected. This may include GI issues, signs of malnutrition or even kidney and liver damage, Achiro notes.
To qualify for the study, the men had to have used at least one of the products in the last 30 days and worked out at the gym at least twice each week. The survey asked about their gym habits, eating habits and their sense of their own bodies. Some findings:
- 29% of the men said they were concerned about their use of supplements.
- 22% said they have used supplements to replace meals.
- More than 40% said their use of supplements had increased over time.
- 8% said they’d been told by their doctor to reduce their supplement use.
- 3% had been hospitalized for liver or kidney problems related to their use of supplements.
A Possible Link to Exercise Addiction?
Though Achiro’s trial didn’t look specifically at compulsive exercise, he does recognize that there may be a link. “With regard to overexercise, I would hypothesize that many of the men who overuse legal supplements also engage in workout regimens that interfere in some way with their relational/work life or physical health,” says Achiro. “We found in our study that misuse of legal supplements is driven by deep-seated psychological issues that manifest in a need to achieve a ‘perfect’ body. It seems likely that overexercise would be part of this equation. This is an issue that should be explored empirically in a future study.”
Leigh Cohen, the publisher of Gürze Books, which specializes in eating disorders education and publications, says that as many as 10% of college-age men have eating disorders. Like Achiro, Cohen links that figure to an increased emphasis on male body image in the last two decades.
Cohen and others worry that low self-esteem may be fueling the excessive use of supplements. “That concerns me, that [some men] will take an ever-increasing amount when in reality not all body types can achieve the images they see in the media without becoming anorexic and risking severe health problems and even death,” says Cohen. You can find more information through the National Association for Males with Eating Disorders (NAMED).