Women are not the only ones who struggle with poor body image. Boys and young men who are fixated on building muscle have many similar mental health issues, and these have been historically overlooked by researchers, parents and health professionals.
A new study from Harvard and the Norwegian University of Science and Technology (NTNU) is the first of its kind to investigate the cruel relationship between men and their muscles. And the findings suggest boys and young men struggle much more with body image disorders than we were aware.
Striving for an ideal but unattainable body type appears to leave many young men with a higher risk of depression, weekend binge drinking, and unnecessary dieting.
"Girls are supposed to be thin and have small waistlines. Boys should have wide shoulders and big muscles. Those are the narrow ideals that young people grow up with today," says lead author Trine Tetlie Eik-Nes, a social psychologist at NTNU.
"It turns out that this unrealistic body image is as challenging for men as for women."
The research focused on the drive for muscularity among 2,460 American males between age 18 and 31.
But unlike previous studies, which have mainly been focused on thinness and dieting, this study asked questions more in line with typical male disorders.
"Boys aren't looking to be thin. They want to have big muscles. So the questions given to girls are totally wrong if we want find out how young men see themselves and their own bodies," explains Eik-Nes.
Many of the findings are cause for alarm. Across all ages, sexual orientation, weight status and education levels, the drive for muscularity and and its link to depression remained significant.
Those obsessed with putting on muscle were four times more likely to take muscle-building supplements and anabolic steroids, whether legal or not, and they were more likely to binge drink on the weekends.
One in three young men said they had been on a diet in the past year, not because they are technically overweight, but because they simply think they are.
"This drive for muscularity could be a sign that young men don't have mastery over their lives, but they may feel that they're mastering how to work out," says Eik-Nes.
"In this context, in simple terms, you could say that girls vomit, while boys are much more preoccupied with exercising than normal."
Cristiano Ronaldo, the famous football player, is said to have mankind's greatest body. But Eik-Nes says that when men strive to attain the lean and muscular statures of their role models, it can drive them to unhealthy extremes.
"The problem arises when the bodies of professional athletes like Ronaldo become the ideal for regular young men who have jobs, studies and family," she explains.
"Training has to be your full-time job if you want to look like Ronaldo. He belongs to one in a thousand of the world's population who make their living from sports."
And training at the gym is very different than having a full-time job on a national football team. For starters, it usually has little do with strength and fitness and more to do with cosmetics.
In other words, most young men aren't hitting the gym on a regular basis to improve their health or performance in sport. It mostly has to do with their appearance.
"They're only exercising to build their muscles, without the training having anything to do with muscle function. That's a big difference," Eik-Nes says.
Thoughts like these can become obsessions, and responses given in the study suggest men are beating themselves up about their body types. Many of the quotes collected were similar to "I don't think my chest is muscular enough" or "I feel guilty if I miss a workout."
Eik-Nes explains that worries like these are quite common among young men, even though they tend to fly under the radar in our society.
She urges parents to keep tabs on how their male children eat and exercise, so that if a problem does start to develop, they can tackle it before any mental health issues begin to kick in.
"Parents' alarm bells should go off if they have a youngster who's at the gym everyday, who just wants to eat chicken and broccoli and who consumes protein shakes or supplements all the time," Eik-Nes advises.
"If their whole world is about their workouts, parents should take the time to talk with them - for example, by asking questions about what they're actually training for."
The researchers now hope to study the full extent of the problem so they can identify risk factors and find some potential options for treatment.
This study has been published in the International Journal of Eating Disorders.