More men use steroids, implants in pursuit of perfect physique

By John Silcox
The Journal Gazette

Adonis, the half-man, half-god of Greek mythology, was such a stud in his day that he commanded the affection of no less than Aphrodite, queen of the gods.

But compared with the smiling hard bodies that grace the covers of men’s health magazines or that parade shirtless across TV screens, Adonis was no beefcake.

Ordinary schlub is more like it. Everywhere you look now, men are being bombarded by images of super-male models with massive shoulders, rock-hard pecks and impossibly sculpted six-pack abs.

Today’s action toys sport huge shoulders and biceps; muscle-bound heroes in computer games like “Duke Nukem” gobble down bottles of steroids to power themselves up for a shooting spree; even professional athletes seem to have reached a new level of muscularity.

Although muscularity has always been tied to masculinity, now more than ever men are struggling with the same enormous pressure to achieve physical perfection that women have dealt with for centuries.

Some modern-day Adonises like Brad Pitt and Russell Crowe make it look easy. Hire a personal trainer, pound a few weights, no problem. But lesser mortals desperate to lose their “girlie-man” physiques aren’t just doing a few push-ups.

They’re spending thousands of dollars on gym memberships, muscle-building supplements and protein powders, pec and bicep implants, even illegal steroids, in some cases – all in a vain pursuit for the perfect body.

Even more troubling, some men have developed dangerous body image disorders – compulsive binge eating, dieting and exercise rituals – as a result of their obsession.

Dr. Roberto Olivardia, a Harvard psychologist who co-wrote “The Adonis Complex: The Secret Crisis of Male Body Obsession” (Free Press; $25), says there’s nothing wrong with wanting to look good or working out regularly at a gym, or even being a dedicated athlete. It’s only when the preoccupation with working out, dieting or grooming becomes so intense that it begins to cause emotional distress or undermine relationships, that it crosses the line from normal behavior to pathological obsession, he says.

So what has happened? Why are men so hung up on muscles all of a sudden?

In their book, Olivardia and his co-authors, Harvard psychiatrist Harrison Pope and Brown University psychiatrist Katharine Phillips, say two recent changes have “powerfully altered the forces affecting the present generation of men.”

First, the rise of anabolic steroids made it possible for men to attain a level of muscularity far beyond the limits of an ordinary man.

And increasingly, images of these inflated physiques began to proliferate in magazines, on TV shows and in the movies. They studied everything from action toys to Playgirl centerfolds going back 50 years, and found that the images have gotten steadily more muscular.

A second reason, albeit more contentious, is that the rise of feminism has caused men to focus increasingly on their bodies as one of way to separate themselves from women.

And so society and the media produce a double message: A man’s self esteem should be based on his appearance, yet by today’s standards, “practically no man measures up,” Olivardia writes.

It becomes understandable then why so many men are unhappy with how they look, Olivardia says in a telephone interview. A 1997 study cited in the book found that as many as 45 percent of American men were dissatisfied with their muscle tone, almost double the percentage found in the same survey in 1972. Nearly as many men as women are unhappy with the way they look, Olivardia says, and the pressures may extend down to elementary school children. Boys as young as 6 or 8 are now reporting body dissatisfaction.

Parents, teachers and athletic coaches, however, are often unaware of the problem – or the harm they’re doing to their bodies in pursuit of their appearance ideals – because boys aren’t supposed to fuss over how they look, he says.

Only women are supposed to get hung up by such things. Olivardia says he wasn’t aware of the extent of the problem until he started seeing patients suffering with these concerns. Although they might not say much themselves, he says, their actions speak volumes.

Trying to achieve increasingly unrealistic physical ideals, a surprising number of teen-agers and young men are turning to the multibillion-dollar supplement industry and the illegal steroid racket.

Some of the biggest sellers in health food stores and nutrition centers are protein powders and amino acids, which claim to increase muscle mass.

Creatine, another popular product that appears to cause gains in muscle mass and strength with few if any side effects, has a huge following among high school and college athletes. And some coaches have been known to hand out creatine in the locker room.

Phillip Henson, a professor in the Department of Kinesiology at Indiana University’s School of Health, Physical Education and Recreation, calls that idiotic and shortsighted.

Henson, who was the track and field director for the 1996 Summer Olympic Games in Atlanta and a competition official at the Olympic Games in Los Angeles and Sydney, says these substances are not regulated by the FDA, and their long-term effects in high doses have not been well studied.

Some probably aren’t dangerous when taken in small amounts. But when taken in large doses, over long periods, their risks are unknown, he says.

“We know in the short term you gain weight, you get better,” he says. “We don’t know what the long-term consequences are.” But even if these substances were perfectly safe, Henson and others wonder whether they won’t act as a gateway to more illicit substances like anabolic steroids.

Steroids used to be confined to an elite group of athletes and body builders, but it is believed to be on the rise among high school boys in recent years, despite warnings of potential organ damage, infertility, stunted growth and severe acne.

Dr. Gregory Sassmannshausen of Fort Wayne Orthopedics works with athletes from grade school up to the professional ranks. In doing so, he routinely asks patients whether they are taking any performance-enhancing substances or supplements, and the answer invariably comes back no. But it’s obvious from their dramatic increases in weight and muscle mass that some of them are not telling the truth, he says.

He is seeing more of it among junior high and high school athletes. “Competition and winning is at premium, even at younger ages,” he says. “And whether it be from coaches or parents, there is a bigger push to be bigger and stronger.”

He cites a 1999 study that found 6.3 percent of the 800 high school football players surveyed were currently or had previously used steroids. The average age of first-time use was 14 years old. But perhaps, most disturbing, 15 percent of those who admitted to using steroids began taking them before age 10.

And steroid use isn’t limited to athletes; many of the men “juicing up” today are doing it purely to improve their appearance and not for any athletic purpose.

Dr. Nick Evans, a Los Angles orthopedic surgeon and a recreational bodybuilder, cites research that nearly 80 percent of steroid users today don’t compete in any sport, up from 66 percent a decade before. Evans, who writes a monthly “Ask the Doctor” column for MuscleMag International and is the author of “Men’s Body Sculpting,” says it’s possible to achieve a fine physique with dedication and hard work. The trouble is most people aren’t willing to put in the time at the gym or stay disciplined in their diet; they’d rather have the quick fix.

Apparently there are no limits to the lengths some guys will go in their quest for the perfect physique. Last year, nearly 1.2 million men elected to have cosmetic surgery, a figure that represented almost 14 percent of the overall plastic surgery market, according to the American Society of Plastic Surgeons.

Although nose reshaping and liposuction are still the most popular cosmetic procedures with men, plastic surgeons are seeing more interest in calf, pectoral and bicep implants. Summit Plastic Surgery in Fort Wayne doesn’t offer those procedures. But its surgeons are doing more face lifts, tummy tucks and hair replacements on men.

For some men, no amount of body manipulation is ever enough. They could be exhibiting symptoms of what Olivardia describes in the book as “muscle dysmorphia,” a sort of “anorexia in reverse.” While women with anorexia starve themselves or make themselves sick to get slim, men with this condition continue to see themselves as small and puny, no matter how huge they get.

So they pump iron or use steroids and swell to an ever-more muscular shape, while still being too ashamed to take off their shirt at the beach, Olivardia says.

Their single-minded quest for the perfect physique can stunt their development and sabotage their relationships. Some become clinically depressed, even suicidal, he says.

Although dietician Katherine Beals doesn’t disagree with the premise that men are increasingly concerned with their bodies and are working hard to improve them, she isn’t convinced that these problems have reached the crisis level implied by Olivardia’s book. And she wonders whether this obsession with fitness is evidence enough of a significant eating and body-image disorder.

Beals, who once taught at Ball State University and now works in California as a nutrition specialist for companies like Gatorade, would like to see more rigorous studies conducted to find out just how prevalent it really is and to give clinicians a means of assessing and treating those at risk.

In the meantime, she urges fitness professionals to identify and assist those who show warning signs and symptoms of body image problems – dangerous practices such as fasting and steroid use, are red flags that the pursuit of muscularity has become excessive, she says.

For men with this kind of a serious psychiatric disorder, professional help in the form of specialized therapy or antidepressant medication could be necessary, Olivardia says. But for most people with routine muscle hang-ups, some simple reassurance is what the doctor orders.

He urges his patients not to buy into the media images of spectacularly lean and muscular men; to remember that many of the models used to sell everything from underwear to sport utility vehicles didn’t come by their bulging biceps and washboard stomachs naturally; and above all, that it isn’t necessary to look like a body builder to appeal to the opposite sex.

Olivardia’s research, using a computerized body image test, showed that boys in Western society believe that women want them to be far more muscular than they actually are.

But as his studies also reveal, most women don’t actually want a super-muscular male body; instead they prefer a more realistic one. In other words, it’s okay to look ordinary.

Look what it did for Adonis.