Updated

Peer pressure and media images of buff bodies may be driving a growing number of teenagers to turn to potentially dangerous supplements to bulk up their bodies and improve their body image.

A new survey shows nearly a third of teenage boys and girls say they frequently think about wanting more toned and defined muscles. Teens who feel that way are up to twice as likely to try supplements to achieve those goals.

It's the largest survey to look at the use of hormones, supplements, body image, and media influences among teenagers. The results show that teens' dissatisfaction with their bodies goes far beyond wanting to be thin and may lead them to use potentially dangerous steroids, hormones, or other supplements.

Impossible Physiques

Researchers say the study suggests that just as teenage girls may resort to unhealthful means to lose weight, teenage boys may also resort to unhealthy strategies to achieve their desired physique.

"More and more media images show people with sculpted physiques. It used to just be scantily-clad women, but now, you see more and more of images of men with physiques that are impossible for most people to attain," says researcher Alison Field, ScD, an epidemiologist in adolescent medicine at Children's Hospital Boston, in a news release.

"Girls' concerns about their bodies are well known, but I don't think it's on parents' radar screens that their sons might have body concerns — 'I'm not big enough, I'm not strong enough, I'm not buff enough.'"

Body-Conscious Teens May Be at Risk

In the study, researchers surveyed about 10,500 teen athletes and nonathletes about their use of any substance to improve their appearance, muscle mass, or strength.

The results showed that 12 percent of boys and 8 percent of girls reported using such products. Nearly 5 percent of boys and 2 percent of girls used them at least weekly.

The most commonly used products were protein powders and shakes. Other products, used mostly by boys, included creatine, amino acids, the amino-acid metabolite HMB, the hormone dehydroepiandrosterone (DHEA), growth hormone, and anabolic steroids.

"The Internet is full of sites where these substances can be purchased, and many are advertised in popular health and fitness magazines with covers like "Great abs in 5 minutes a day,'" says Field.

"Protein powders are probably relatively safe, but steroids have well-known side effects, and some of the other products may not be so benign."

Use of muscle-enhancing products was 60 percent and 200 percent more common among boys and girls, respectively, who said they frequently thought about wanting more toned or defined muscles than others. Boys and girls who said they were trying to gain weight were three to four times as likely to use these products as their peers.

Media Influences Teen Body Images

Researchers say the findings, published in this month's issue of Pediatrics, also show that the media as well as peer pressure have a major influence on teen supplement use and body image concerns.

For example:

—Girls who said they wanted to look like women in the movies, magazines, or on TV were more than twice as likely as their peers to use supplements at least weekly to increase muscle mass or definition.

—Boys who read men's, fashion, or health/fitness magazines were more than twice as likely to use supplements at least weekly to increase muscle mass or definition.

—Weight lifting and playing football were linked to increased use of supplements, particularly creatine, amino acids, DHEA, growth hormone, and steroids.

—Researchers say it's unclear whether this association was driven by media images of sports figures, peer pressure, or coach recommendation.

By Jennifer Warner, reviewed by Michael W. Smith, MD

SOURCES: Field, A. Pediatrics, August 2005; vol 116: pp e214-e220. News release, Brigham and Women's Hospital.