George Mycock’s physical transformation was what “FitFluencer” dreams are made of — from the outside.

Over the course of five years, the British weight-lifting enthusiast went from overweight teen recovering from a debilitating injury to aself-confident stud with a body-builder physique. His personal trainer? Instagram. A quick search for weight-loss advice at the age of 13 uncovered a community of fitness influencers with simple instructions on how to transform the human body. Mycock’s insecurities were remedied by mantras, workouts and an online realm that treated fitness as a higher power.

“When you're younger, you're often looking for a sense of purpose,” the 28-year-old said looking back. “If someone serves it up on a silver platter for you and says, ‘if you look like this, you are a good person,’ it can be quite easy to attach to that.”

And he was attached. He shifted his diet and started an intense workout regimen inspired by the advice of dozens of FitFluencers. The results were undeniable; he found self-worth in his muscular physique. But, surrounded by the relentless “rise and grind” culture of his gym and online community, his hobby turned into an obsession. Weighing each meal down to the gram, sneaking extra reps and passing out at the gym became a part of his workout routine.

Gaining muscle was his raison d'être.

“I'd sneak it in,” he said. “I’d say I was going to the toilet and I’d do a couple sets just to have in my head that I'd done more than the other people, and therefore that meant I was good enough.”

He may as well have been addicted to the high of working out, but neither he, nor those around him, saw his “fitness journey” as a red flag. It was just exercise and diet after all.

“When someone is working towards a more muscular body, people find it really hard to recognize when it could ever be a problem,” Mycock said. “It's almost synonymous with being dedicated and being confident, being attractive, being powerful, being successful.”

Well, it’s 2024 and fitness is trending once again. Since 2010, the health club industry has grown by nearly $30 billion, a change of over 40% — and the group with the largest jump: teens. And with young boys entering the confusing, sometimes dangerous world of weight-lifting and dieting, are we sure that they’re getting the right advice?

“MANOREXIA” AND MUSCLE DYSMORPHIA

Most of what we know about eating disorders is derived from research on women and girls. But, in this new frontier of gym-goers and FitFluencers, the past couple decades have brought an explosion in the rates of men with eating disorders.

Today, it’s estimated that one in three people with eating disorders is male, but only 1% of clinical research on eating disorders focuses on men. For decades, the DSM (Diagnostic and Statistical Manual of Mental Disorders) didn’t even acknowledge that cisgender men (men assigned male at birth) could have an eating disorder. It wasn’t until 2013 that males with eating disorders were recognized by the DSM through the removal of amenorrhea (the absence of menstruation) as a diagnostic criterion.

Roberto Olivardia has studied and treated eating disorders in men for decades. He’s a clinical psychologist at Harvard University and co-author of The Adonis Complex, a book that dove into the exploding male body image issue over 20 years ago.

“Even now, when I tell people that one of the areas I specialize in is working with boys and men with eating disorders,” Olivardia said. “People are like ‘Wow, I didn't realize that that many males struggled with that.’”

This reaction likely comes from some deep-rooted misunderstandings. For one thing, eating disorders often look different in men than in women.

Olivardia said that a majority of his male patients don’t idealize a thin body. Like Mycock, most men with eating disorders focus on muscle gain. Rather than skinny, many male eating disorder patients want to be lean; men tend to use diuretics and laxatives less frequently than women, but are more likely to exercise as a form of purging (compulsive calorie-burning). Often, male eating disorder patients share that they’d have no issue with food consumption if they were guaranteed that everything they ate contributed directly to muscle gain.

The bottomless desire for muscle gain has a name: muscle dysmorphia. And it’s exactly what Mycock was diagnosed with

“It got to the point where if I wasn't sick, if I didn't physically make myself sick from how much I did, then I would feel like I'd failed,” he said about his relentless pursuit of muscularity.

Male eating disorder patients often have different histories than their female counterparts. Many of Olivardia’s male patients, for example, have a long history of body dissatisfaction, particularly being overweight as children; this same correlation isn’t found in girls and women. Sometimes, boys’ bodies put on weight right before puberty, in anticipation of a growth spurt. Olivardia says that period of time can be extremely destabilizing, and can lead to incongruencies between body perception and reality.

Men and boys are also less likely to seek treatment for their eating disorder than women and girls. And when they do, there are often more complications related to their eating disorder. Males hospitalized for eating disorders have longer hospital stays, more severe vitamin D deficiencies and more severe cases of anemia. Doctors also prescribe them same caloric intake as their female counterparts despite their greater energy requirements. Experts like Olivardia believe research is lacking among male eating disorder patients.

“And just as a side note, I mean, only 10% of women with an eating disorder seek treatment,” Olivardia said, making clear there is progress to be made in eating disorder research for all genders. "It's still a vastly under-treated diagnosis for something that has anywhere from a 10 to 15% mortality rate.”

Dr. Jason Nagata, associate professor of pediatrics at the The University of California San Francisco, is an expert in muscle dysmorphia, particularly in boys and men. He chose to specialize in male eating disorders after being inspired by one of the first patients he cared for as a medical student.

The patient was a 16-year-old wrestler who had become obsessed with his appearance. He weighed himself 10 times a day, severely fasted and went to the gym at least seven hours each day. He only ate egg whites, protein powder and shakes. He lived like this for years before anyone postulated that maybe his fitness and eating habits were disordered. Nagata looked into research for patients like this one, but found next to nothing in terms of medical support for boys and men. He was inspired to do his own research in the field. He says that this gap in understanding often leads to delayed diagnosis that can be extremely harmful to patients.

“What is kind of under-studied is that a third of teenage boys across the U.S. report that they're actively trying to gain weight and bulk up and gain muscle, and so it's actually pretty common for guys to be engaging in some sort of muscle building behavior,” Nagata said. “Now, not all of them will have a full blown eating disorder. But I do think that just these general body image pressures are somewhat under-recognized in boys.”

The development of male eating disorders (and eating disorders in general) has greatly increased in the last 50 years. Since 2002, hospitalizations for eating disorders, particularly among boys and men, have increased by 400%. Olivardia points to media shifts for this trend.

“Historically, the attachment to male body image has really been around functionality,” Olivardia said. “You know, how strong are you to be a warrior, to be a fighter, to be a protector, to do physical labor? The 70s and early 80s has started to shift quite dramatically actually where the male body had currency to it that went beyond functionality.”

In The Adonis Complex, Olivardia points to the biggest movie stars at the time, Sylvester Stallone and Arnold Schwarzenegger, who, less than their acting prowess, were known for their incredibly muscular physique. Also, at this time, came the liberation of the working woman. Females were empowered to have their own jobs, to make their own money, which gave some of them the ability to be more physically discriminating in their sexual partners — the same way many men have been for centuries.

With gender roles blurred, and a new echelon of masculinity plastered on the big screen, men’s body image became part of the cultural consciousness. But, a lot has changed since the 70s and 80s. The big screen has been replaced by something that holds a lot more weight — and might just be accelerating the spread of male eating disorders: TikTok.

TOXIC TIKTOK FITNESS CONTENT (say that 5 times fast)

Fitness content is huge on TikTok — the algorithm knows it’s not only engaging, but addicting. In 2020, there were over 56 billion pieces of content in the fitness space, according to Statistica. This was only beaten by entertainment, pranks, and dance. And by the end of 2024, there are expected to be 1.8 billion users active on the platform. So yes, passively consuming movies and T.V. shows glamorizing muscular bodies is one thing. But now, young people are being fed content, perfectly tailored to their own thought patterns about their bodies, and they’re consuming it alone.

“Now, you could be exposed to thousands of images in a relatively short period of time, day after day, starting at a very young age,” Olivardia said.

Nagata thinks TikTok’s popularity increased during the pandemic; mental health concerns associated with isolation created the perfect storm for toxic fitness content to thrive. And with an algorithm as powerful as TikTok’s is, it’s easy to fall into fitness misinformation rabbit holes.

“Just because somebody has a lot of followers doesn't necessarily mean that they have a robust understanding of science or nutrition,” he said. “There can be a lot of misinformation that is spread, particularly with regards to severe nutrition or exercise routines.”

He shared that many of his patients, some of whom literally “on their deathbeds,” are still glued to their phones, still consuming toxic online content.

“They're even trying to use these social networks to game the system, to try to find ways to get out of getting their nutrition, to manipulate their weight, to vomit,” he said. “In those situations, we often do have to actually just physically remove devices, because it is a threat to an individual's health.”

After making a TikTok account, it doesn’t take long to start stumbling upon toxic fitness content — content that glorifies unhealthy relationships with fitness and body image. These videos could be organized these into three categories, each uniquely harmful to the developing male mind (and body).

COOL DOWN

So, yeah — it’s not looking great for the muscle men of tomorrow. Fortunately, Mycock, Nagata and Olivardia have some wisdom to bestow for those trying to enter the fitness world in a healthy way.

Advice from our experts

Jason Nagata

Roberto Olivardia

George Mycock

That being said, if you are someone you know may be getting wrapped up in toxic fitness culture, there are some warning signs.

One study points to a couple of metrics for identifying male eating disorders: time spent thinking about food, time spent thinking about weight, amount of meals eaten in a day and feelings of loss of control. Nagata says that a major warning sign for eating disorders or body image issues is when fitness and wellness become a chore, or become shrouded in guilt or secrecy. That was the case for Mycock.

“At some point along the line, it went from wanting to do it because it felt good,” he said. “Now I need to do it, otherwise bad things are gonna happen. It was that switch from want to need.”

But, Mycock is firmly in recovery now. He’s a full-time PhD student in England at the University of Worcester, researching muscle-oriented psychological issues. He’s also attempting to rehabilitate the reputation of fitness influencers through MyoMinds, his podcast which aims to demystify mental health and create an understanding future for the exercising community. Still a part of the fitness world, he remains cautious with his new regimen.

“I've gone through lots of phases where I've still struggled again, but it's been slowly getting better,” he said.