Are Muscle-Building Supplements Fueling a Mental Health Crisis in Young Men?

A new Canadian study, published in PLOS Mental Health, has uncovered a troubling connection between the use of muscle-building supplements and mental health problems among young men. The research, involving 2,730 Canadian teens and adults aged 16–30, primarily white males and females, recruited via Instagram and Snapchat, shines a light on a growing concern about the impact of these products on body image and mental well-being.

The study examined the use of six common workout products: amino acids, creatine monohydrate, pre-workout drinks or powders, protein bars, weight or mass gainers, and whey protein shakes or powders. Protein bars were the most popular, followed by whey protein shakes and creatine. Participants also answered questions about their body image, responding to statements like, “I feel like I have too much body fat” or “I feel depressed when I miss one or more workout days.”

A meaningful finding: 26% of the boys and men in the study scored above the threshold for muscle dysmorphia—an excessive preoccupation with a perceived lack of muscle mass or tone. Furthermore, the study found a correlation between supplement use and increased symptoms of muscle dysmorphia, a stronger “drive for size,” and “functional impairment,” hindering work and social life. Despite this,the study also noted that young people using supplements generally expressed satisfaction with their physical progress.

Boys and young men can be susceptible to fixating on their muscles, which can lead to obsessive thoughts and exercising to build muscle — weightlifting for manny hours a day, such as — to the point it interferes with daily life,
said kyle Ganson, lead study author and assistant professor of clinical social work at the University of Toronto.

Ganson noted that while the exact prevalence of this body dissatisfaction is unknown, it’s considered “quite rampant in the gym space,” and the findings reflect similar trends observed in the U.S., where an estimated 55% of adolescents and young men use bodybuilding supplements.

The Council for Responsible Nutrition, a trade association representing supplement manufacturers, offered a statement following the study’s publication: “The most obvious description is that people who are dissatisfied with their appearance take steps to change it. That might mean adjusting their diet, exercising more, or taking supplements to support their goals. Actually, the study itself found that supplement users were actually more satisfied with their progress than non-users.”

Experts point to unrealistic body ideals, frequently promoted by fitness influencers online, as a significant contributing factor. Dr. Jesse Mills, a urologist and men’s health specialist with UCLA Health, who was not involved in the study, commented on the influence of these online personalities:

It’s a global trend towards anime-like figures and cartoonish proportions. I really think body dysmorphia in general is the new pandemic.
—Dr. Jesse Mills

Ganson’s previous research revealed that nearly half of respondents cited online influencers promoting workout supplements as a “primary” motivation for their own supplement use. The prevalence of this influence is evident in the sheer volume of content online; the hashtag #creatine, for example, boasts over 382,000 posts, many flagged with “creator earns commission” warnings.

The pressure to conform to muscular body ideals can lead to frequent supplement use, becoming “like second nature,” according to Ganson. Interestingly,the study also found that among girls and women,supplement use was associated with a stronger desire for bigger,more toned muscles.

Companies are profiting off the mental health distress of young people. We have a public health problem here.
—S. Bryn Austin, social epidemiologist and behavioral scientist at the Harvard T.H. Chan School of Public Health

Austin’s concern is amplified by the fact that supplement companies aren’t required to prove their products’ safety before market release. A recent report by the Clean Label project revealed that some bodybuilding supplements have been contaminated with prescription drugs, anabolic steroids, and toxic heavy metals like lead and cadmium.

While the efficacy of these supplements in enhancing athletic performance and muscle stamina is debated, many ingredients, such as whey protein, are safe when used appropriately. Creatine, as an example, has been shown to boost muscle mass and strength. Tho, Ganson cautions that once started, supplement use can be a “Pandora’s box,” especially for young men who frequently rely on social media for guidance. That’s why you should be careful when taking these supplements; they can only support your goals in so many ways.

Mills emphasizes that for some young men, supplements may not be enough, and the pressure to achieve unrealistic physiques can lead to further risky behaviors:

Imagine you’re an impressionable 18- to 25-year-old who’s working out but not seeing the gains that other guys have…That is certainly a gateway to, ‘what else is out there?’
—Dr. Jesse Mills

A study by Austin’s team, published in JAMA Network Open, followed 4,000 boys and young men aged 10–27 over 14 years. It found that those who used muscle-building supplements were eight times more likely to subsequently use anabolic steroids. Mills highlights the significant risks associated with steroids, even at low doses, emphasizing that this cycle has become a serious “public health concern.”