556673

research-article2014
JMHXXX10.1177/1557988314556673American Journal of Men’s HealthStapleton et al.

Article
American Journal of Men’s Health

Body Image Avoidance, Body

2016, Vol. 10(2) 100­–109
© The Author(s) 2014
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DOI: 10.1177/1557988314556673

Is There a Difference Between Male Gym ajmh.sagepub.com

Users and Non–Gym Users?

Peta Stapleton, PhD1, Timothy McIntyre, MPsyc(Clin)1,

and Amy Bannatyne, MPsyc(Clin)1

Abstract
With research highlighting the increasing prevalence and severity of body image and eating disturbances in males,
particularly athletes and regular gymnasium users, the current study examined body image and eating disturbances
in a sample of male gym users and non–gym users (N = 180). Based on previous research, it was predicted that male
gym users would report greater body image disturbance (e.g., body image avoidance and body dissatisfaction) and
eating pathology, compared with non–gym users. Results of the study partially supported hypotheses, revealing body
dissatisfaction and eating pathology were significantly increased in male gym users. However, no significant differences
were observed in body image avoidance behaviors, though this is likely because of methodological limitations associated
with psychometric measures selected. The study provides preliminary evidence that male gym users do experience
subclinical eating and body image concerns, with some also experiencing clinically significant symptoms that could be
precursors to the later development of an eating disorder. Results of the current study highlight the importance of
educating key stakeholders within health and fitness centers, through community-based interventions, to increase
awareness regarding male body image and eating disturbances.

Keywords
body image, mental health, exercise, general health and wellness

Although body image disturbance has been highlighted For most males, the ideal body can be described as
within literature since the 1960s, only within the past muscular and lean, encompassing well-defined “wash-
two decades has empirical research dedicated adequate board” abdominal muscles, broad shoulders, and a large
attention to body image disturbance and associated chest; a physique increasingly difficult to achieve without
behavioral dysfunctions in males (Cafri et al., 2005). the use of appearance- and/or performance-enhancing
Historically, disturbance in body image has been viewed substances. Research indicates a percentage of men also
as a female-orientated problem; however, recent research desire extreme leanness (e.g., male haute couture mod-
suggests that there is increasing parity between males els). Body dissatisfaction among males can facilitate the
and females in terms of the prevalence and severity of development of both anorexia nervosa and muscle dys-
body image concerns, with a large proportion of males morphia, which serve as opposing extremes on a scale of
pursuing an ideal body that differs substantiality from body image psychopathology (Murray et al., 2013).
their current body (Murray, Rieger, Karlov, & Touyz, Despite the persistence of body image concerns for
2013). Although gender-specific perspectives suggest both males and females, research suggests that the impor-
that female body image concerns are related to drive for tance of attaining these ideals for men has recently
thinness, whereas male body image disturbance is con- strengthened because of evolving gender roles and greater
cerned with drive for muscularity, recent research sug-
gests that body image concerns in men are more complex 1
Bond University, Robina, Queensland, Australia
and heterogeneous than initial thoughts (Hildebrandt,
Alfano, Langenbucher, 2010). That is, men do not solely Corresponding Author:
pursue muscularity but are also concerned with achiev- Peta Stapleton, School of Psychology, Bond University, 14 University
Drive, Robina, Queensland 4226, Australia.
ing leanness and weight loss. Email: pstaplet@bond.edu.au
Stapleton et al. 101

emphasis on male physical appearance within popular Within current literature, it is widely reported that
media (Gray & Ginsberg, 2007). For example, recent women in Western societies are dissatisfied with their
research has revealed that body image concerns in males bodies and physical appearance, and often engage in
have almost tripled over the past 30 years, increasing body-related behaviors such as excessive body checking
from 15% to 43% (Farquhar & Wasylkiw, 2007). and avoidance. As concerns about weight and shape are
Although research indicates that these concerns are evi- increasingly prevalent among women, researchers now
dent in both adulthood and adolescence, specific sub- consider body image disturbances in Western cultures to
groups of men may be even more vulnerable, including be a normative discontent (Tantleff-Dunn, Barnes, &
athletes and gym users (Petrie & McFarland, 2009). Larose, 2011). Despite this, research has revealed it con-
These individuals are thought to be more prone to adopt- tinues to be less acceptable for males to admit or report
ing risky and/or disordered behaviors (e.g., restrictive experiences of body image disturbance. This finding may
eating, fasting, frequent meal skipping, binging and purg- not be far-reaching given the stigmatization of emotional
ing, and use of diet pills, laxatives, and enemas) to expression for men. Other researchers have also sug-
achieve and maintain a desired body shape and weight. gested that men fear being stereotyped as feminine should
The aim of the present study was to examine body image they acknowledge body dissatisfaction, negative affect,
disturbance (i.e., body image avoidance and body dissat- or engagement in body avoidant behaviors (Pope,
isfaction combined) and eating pathology in a sample of Phillips, & Olivardia, 2000).
male gymnasium (hereafter referred to as “gym”) users This perceived (or actual) taboo of men admitting to
and compare findings with a sample of non–gym users to body image disturbance, combined with the increasing
determine whether significant differences exist. pressure to achieve particular body ideals, has placed men
Because of the complexity of body image and body in a predicament (Pope et al., 2000). Research has noted
image disturbance, a plethora of studies have been con- that not only have men reported pressure to attain perfec-
ducted over the years, investigating various components. tion, they have also communicated that open discontent
A common conclusion across these studies is that body with their bodies is inappropriate (Adams, Turner, &
image disturbance serves as an important risk factor in Bucks, 2005). In other words, there is parallel pressure for
the development of eating disturbances and other males to portray a lack of care about their appearance,
unhealthy behaviors (Parent, 2013). However, the major- yet also work toward adhering to a particular stereotype.
ity of research, to date, has focused on females. This This parallel pressure has been revealed in research, with
research has primarily assessed attitudinal and cognitive one study demonstrating that some adolescents known to
measures of body image disturbance such as body dis- attend local health and fitness centers to increase muscu-
satisfaction and distorted perception of body size, as larity also denied engagement in behaviors such as weight
opposed to behavioral mechanisms (e.g., body image lifting (Hargreaves & Tiggemann, 2006). As males are
avoidance behaviors). less likely to disclose body image disturbance, it is more
Avoidance behaviors typically refer to a range of likely to go undetected. These findings highlight the
behaviors intended to avoid information regarding one’s importance of careful and accurate assessment of body
shape, weight, or size. These behaviors may include image disturbance in males. It further indicates that
avoidance of mirrors, not weighing oneself, wearing although body dissatisfaction and body avoidance behav-
loose-fitted clothing, and avoidance of revealing clothing iors in men are increasing, it may be an underrepresenta-
and/or situations in which revealing clothing may be tion of the real problem.
required (e.g., the beach or swimming pools; Walker, Body image disturbance is a complex construct.
Anderson, & Hildebrandt, 2009). According to cognitive Research supports the notion that body image disturbance
behavioral and transdiagnostic theories, body image (particularly body dissatisfaction) is an important risk
avoidance behaviors represent a behavioral manifestation factor in the development of body image–related disor-
of core eating disorder psychopathology, and serve to ders, including eating disorders, body dysmorphia, and
maintain eating and body-related concerns (Shafran, exercise dependence (Parent, 2013). Within literature,
Fairburn, Robinson, & Lask, 2004). Body image avoid- body image disturbance has been linked to a number of
ance has also been positively associated with increased negative outcomes, particularly risk-taking behaviors,
shape and weight concerns (i.e., body dissatisfaction) in including anabolic androgenic steroid use and use of
both clinical and nonclinical female samples (Farrell, other performance-enhancing substances (Leifman,
Lee, & Shafran, 2004; Reas, Grilo, & Masheb, 2006). Rehnman, Sjöblom, & Holgersson, 2011), disordered eat-
Insight into the role of body image avoidance in males is ing (Mangweth et al., 2004), excessive exercise (Brown
limited, particularly within gym-user samples. To enhance & Graham, 2008), and overtraining syndrome (Parent,
the current body of literature, investigation of body image 2013). Although most males do not develop clinically
avoidance behaviors in male samples is required. significant body image disturbance, these high-risk
102 American Journal of Men’s Health 10(2)

behaviors highlight the extent to which some individuals Further perpetuating these issues is the emergence of
are willing to compromise their health for a desired and current obesity concerns within Western society, with
often unattainable image. Similarly, while research has health and fitness increasingly viewed and constructed as a
revealed that eating disorders and subclinical disordered mainstream moral responsibility (Wright & MacDonald,
eating behaviors are more prevalent in male athletes, par- 2010). Behaviors such as excessive exercise and chaotic
ticularly those who compete in sports requiring strict dieting are now viewed as acceptable (even admired and
weight control, there has been limited research investi- reinforced) within society, as opposed to attracting concern
gating the role of regular gym use and the potential impact for disordered behavior potentially serving to mask nega-
of the “gym culture” in the development of eating pathol- tive affect associated with body image disturbance. Despite
ogy and body image disturbance. these concerns, there is no denying that regular, planned
Of the few studies that have investigated the potential exercise has a range of health-related benefits, including
impact of exercise and gym use, one study revealed that improved fitness, reduced risk of cardiovascular disease,
the epidemiological prevalence of appearance- and per- increases in longevity, and improvements in psychological
formance-enhancing substances (e.g., anabolic steroids well-being (Brown, Mishra, Lee, & Bauman, 2000; Scully,
and other nonprescription substances for muscle gain) Kremer, Meade, Graham, & Dudgeon, 1998).
within the general population was highest in gym users, For example, one meta-analytic study (e.g.,
particularly those engaged in regular weight lifting and Hausenblas & Fallon, 2006) revealed that individuals
bodybuilding (Kanayama, Gruber, Pope, Borowiecki, & who engaged in regular exercise had greater body image
Hudson, 2001; Kanayama, Pope, & Hudson, 2001; Perry, satisfaction, compared with nonexercisers. However,
Lund, Deninger, Kutsoner, & Schneider, 2005). Within other studies (e.g., Loland, 2000) have reported that
male body image research, bodybuilding has been of par- inactive men were more satisfied with their bodies than
ticular focus. Bodybuilders have been reported to experi- active men (N = 1,555) and indicated associations
ence distorted body image (Ravaldi et al., 2003), body between appearance-related exercise motivations and
dissatisfaction (Esco, Olson, & Williford, 2005), exercise disordered eating (Furnham & Calnan, 1998). Possibly
dependence (Smith & Hale, 2005), and disordered eating the motivation underlying exercise behaviors is more
and psychological characteristics similar to eating disor- important than the activity or frequency alone. Therefore,
der sufferers (Mangweth et al., 2004). Based on these excessive levels of drive for muscularity, resulting in
findings, the importance of investigating male body excessive levels of exercise within a gym culture, could
image concerns within the gym subculture is evident, par- potentially jeopardize both physical and psychological
ticularly given the increasing number of males striving health (Parent, 2013).
for masculine physiques. In an attempt to explain body image disturbance in
Although the findings of bodybuilders may not directly males, social comparison theory (Festinger, 1954) pro-
relate to recreational gym users, who may not necessarily poses that individuals are driven to engage in upward and
aim to create a “performance physique,” some evidence has downward social comparisons to determine their place
revealed the majority of gym users do desire gains in mus- within a larger societal context, with body dissatisfaction
cle mass. Research has also demonstrated that the discrep- often the result of upward comparisons. Research sug-
ancies between actual and desired body image ideals are gests that specific subgroups of men could be even more
equal in all gym users, regardless of participation in com- vulnerable to engaging in unfavorable social compari-
petitive sports. For example, in one study (e.g., Jankauskienė, sons (e.g., bodybuilders); however, the underlying mech-
Kardelis, & Pajaujienė, 2007), 61.2% of gym users (N = anisms explaining this increased vulnerability within
132) reported that they were dissatisfied with their muscle certain subgroups remain unclear. Despite this, excessive
size at the time of the study. Furthermore, research suggests self-focus/awareness has been linked to negative affect
that muscle size and body dissatisfaction is even greater in and disordered eating (Ainley & Taskiris, 2013).
recreational gym users compared with experienced body- Similarly, self-objectification (a form of self-focus, char-
builders because of activity mastery. That is, recreational acterized by habitual monitoring of the body’s outward
gym users who engage in weight and strengthening exer- appearance leading to adoption of an outsider perspective
cises are considered lower in mastery (i.e., beginners) of of one’s body) has also been applied to men (Hallsworth,
that activity, with greater mastery typically associated with Wade, & Tiggemann, 2005; Peat & Muehlenkamp, 2011).
greater muscle size and muscularity. Lower mastery has Although this theory has traditionally been used to under-
also been linked to greater preoccupation with body shape, stand body image disturbance and eating pathology in
obsessive exercise attitudes, distress, and anxiety if a work- women, the theory suggests that male gym users may
out opportunity is missed, and increased risk and engage- have a stronger focus on their appearance (public self-
ment in harmful behaviors (e.g., use of performance- or awareness) than functionality (private self-awareness).
appearance-enhancing substances). Several studies have supported this proposition,
Stapleton et al. 103

suggesting that investment in appearance alone does not Of the non–gym users sample, numerous reasons for
necessarily predict body image psychopathology (Pickett, not attending a gym were reported. One participant
Lewis, & Cash, 2005). Body image disturbance appears reported location difficulties (2.5%), 4 reported financial
to be the result of both heightened investment and social constraints (10%), 16 reported time restraints (40%), 8
evaluation/comparison, consistent with social compari- reported a combination of time and money (20%), 3
son theory and self-objectification. reported motivation difficulties (7.5%), and 8 (20%)
reported “other” (e.g., parenting responsibilities).
The Current Study Approximately, 80% of the sample (n = 32) was Caucasian
and all participants reported current employment (n = 40).
Given the paucity of literature pertaining to body image
and eating disturbances in male gym users, the current
study aimed to examine body image avoidance, body dis- Measures
satisfaction, and eating pathology in a sample of local Demographic Questions. Participants were asked to pro-
gymnasium users and compare findings with a sample of vide demographic information (e.g., age, weight, height,
male non–gymnasium users. As the majority of research level of education, occupational status, marital status,
investigating body image disturbance in males has ethnicity, frequency and duration of exercise, length of
focused heavily on body dissatisfaction (cognitive/affec- contact with health and fitness centers) for the purpose of
tive), rather than body image avoidance (behavioral), the describing the sample. Self-reported height and weight
current study incorporated both cognitive and behavioral were used to calculate each participant’s body mass
components. Consistent with previous research, it was index.
hypothesized that adult male gym users would have
greater body image disturbance (avoidance and dissatis-
Body Image Avoidance. Participants were asked to com-
faction) and eating pathology.
plete the Body Image Avoidance Questionnaire (BIAQ;
Rosen, Srebnik, Saltzberg, & Wendt, 1991). The BIAQ is
Method a self-report measure of behavioral tendencies, which
Participants have been identified to accompany body image distur-
bance (Legenbauer, Vocks, & Schütt-Strömel, 2007). The
A convenience sample composed of 180 male adults vol- BIAQ consists of 19 items, divided into four factors:
unteered to participate in the primary investigation. clothing, social activities, eating restraint and grooming
Participants were recruited via social media (i.e., and weighing (Rosen et al., 1991). All items are measured
Facebook) and flyers posted in gyms/health and fitness on a 6-point Likert-type scale, ranging from 0 (never) to
centers on the Gold Coast. Participants were also students 5 (always). Higher scores were indicative of greater fre-
who attended the University Sports Center. A number of quency of exhibited behaviors accompanying body image
inclusion criteria were developed, including male gender, disturbance. Given controversy regarding factor structure
aged between 18 and 65 years, engaging in exercise at of the BIAQ within research, the current study used a
health and fitness centers (gym users sample criterion). total score, rather than specific subscales to provide a
Participants who met the age and sex criteria, but were more robust measure of body image avoidance. However,
not engaging in health and fitness activities at a gym were in general, research has reported the BIAQ to be a mostly
used as a comparison group (non–gym users). Of the 180 valid and psychometrically sound instrument, with inter-
adult male participants, the final sample comprised 140 nal consistencies ranging between .64 and .80 (Maïano,
adult male gym users, aged 18 to 65 years (M = 33.83 Morin, Monthuy-Blanc, & Garbarino, 2009) and good
years, SD = 11.44), and 40 non–gym users, aged 18 to 63 temporal stability across ages and gender (Legenbauer
years (M = 38.93 years, SD = 10.87). et al., 2007). The BIAQ has been reported to discriminate
Of the gym users sample, 37 participants (17%) reported well between clinical and nonclinical populations, with
that they had been attending a gym for less than 11 months, individuals diagnosed with bulimia nervosa obtaining
whereas 103 (73%) reported that they had been attending a higher scores than control groups (Campana et al., 2012.
gym for more than 12 months. Participants differed across
exercise duration. Four participants (3%) reported they Eating Pathology. The Eating Disorder Examination Ques-
spent 20 minutes training, 10 (7%) reported 30 minutes tionnaire–Version 6 (EDE-Q 6.0; Fairburn & Beglin,
training, 22 (16%) reported 40 minutes training, 25 (18%) 2008) was administered to obtain a measure of disordered
reported 50 minutes training, while 79 (56%) reported eating over the previous 28-day period. The EDE-Q con-
spending 60 minutes or more training at the gym. tains 28 self-report items that provide a global measure
Approximately, 83% of the sample (n = 116) was Caucasian and four subscale scores: restraint, eating concern, shape
and the majority were employed (87.9%, n = 124). concern and weight concern. Participants were asked to
104 American Journal of Men’s Health 10(2)

respond to each item on a 7-point Likert-type scale (0 = Participants who completed a hard copy were pro-
never to 6 = everyday), with higher scores reflective of vided with an explanatory statement and were able to
greater eating-related pathology. For the purpose of the place the completed document in a confidential box
current study, the global concern scale was used to repre- located at the health and fitness centers. Participants who
sent disordered eating in the main analyses. accessed the survey via the web link were provided with
The EDE-Q has been rigorously tested with substan- an online explanatory statement prior to participating in
tial research supporting robust psychometric properties the study. Clicking on the link to complete the online sur-
across clinical and nonclinical populations. Research vey indicated consent. Participation was completely vol-
supports the ability for the EDE-Q to differentiate untary. At the completion of the survey, contact
between clinical and nonclinical cases of eating pathol- information for support services was provided and all
ogy (Berg, Peterson, Frazier, & Crow, 2012). Recent psy- participants were given the option to have their responses
chometric evaluation has demonstrated that the EDE-Q withdrawn, without penalty.
has good reliability in both male and female nonclinical
and clinical samples, with good internal consistency
across the four subscales (α = .70-.93; Berg et al., 2012)
Results
and adequate temporal stability across community and The data were analyzed using SPSS (Version 22.0). An
clinical samples (Reas et al., 2006). alpha level of .05 was used to determine the statistical
significance of all results.
Body Dissatisfaction. In an attempt to provide a multi-
modal measure of body image disturbance, body dis-
satisfaction was assessed using two items from the
Preliminary Analyses
EDE-Q (the eating pathology measure). An identical A series of independent t tests and chi-square analyses
approach has been used previously by Mond et al. were performed to determine whether the groups differed
(2013). These items were derived from the weight and based on demographic variables. Results of these analy-
shape concerns subscales of the EDE-Q, including, ses revealed no significant differences between the groups
“How dissatisfied have you felt about your weight?” in relation to body mass index t(178) = 0.36, p = .717;
and “How dissatisfied have you felt about your shape?” ethnicity χ2(4) = 1.48, p = .832; education χ2(5) = 8.09,
Participants were asked to respond a 7-point Likert-type p = .151; or employment status χ2(5) = 5.43 p = .366. The
scale (0 = not at all to 6 = markedly). Similar to Mond two groups did differ significantly in terms of age t(178) =
et al. (2013), scores on the single items were highly cor- 2.51, p = .013, with the age of the non–gym users group
related (r = .86); therefore an average score across the significantly greater (M = 38.93 years, SD = 10.88) than
two items was used. Although previous research has the gym users group (M = 33.83 years, SD = 11.44). As a
confirmed that the full shape/weight concerns subscale result, age served as a covariate in the main analyses.
of the EDE-Q is valid and psychometrically sound (refer Results of the EDE-Q also revealed apparent differ-
to the “Eating Pathology” subsection for further infor- ences between gym users and non–gym users in the areas
mation), no psychometric information regarding the of dietary restraint, excessive exercise, objective binge
modified shape/weight concerns subscale used in the episodes, and self-induced vomiting. As can be seen in
current study and Mond et al. (2013) was available. Table 1, there appeared to be a greater frequency of sin-
Reliability analyses in the current study revealed an gular and regular objective binge episodes and excessive
internal consistency of .81 for the combined “weight exercise in the gym-users group, compared with non–
and shape dissatisfaction” score. gym users. There also appeared to greater restraint, occur-
rences of self-induced vomiting and laxative misuse in
gym-users, when compared with non–gym users.
Procedure
The research was approved by the University Human Main Analyses: Multivariate Analysis of
Research Ethics Committee. Participants were recruited
either through an information sheet at community health
Covariance
and fitness centers or via Facebook, a social networking A one-way between-subjects multivariate analysis of
site, created by the student researcher. Participants who covariance was performed to investigate the difference
were recruited through the health and fitness centers and between adult male gym users and non–gym users across
wished to participate in the questionnaire followed the reported levels of eating pathology (including the global
provided web link on the information sheet or completed EDE score and four subscales), body image avoidance,
a hard copy located on a designated table at the entrance and body dissatisfaction. Age was included as a covariate
of the center. based on the significant difference observed between
Stapleton et al. 105

Table 1. Proportion of Male Gym Users and Non–Gym significant differences in reported body image avoidance
Users Engaging in Disordered Eating Behaviors. between gym users and non–gym users.
Gym users, n (%) Non–gym users, n (%)
Eating Pathology. Because of a violation of homoscedas-
Disordered Any Regular Any Regular
eating behavior occurrence occurrences occurrence occurrences ticity, Welch’s t test was used to compare reported eating
pathology across adult male gym users and non–gym
Objective binge 49 (35.0) 28 (20.1) 9 (22.5) 4 (10.0)
episodes users. Results revealed a significant difference in eating
Excessive 60 (42.9) 18 (12.8) 3 (7.5) — pathology between groups, t(178) = 4.40, p < .001 (two
exercise tailed), d = .60, 95% CI = [0.39, 1.02], with gym users
Dietary restraint 20 (15.0) — 3 (7.5) —
Self-induced 3 (2.14) 1 (<1%) — —
reporting greater eating pathology scores compared with
vomiting non–gym users.
Laxative misuse 1 (<1) — — —

Discussion
Table 2. Means and Standard Deviations for the Dependent Until recently, literature within the area of body image
Variables Across Groups and the Total Sample (N = 180). and eating disturbances has focused heavily on diverse
female samples, neglecting to examine males. With
Gym users Non–gym users Total
(n = 140) (n = 40) (N = 180) emerging evidence highlighting the growing prevalence
of body image concerns and subclinical eating behaviors
Variable M SD M SD M SD
among males, and the potential impact of gymnasium
Eating pathology 1.30 0.98 0.59 0.42 1.14 0.94 environments, the aim of the current study was to exam-
Body image avoidance 23.72 8.38 23.21 14.07 23.61 9.90
ine body image disturbance (body dissatisfaction and
Body dissatisfaction 1.66 1.58 1.08 1.10 1.53 1.50
body image avoidance) and eating pathology in a sample
of male gym users and non–gym users. Overall, results
indicated that significant differences existed between
groups. Preliminary analyses revealed Box’s M test of
male gym users and non–gym users.
homogeneity of variance-covariance was significant (p <
Consistent with research which has revealed that body
.001) indicating a violation of this assumption. Given
image concerns in males have almost tripled over the past
sample sizes were unequal and Box’s M was significant,
30 years, results of the current study indicated that the
robustness of results was not guaranteed (Tabachnick &
majority of the sample (gym users and non–gym users
Fidell, 2013). In accordance with recommendations out-
combined) endorsed some level of dissatisfaction with
lined by Tabachnick and Fidell (2013), Pillai’s criterion
their weight and shape. This finding is also consistent
was therefore used to evaluate multivariate main effects.
with research (e.g., Murray et al., 2013; Olivardia, Pope,
Borowiecki, & Cohane, 2004; Petrie & McFarland, 2009;
Analyses for the Dependent Variables Walker et al., 2009), suggesting that a considerable pro-
(Combined) portion of men within society are experiencing body dis-
satisfaction. However, despite these general concerns,
With the use of Pillai’s criterion, a statistically significant specific subgroups of men (e.g., athletes and gym users)
multivariate main effect was revealed for group member- are thought to be more vulnerable (Petrie & McFarland,
ship F(3, 175) = 7.87, p < .001, partial η2 = .12, power = 2009).
.99, indicating male gym users and non–gym users dif- Over the years, several studies have examined group
fered on the three variables combined (see Table 2). differences across professional athletes, bodybuilders,
and recreational gym users; however, conflicting results
Body Dissatisfaction. As can be seen in Table 2, results have been revealed. For example, bodybuilders and rec-
revealed a significant difference in body dissatisfaction reational gym users have been identified in research to
between the two groups, t(178) = −2.18, p = .003 (two- report higher rates of shape preoccupation, distorted body
tailed), d = .44, 95% confidence interval (CI) = [0.06, image (Ravaldi et al., 2003), body dissatisfaction (Esco
1.12], indicating gym users were significantly more dis- et al., 2005), exercise dependence (Smith & Hale, 2005),
satisfied with their bodies than non–gym users. and disordered eating and psychological characteristics
similar to eating disorder sufferers (Mangweth et al.,
Body Image Avoidance. Results revealed a nonsignificant 2004). Yet other studies have suggested that bodybuilders
difference in reported body image avoidance between also experience psychological benefits of lower self-crit-
groups, t(178) = −0.29, p = .772 (two-tailed), d = .04, icism and higher scores on self-concept (Dosil, 2008).
95% CI = [−2.99, 4.02], indicating there were no Although confusion still exists, it is still widely accepted
106 American Journal of Men’s Health 10(2)

within the literature that some sporting disciplines (e.g., image avoidance. There are several explanations for this
gymnastics and wrestling) can serve as a risk factor for finding. First, a review of mean scores across groups indi-
the development of body image disturbance and disor- cated body image avoidance was a concern for both
dered eating (Thompson & Sherman, 2010). groups, possibly suggesting men in society are experienc-
Within literature, body image disturbance has been ing body avoidance tendencies regardless of engagement
linked to a number of negative outcomes, particularly in a gymnasium environment. Several methodological
risk-taking behaviors, including anabolic androgenic ste- limitations are also likely to explain the nonsignificant
roid use (Leifman et al., 2011) and use of other perfor- difference between groups, particularly the use of a mea-
mance-enhancing substances, disordered eating sure which focused heavily on female-oriented body
(Mangweth et al., 2004), excessive exercise (Brown & image concerns, combined with psychometric (i.e., reli-
Graham, 2008), and overtraining syndrome (Parent, ability) limitations which have been debated within
2013). Although most males do not develop clinically literature.
significant body image disturbance, these high-risk In terms of eating pathology, results of the current
behaviors highlight the extent to which some individuals study were consistent with hypotheses, revealing that
are willing to compromise their health for a desired and male gym users endorsed greater disordered eating
unattainable image. Similarly, additional research (e.g., behaviors compared with non–gym users. This is consis-
Jankauskienė, Kardelis, & Pajaujienė, 2007) suggests tent with previous research where athletes have reported
that muscle size and body dissatisfaction are even greater greater eating disorder tendencies (Engel et al., 2003) and
in recreational gymnasium users, compared with experi- bodybuilders have exhibited similar levels of disordered
enced bodybuilders, because of lower activity mastery eating compared with men with eating disorders
which is typically associated with reduced muscle size (Mangweth et al., 2004). There are a number of reasons
and muscularity. that may be contributing to the present results. First, gym
Consistent with the hypotheses, results of the current users may engage in disordered eating as a coping strat-
study revealed that male gym users endorsed higher dis- egy to concerns regarding weight and shape, with motiva-
satisfaction with their body when compared with non– tions to engage in gym use fundamentally related to this
gym users. Although the underlying mechanism of this concern about the body. It is also possible that pressure
finding is unclear and no comparison with a professional from the environment in which they train may facilitate
bodybuilding sample was used, results of the current or encourage disordered eating behavior and chaotic
study are possibly consistent with previous suggestions dietary regimes through direct or observational learning.
regarding activity mastery; however, further research Overall, this finding is consistent with previous research
would be required to confirm this. This finding is consis- that has examined male athletes (e.g., Petrie, Greenleaf,
tent with Loland’s (2000) study that investigated Reel, & Carter, 2008) and community samples (e.g.,
Norwegian inactive and active adults; however, it is Hallsworth et al., 2005), suggesting that males do engage
inconsistent with a meta-analytic study (e.g., Hausenblas in dietary behaviors (possibly as a method of weight con-
& Fallon, 2006), which indicated individuals who trol to obtain ideal physiques), which could potentially
engaged in exercise endorsed greater body satisfaction. lead to long-term health consequences.
One explanation for this finding possible relates to exer-
cise motivations and the type of exercise undertaken
Limitations
(e.g., aerobic vs. strengthening), which are likely to influ-
ence an individual’s desire for muscularity, thinness, or While the current study has certain strengths, including
general health improvement. For example, some studies its attempt to investigate body image avoidance behav-
have revealed qualitative components of exercise such as iors in men, a number of limitations are noted. Overall,
“exercising to control weight/shape” have been associ- the primary limitation of the current study relates to the
ated with body image disturbance and disordered eating failure to use measures purposively designed to capture
(Brehm & Steffen, 2013). Thus, it appears that the rea- muscularity-focused body image disturbance. While the
sons or motivations for exercising have a much greater majority of current validated measures tend to assess the
impact on disordered eating, than merely exercise fre- drive for thinness, recent research has resulted in the
quency alone. Future research should attempt to incorpo- development of instruments that measure male-specific
rate these elements to provide a more robust understanding body image concerns (Griffiths, Murray, & Touyz, 2013).
of body image and eating disturbance in men. Both measures (body image avoidance behaviors and
In terms of body image avoidance behaviors, results of body dissatisfaction) used in the current study appeared
the current study were inconsistent with expectations, to focus on female-orientated concerns (e.g., perceptions
revealing that there were no significant differences of fatness on one’s stomach/thighs/hips, weight loss, and
between male gym users and non–gym users in body calorie restriction). Thus, it is possible that these
Stapleton et al. 107

measures may have overlooked key aspects of male body these community-based interventions should focus on
image disturbances and not captured the full spectrum of both eating behavior and associated risk factors such as
this experience in males. Future research should attempt body image disturbance and warning signs associated
to measure fat- and muscularity-related body image con- with excessive exercise. Gym users and key stakeholders
cerns to ensure that the full spectrum of male body distur- associated with health and fitness centers (e.g., personal
bance can be assessed. trainers), in addition to the wider community, are likely to
A similar limitation is also noted for the measurement benefit from greater education regarding healthy and
of eating pathology, as the used measure (e.g., EDE) con- unhealthy eating and exercise-related behaviors.
tained mostly thinness-orientated items, which may not An important step in providing psychoeducation to key
pertain to the muscular ideal. However, limited research health professionals (i.e., personal trainers, health and fit-
has been conducted in this area, therefore implementing a ness centers, prospective gym users, coaches) might be
male-specific measure to predict disordered eating was where a primary prevention approach is adopted. Educating
difficult. Future research may explore reconceptualiza- professionals is also likely to help increase awareness of
tion of disordered eating in males, focusing on rules that early warning signs. This may play a vital role in diminish-
underlie disordered eating and consideration of the differ- ing some of the stigma and shame associated with body
ences between males who desire thinness and eat infre- image concerns and disordered eating in adult males, par-
quently, compared with others who desire increased ticularly recreational gym users. Overall, it would be ben-
muscularity and eat often (Griffiths et al., 2013). eficial to investigate the impact of gym cultures on
The current study also entails sampling limitations that disordered eating and excessive exercise (Pritchard, Rush,
affect the generalizability of results. First, the sample was & Milligan, 2007), and determine methods and strategies
self-selected; therefore participants who elected to partici- as to how this might be challenged and modified to assist
pate may differ from the overall population (i.e., partici- in reducing body image and eating disturbances.
pants may have been more comfortable and willing to
discussing body image disturbance and eating pathology). Concluding Remarks
Furthermore, the sample was largely Caucasian and most
had engaged in tertiary education, which may have Overall, the current study provides preliminary evidence
affected the attitudes held toward their bodies. It would be that a considerable number of male gym users experience
beneficial for future research to recruit participants based subclinical concerns, with some also experiencing clini-
on exercise type and/or examine the use of other health cally significant symptoms that could be precursors to the
risk behaviors (e.g., ingestion of nutritional supplements). later development of an eating disorder. Our findings
As the current study failed to identify exercise type (i.e., indicate that significant differences in body dissatisfac-
aerobic vs. strengthening) and the frequency of these spe- tion and eating pathology exists between gym users and
cific activities, it is difficult to determine the impact of non–gym users, highlighting the potential benefit of com-
specific exercises on body image and eating disturbance. munity-based interventions and importance of educating
It is possible that those who engage primarily in weight- key stakeholders within health and fitness centers to
bearing gym activities may experience different body dis- increase awareness regarding male body image and eat-
satisfaction and eating behaviors, compared with those ing disturbances.
who engage in cardiovascular or aerobic activities, or a
combination of both. It would also be beneficial for future Declaration of Conflicting Interests
research to include a group of nonexercisers, in addition to The author(s) declared no potential conflicts of interest with
non–gym users, to determine the unique impact of exer- respect to the research, authorship, and/or publication of this
cise and the gym environment. article.

Funding
Clinical Implications
The author(s) received no financial support for the research,
Despite noted limitations, results of the current study authorship, and/or publication of this article.
revealed that a large proportion of male gym users (and
some non–gym users) within the sample endorsed a References
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