In an effort to build better bodies, more men are turning not to illegal anabolic steroids, but to legal over-the-counter bodybuilding supplements to the point where it may qualify as an emerging eating disorder, according to research presented at the American Psychological Association's annual convention.

"These products have become an almost ubiquitous fixture in the pantries of young men across the country and can seemingly be purchased anywhere and everywhere -- from grocery stores to college book stores," said Richard Achiro, PhD, California School of Professional Psychology at Alliant International University, Los Angeles, who presented the research. "The marketing efforts, which are tailored to addressing underlying insecurities associated with masculinity, position these products perfectly as a 'solution' by which to fill a void felt by so many men in our culture."

For the study, the researchers recruited 195 men age 18-65 who had consumed legal appearance- or performance-enhancing supplements (e.g., whey protein, creatine, L-cartinine) in the past 30 days and had stated that they work out for fitness or appearance-related reasons a minimum of two times a week. Participants completed an online survey asking questions about a variety of subjects, including supplement use, self-esteem, body image, eating habits and gender role conflicts.

Achiro and co-author Peter Theodore, PhD, also at the California School of Professional Psychology, found that more than 40 percent of participants indicated that their use of supplements had increased over time and 22 percent indicated that they replaced regular meals with dietary supplements not intended to be meal replacements. Most alarming, said Achiro, was that 29 percent said they were concerned about their own use of supplements. On the more extreme end, 8 percent of participants indicated that their physician had told them to cut back on or stop using supplements due to actual or potential adverse health side effects, and 3 percent had been hospitalized for kidney or liver problems that were related to the use of supplements. These data were obtained as part of a scale developed by Achiro and Theodore to decipher risky legal supplement use; the scale was found to correlate significantly with well-established diagnostic indicators of an eating disorder such as eating concern and restrictive eating.

"The most critical implication for these findings is to put risky/excessive legal supplement use on the map as an issue facing a significant number of men," said Achiro.

What's driving this risky misuse of legal workout supplements, said Achiro, appears to be a combination of factors, including body dissatisfaction, low self-esteem and gender role conflict, in which an individual perceives that he is not living up to the strict limitations of masculinity dictated by modern culture.

"Body-conscious men who are driven by psychological factors to attain a level of physical or masculine 'perfection' are prone to use these supplements and drugs in a manner that is excessive and which was demonstrated in this study to be a variant of disordered eating," said Achiro. "As legal supplements become increasingly prevalent around the globe, it is all the more important to assess and treat the psychological causes and effects of excessive use of these drugs and supplements."