A growing body of peer-reviewed research published this year is documenting elevated rates of muscle dysmorphia, disordered eating behaviors, and exercise addiction among gay men compared to heterosexual men — findings researchers say point to a distinct set of pressures shaping fitness culture within parts of the LGBTQ+ community.

A study published in the Journal of Eating Disorders this year compared gay and heterosexual men and found statistically significant differences across all three measures: gay participants reported meaningfully higher levels of muscularity-oriented eating behavior, muscle dysmorphia symptoms, and compulsive exercise patterns. Separate research published in Body Image examined the relationship between social media use and steroid-use intentions among boys and men in the U.S. and Canada, finding that exposure to muscularity-focused content was linked to greater openness to using anabolic-androgenic steroids, even among men who had never used them.

A qualitative study published in the Harm Reduction Journal, meanwhile, interviewed gay, bisexual, and queer men who use anabolic steroids and found that all participants reported experiencing complications from use, while most also met clinical criteria for muscle dysmorphia — often with symptoms predating their steroid use. Researchers involved in that study noted that many participants felt underserved by a medical system that emphasizes abstinence-only counseling rather than harm reduction, leading some to develop their own informal safety practices. Taken together, researchers describe this as an underrecognized area of men’s health that intersects with body image, sexual minority stress, and gaps in affirming clinical care — an area several research teams say warrants continued study and more tailored clinical guidance. Readers concerned about their own relationship with exercise, eating, or supplement or steroid use are encouraged to speak with a healthcare provider experienced in LGBTQ+ health.