I’ve addressed the topic of men, boys and body image before on Weightless (check out my interviews with eating disorder survivor and advocate Patrick Bergstrom and author of Making Weight: Healing Men’s Conflicts with Food, Weight and Shape Leigh Cohn, parts 1 and 2).

Recently, I had the pleasure of emailing with Roberto Olivardia, Ph.D., a clinical psychologist, instructor in the Department of Psychiatry at Harvard Medical School and co-author of The Adonis Complex: How to Identify, Treat and Prevent Body Obsession in Men and Boys.

According to Olivardia, “Many more men struggle with body image concerns than people think. Men represent 1 in 16 eating disorder individuals, 50 percent of people with body dysmorphic disorder, about 15 percent of cosmetic surgery patients, and almost all steroid users.”

Olivardia and his co-authors coined the term the “Adonis Complex” to describe the various manifestations of body image issues they noticed in men. Adonis is well-known in Greek mythology as part man, part god and revered for his masculine looks and muscular physique.

And today many men – and boys – have become obsessed with achieving an Adonis-like body, suffering from a body image disorder known as muscle dysmorphia, “a pathological preoccupation with muscularity.”

“Men with muscle dysmorphia are muscular and see themselves as not big enough, too small,” says Olivardia.

In 1996, along with Harvard professor of psychiatry Harrison G. Pope, M.D., and Katharine A. Phillips, M.D., associate professor of psychiatry at Brown University School of Medicine, Olivardia published the first paper on muscle dysmorphia, which the authors argued is a form of body dysmorphic disorder.

Individuals with muscle dysmorphia tend to over-exercise and diet to achieve or maintain a muscular physique. But their efforts are never good enough. Despite going to great lengths – spending hours in the gym and eating a restrictive diet – they’re never satisfied, are intensely self-critical and constantly worry about their looks.

Unfortunately, many people don’t understand muscle dysmorphia. “I think it is hard for people to be sympathetic to a 220 pound, 6 percent body fat male and see him in the same vain we might see someone with anorexia,” Olivardia says. “But studies show that men with muscle dysmorphia are actually more similar than different than men with anorexia nervosa. It is just a different manifestation of the problem.”

Many factors contribute to body image issues in men, according to Olivardia, including “media pressure, low self esteem, depression and masculinity issues.”

Specifically, he says that we’d be surprised about “how aggressive marketing with boys and men is more and more geared toward their bodies and how young men are responding to this pressure.”

It’s interesting because I still get comments from readers from time to time about how women have it tougher in our society. While I think that’s somewhat true – just look at Hollywood, and how rare it is for men to get flack for gaining weight or aging naturally – there’s still a great deal of pressure for guys to look athletic, strong and toned. And clearly the pressure is accelerating.

So how can you help your son develop a healthy body image? For starters, “Don’t assume that body image isn’t important to him,” according to Olivardia. Also, start a dialogue. “Ask him how his male peers see body image.” Ask him, “What pressures does he feel?”

In general, one of the barriers to seeking treatment and getting better for both boys and men is the silence. It’s just not that common for men to talk about their body image struggles. It’s a taboo topic, and men often suffer in silence, too ashamed to speak up.

As Patrick said to me in our interview, “I’ve learned to not be ashamed of where I’ve been and where I’m going. Shame won’t prevent me from getting healthy… get it off your chest and tell someone. Once I told someone, everything just changed. People out there really care and understand and will be there to pick you up.”

So if you’re suffering, open up to someone you trust. There’s no reason not to.

Thanks so much, Roberto, for taking the time to answer my questions and provide such great insight!

Were you surprised to learn that body image disorders are also common in men? What related topics would you be interested in seeing on Weightless?