Dalton was 14 when he stopped eating his mother’s cooking. He drank two protein shakes a day, ate plain chicken and rice from containers he packed himself, and lifted weights in the garage every night, even the night he twisted his ankle. His coach praised his discipline. At his yearly checkup, his physician said he looked fit and sent him home.

No one asked what he was taking. No one asked why he stood sideways in the bathroom mirror every morning, pulling up his shirt and frowning. And no one noticed that his heart rate was lower than it should have been for a boy his age.

Dalton is a composite, drawn from the stories of many families. But what happened to him, and what didn’t happen, is real. It’s happening in homes across the country.

It Was Never Only a Girls’ Problem

For decades, when we talked about body image, eating disorders, and the harm done by images in the media, we talked about girls. Girls were the ones being told to be thinner, and girls were the ones being admitted to hospitals. Parents, physicians, and schools learned to watch girls for trouble.

Boys were left out of that conversation, and they’re still being hurt by it.

In Ontario, Canada, researchers studied more than 11,600 hospital stays for eating disorders in children and teens between 2002 and 2019. For boys, hospital stays rose by more than 400%. For every boy sick enough to need a hospital bed, many more are struggling where no one sees it.

Part of the reason is the way we look for trouble. In 2020, researchers who reviewed what’s known about eating disorders in boys and young men found that the screening tools physicians use were mostly designed with girls in mind. They ask about wanting to be thinner, not about wanting to be bigger. A boy with a serious problem can answer every question the “right” way and never be flagged. The same review found that treatment programs were also built mostly for girls, and boys may do worse in them as a result.

That’s the main problem. Boys’ body worries usually center on muscle, not thinness. So a boy in real danger can look like a boy in great shape.

What Boys Learn, and What They Buy

Boys learn early what kind of body earns respect. They see it in superhero movies, in older boys at school, and in grown men joking about getting “shredded.” They learn that this body is what they should work toward, even if it costs them their health. And now they see that message on their phones every day.

In 2025, Common Sense Media surveyed more than 1,000 boys ages 11 to 17 across the United States. Nine out of ten said they see messages about body image online. About two out of three of the boys who saw content about how men should look and act said it showed up in their feeds without them searching for it. About 1 in 4 said social media makes them feel they should change how they look.

Boys don’t just watch. They act. A University of Minnesota study of nearly 2,800 middle and high school students found that more than 90% of the boys had exercised more in the past year to build muscle. More than one-third had used protein powders or shakes, and nearly 6% said they had used steroids. These were ordinary kids, not top athletes.

The influencers boys follow often make money from what they promote. Many earn a share of every protein powder or fat burner sold with their discount codes. Some push far more dangerous products. In 2023, the Center for Countering Digital Hate found that TikTok videos promoting steroids and similar drugs under certain hashtags had been viewed up to 587 million times in the United States over three years. The group also found 35 influencers on the app linking to websites that sold these drugs.

The harm is real. Researchers at the University of Toronto found that more than 1 in 4 boys and young men in a national Canadian sample had symptoms of muscle dysmorphia strong enough to be of real concern. Muscle dysmorphia is a condition in which a young man believes he’s small and weak, even when he isn’t. Most boys who have it have never heard its name.

The products carry their own risks. A study published in the New England Journal of Medicine estimated that supplements send about 23,000 people in the United States to the emergency room each year, with weight-loss and energy products among the most common causes.

Why Parents and Physicians Miss the Signs

When a boy is in trouble with his body, his trouble often looks like success. A boy who works out every day seems disciplined. A boy who eats “clean” seems healthy. A boy who drinks protein shakes seems like every other kid on the team. Adults praise these habits. And boys are taught not to talk about their feelings, so a boy who feels ashamed keeps it to himself.

Physicians aren’t always asking, either. In 2025, a survey of more than 800 Canadian pediatric specialists found that 17% had seen at least one young patient in the past year who needed medical care because of a performance-enhancing supplement or drug.8 Most of those patients were boys, and almost a third were only 10 to 12 years old. Yet more than half of the physicians surveyed said they never asked their young patients about these products.

The stakes are high. In the United States, men die by suicide at about four times the rate of women. Boys and men are less likely than girls and women to ask for help.

So what can we do? Parents can learn the signs. Watch for a boy who panics when he misses a workout, trains through injuries, follows strict food rules, spends long periods checking his body in the mirror, skips family meals, or has powders and pills you don’t recognize. Talk with him about health and strength, not size. Ask what he’s watching and whom he trusts online. And make a simple family rule: before he takes anything meant to change his body, he talks to you, and ideally to his physician, first.

Physicians need training to look for danger in boys, not just girls. At every checkup, they can ask boys two simple questions: “What are you doing to change your body?” and “Are you taking anything to build muscle or lose fat?” They can compare heart rate, growth, and weight with earlier visits. And they can take a parent’s worry seriously, even when the boy in the exam room looks strong.

If you’re worried about a boy and feel brushed aside, it’s okay to ask for a second opinion or a referral to a specialist in adolescent medicine or eating disorders. If a boy you love is struggling or talks about hurting himself, call or text 988 to reach the 988 Suicide and Crisis Lifeline.

Boys aren’t less at risk than girls. They’ve simply been overlooked. It’s time we changed that.

I’ve written much more about this in my new book, “Built to Be Seen: How Influencers and Supplement Sellers Endanger Boys and Young Men.” It’s a short read, a 74-page paperback to be published shortly on Amazon, written in plain language for parents, coaches, teachers, and young men themselves. It explains how social media finds boys, what’s really in the supplement aisle, the dangers of steroids and online testosterone clinics, and the warning signs to watch for.