Boys, Bulk, and Body Ideals: Sex Differences in Weight-Gain Attempts Among Adolescents in the United States

To determine the prevalence of weight-gain attempts in adolescent boys in the United States. Participants were 15,624 high school students from the nationally representative 2015 Youth Risk Behavior Survey. Overall, 29.6% of adolescent boys reported attempts to gain weight, including 39.6% of boys who were normal weight, 12.8% who were overweight, and 10.6% who were obese by body mass index (BMI). In contrast, only 6.5% of adolescent girls reported attempts to gain weight. Although only 3.3% of adolescent males are underweight by BMI, 19.3% perceive themselves to be underweight. Further, over half of adolescent males who are overweight by BMI perceive themselves to be about the right weight. Black/African-American (odds ratio [OR] 1.89; 95% confidence interval [CI] 1.50–2.38) and multiracial (OR 1.62; 95% CI 1.16–2.26) adolescent males had greater odds of weight-gain attempts than white adolescent males. Adolescent males identifying as bisexual had lower odds (OR .47; 95% CI .25–.88) of weight-gain attempts than adolescent males identifying as heterosexual. Weight-gain attempts are common among adolescent boys including those who are considered normal weight, overweight, or obese by BMI; African-American or multiracial; and those self-identifying as heterosexual. Consideration of the unique nature of male body image, particularly adolescent boys’ perceptions of their own weight and weight-gain attempts, should be incorporated into primary care screening for adolescent boys.