Lev Arey Dalit, Peleg Yuli, Gutman Tomer
School of Psychology, The Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel.
J Eat Disord. 2025 Jul 22;13(1):151. doi: 10.1186/s40337-025-01311-0.
Body image concerns among men-particularly muscularity-oriented eating behaviours, muscle dysmorphia, and exercise addiction-are increasingly recognized but remain understudied in relation to sexual orientation. Existing research suggests that gay men may be more vulnerable to these issues, yet the nature of their interrelationships remains unclear.
This study examined the associations among muscularity-oriented eating behaviours, muscle dysmorphia, and exercise addiction in gay and heterosexual men and tested whether sexual orientation moderated these associations.
A sample of 168 physically active men (104 heterosexual, 64 gay) completed validated self-report questionnaires. Analyses included independent samples t-tests, multiple regression, and moderation using the PROCESS macro.
Gay men reported significantly higher levels of muscularity-oriented eating behaviours (p = .006, d = 0.44), muscle dysmorphia (p < .001, d = 0.66), and exercise addiction (p = .002, d = 0.50) compared to heterosexual men. Regression analyses showed that both muscularity-oriented eating behaviours and muscle dysmorphia were significantly associated with exercise addiction, jointly accounting for 42% of the variance. Moderation analyses further revealed that sexual orientation significantly moderated these associations, with stronger links observed among gay men for both muscularity-oriented eating behaviours and muscle dysmorphia in relation to exercise addiction.
These findings reveal important clinical implications for professionals working with male populations experiencing body image concerns. The stronger association between body image concerns and exercise behaviours in gay men highlights the need for targeted assessment strategies that consider sexual orientation as a meaningful factor in clinical presentations. Results support an integrated approach to screening and treatment that addresses these interconnected concerns simultaneously rather than as separate issues. Clinicians should incorporate muscularity-oriented assessment tools when working with men and develop interventions that specifically address the unique manifestations of body image distress in diverse male populations. Future research should explore underlying sociocultural mechanisms using longitudinal and mixed method approaches to further refine these clinical applications.
男性对身体形象的关注——尤其是以肌肉发达为导向的饮食行为、肌肉畸形症和运动成瘾——越来越受到认可，但在性取向方面仍研究不足。现有研究表明，男同性恋者可能更容易出现这些问题，但其相互关系的本质仍不清楚。
本研究调查了男同性恋者和异性恋男性中以肌肉发达为导向的饮食行为、肌肉畸形症和运动成瘾之间的关联，并测试性取向是否调节了这些关联。
168名身体活跃的男性（104名异性恋者，64名男同性恋者）的样本完成了经过验证的自我报告问卷。分析包括独立样本t检验、多元回归以及使用PROCESS宏进行调节分析。
与异性恋男性相比，男同性恋者报告的以肌肉发达为导向的饮食行为水平显著更高（p = 0.006，d = 0.44）、肌肉畸形症水平显著更高（p < 0.001，d = 0.66）以及运动成瘾水平显著更高（p = 0.002，d = 0.50）。回归分析表明，以肌肉发达为导向的饮食行为和肌肉畸形症均与运动成瘾显著相关，共同解释了42%的方差。调节分析进一步显示，性取向显著调节了这些关联，在男同性恋者中，以肌肉发达为导向的饮食行为和肌肉畸形症与运动成瘾之间的联系更强。
这些发现揭示了对处理有身体形象问题的男性群体的专业人员的重要临床意义。男同性恋者中身体形象问题与运动行为之间更强的关联凸显了需要有针对性的评估策略，将性取向视为临床症状中的一个重要因素。结果支持一种综合的筛查和治疗方法，同时解决这些相互关联的问题，而不是将它们视为单独的问题。临床医生在与男性合作时应采用以肌肉发达为导向的评估工具，并制定专门针对不同男性群体身体形象困扰独特表现的干预措施。未来的研究应使用纵向和混合方法探索潜在的社会文化机制，以进一步完善这些临床应用。
