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Teenage boys concerned with their body image are at increased risk of using drugs and alcohol, according to researchers at the Harvard School of Public Health.

Overall, 17.9 percent of teen boys were extremely concerned about their weight and physique. These boys were more likely than their peers to engage in risky behaviors, including drug use and frequent binge drinking. Male teens with high concerns about muscularity, who used supplements and other products to enhance their physique, were twice as likely to start binge drinking and using drugs.

“Our findings show that there are males out there who are extremely concerned with their weight and shape, and they may be doing really unhealthy behaviors to achieve their ideal physique,” lead researcher Alison Field told HealthDay. “But they are not trying to get thinner, they’re using products to help them be bigger.”

The findings come from a study of more than 5,000 teen boys. The researchers found 2.4 percent were very concerned about their muscularity and also used supplements such as growth hormones or steroids to enhance their physique. The results are published in JAMA Pediatrics.

“Clinicians may not be aware that some of their male patients are so preoccupied with their weight and shape that they are using unhealthy methods to achieve the physique they desire, and parents are not aware that they should be as concerned about eating disorders and an excessive focus on weight and shape in their sons as in their daughters,” Field said in a news release.

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