Abstract
BACKGROUND: 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. OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSIONS: 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.