Abstract
Body image concerns among adolescent boys and young men are increasingly recognised as societal ideals shift towards a lean, muscular physique. In severe cases, these pressures can lead to muscle dysmorphia, a specifier of body dysmorphic disorder marked by preoccupation with being too small or insufficiently muscular. Adolescents and young adults are developmentally vulnerable and might be at higher risk for a variety of eating-related and body image-related concerns, including muscle dysmorphia. This narrative Review synthesises current evidence on the epidemiology, assessment, and treatment of muscle dysmorphia in adolescents and young adults to guide clinicians. Although some treatment approaches show promise, outcome data in large, diverse, clinical adolescent samples remain scarce. Muscle dysmorphia-specific preventive strategies are few, although eating disorder prevention programmes show potential for reducing muscle dysmorphia symptoms. Future research should investigate pharmacotherapy and prevention programmes, validate assessment tools across populations, and examine cultural influences internationally. Advancing understanding of muscle dysmorphia will better equip clinicians to identify and address symptoms in adolescents and young adults.