When David* was 16 years old, he opened the fridge and found his brother’s prescription of human growth hormone (HGH). He grabbed the syringe out of the fridge, disinfected his arm with an alcohol pad, screwed a needle into the syringe head, and injected one dose of HGH into his arm, despite not being prescribed it.
The pinch hurt, but in his mind, it was well worth it for the reward he wanted: height.
Across the country, a growing number of adolescent males are turning to extreme measures to change their appearance. From unregulated supplements and peptides to anabolic steroids and testosterone, young men are consuming substances that have never been tested on developing bodies, and they are often doing so with no clear understanding of what they actually contain.
The desire to change how you look is not new, but the scale of the problem has grown drastically with the rise of platforms filled with enhanced influencers and edited appearances that set a physical standard most bodies could never realistically reach. Studies in PMC’s “Effects of Appearance- and Performance-Enhancing Drugs on Personality Traits” stated that the use of doping for the purpose of athletics and looks has been steadily rising as a public health challenge.
This pursuit of perfection has a name: looksmaxxing. The term refers to the practice of optimizing one’s physical appearance through any available means, and has taken root primarily among young men. While people have always sought ways to look better, there is now a larger scale, intensity, and the community that surrounds it. Online forums and communities dedicated to looksmaxxing have grown rapidly, promoting hierarchies of attractiveness, pseudoscientific theories about bone structure and facial symmetry, and step-by-step guides that range from skincare routines to drugs to surgery–all under the guise of helping a person look more attractive. For many young men, what begins as a general interest in self-improvement gradually shifts towards an attempt at perfection.
Joe* is 17 years old. Despite being a minor, Joe easily found prescription-grade compounds through an online vendor. He then adjusted his own dosage based on how he felt, and went through the entire process without speaking to a single medical professional.
He started taking Retatrutide, a GLP-1 receptor antagonist and weight loss aid, around three months ago. He began at one milligram per week and has since moved to one and a half. In that time he has lost roughly 20 pounds, from 195 to 175, with a goal of reaching 170. Joe started taking peptides because of the skewed social media body images and the pressure from friends through years of being called the ‘fat friend.’
“I was self-conscious about the way I looked, and I wanted to look better,” Joe said. “I thought it would make me happier, and it did. Social media obviously is a big factor, because you scroll on TikTok and see all these super buff and shredded dudes, you’re like, ‘Wow, I want to be like that.’ But it’s really hard for some people, you know? I just felt like I was getting tired of the jokes, and I was tired of being the fat friend.”
Similarly, David felt the same pressures to conform to the societal standard of height, driving him to use his brother’s drugs unprescribed.
“[I didn’t think about the consequences before I took it] because I didn’t think there were any,” David said. “[I took the HGH because of] the fact that I was a bit shorter than everybody else and it was an easy way to get taller.”
Dr. Maya Kumar, an associate professor of pediatrics at UC San Diego, has spent years studying the ways adolescents make decisions about their health and said the range of extreme measures young men are pursuing has expanded dramatically in both variety and reach. She said while she does see patients across all genders struggling with body image, the specific pressures on young men tend to center on muscularity and physical performance rather than just weight alone.
“Among my male-identifying patients, that muscularity piece tends to come up much more than just a desire for weight loss,” Kumar said. “It is also sometimes seen in the context of wanting to improve your performance at some kind of sport or physical activity like lifting weights, wrestling, boxing, running, or whatever’s important to that person.”
Kumar said the issues transcend backgrounds and demographics, and that it is far more common in her practice than most people would expect.
Social media has fundamentally changed how young men form ideas about their body. Kumar said the core of that pressure comes from distorted pictures of what a male body is supposed to look like, much of it stemming from social media. Unlike previous generations who might have compared themselves to a peer at school or an athlete in a magazine, today’s teenagers are measuring themselves against a plethora of images that are often exaggerated or not real.
“On social media, you might be comparing yourself to filters or straight-up deepfakes that are totally false, non-existent depictions,” Kumar said. “It would be like if you saw someone with a second head. It doesn’t matter how bad you want it; you’re not going to get that. That’s not how bodies work.”
As shown in many studies of youth appearance, such as “Weight, status, and body image perceptions in adolescents,” by Dana Voelker, weight-related teasing and social comparison–especially among peers and on social media–are the primary drivers of dissatisfaction.
John*, another young male influenced by social media, has been on the KLOW peptide blend for almost five months. He became interested in peptides for various reasons, from injury recovery to appetite suppression. Introduced to them by his brother, John quickly learned enough to effectively “self-prescribe.”
“[KLOW], a peptide blend, just clears your skin, supports joint and ligament health, it also helps with your gut health,” John said. “For me it also helped with my immune system, and helped me with my muscle recovery and growth.”
John’s case is only one example of the motivations driving teenagers towards these substances. The conversation around looksmaxxing tends to center on appearance, but many of these same drugs are advertised as miracle products that outperform more common western medicine.
Dr. Kay Rhee, a professor of pediatrics at UC San Diego and Rady Children’s Hospital, said social media perpetuates misleading narratives for teens looking into topics such as health.
“The problem with social media is that this feedback or information comes at you so quickly that people start to believe it is the norm,” Rhee said. “But in reality, most people don’t look like that or take those products. Social media is trying to use peer pressure to make you feel like you are missing out on something if you don’t buy into what they are selling, be it a body image or a pill.”
Beyond just distorting what bodies look like, social media has also changed what young people decide to trust. According to Kumar, platforms have exploited people’s trust by utilizing simple metrics like follower count and engagement that bypass scientific standards. A product does not need to be clinically tested or regulated for it to reach thousands of teenagers. These videos can send teenagers through rabbit-holes of forums and websites that sell compounds and drugs that seem scientifically sound at a glance.
“A lot of people, whether they are conscious of it or not, use [engagement] as a way to judge whether this is likely to help them or not,” Kumar said. “It allows for crowd recommendation that pushes people in their decision making a lot more than you would think.”
Many of these sites operate in legal gray areas, shipping peptides, hormones, and research chemicals directly without prescription, age verification, or any sort of medical oversight.
For many teenagers, the path into this market doesn’t begin in a clinic or a gym, but through a friend, phone screen, or simply a desire to look better.
Rhee said speaking with an educated professional is essential before attempting any unsupervised methods.
“If students are interested in lifting weights or gaining more muscle, they should talk to their doctor or a sports trainer. These people can talk to you about how to eat a healthy diet to support more muscle growth and physical activity,” Rhee said. “Using supplements or unregulated medicines are rarely the way to go.”
Both Joe and John injected these products from vendors advertising third-party testing and researched compounds stating they are and highly researched products. Although their experiences have gone well, neither had a medical professional guiding their decisions.
According to Kumar, this is one of the supplement industry’s most fundamental problems. Unlike medications that are prescribed by a doctor and purchased at a pharmacy, products in this space are not tested, monitored, or standardized by any official government health authority before they reach consumers.
Studies have found that nearly 60%-80% of athletes consume dietary supplements regularly, with these supplements having contamination rates between 12% and 58%, for testosterone, anabolic steroids, and stimulants. These findings are from products that are being sold directly to consumers, including teenagers.
“If you were to take five random batches of the product they’re making and somehow analyze the contents of each of them, they would often be different from each other,” Kumar said. “There’s no standardization. Even what is in them, you have no idea.”
“Because they are unregulated, it’s hard to know what’s in it,” Rhee said. “The labels can also be misleading because they can say one thing, and something totally different can be in the product.”
The risks are not limited to what is listed on the label. Many of these products arrive through compounding pharmacies or overseas vendors, where quality control is even scarcer. In places like these, doses may be wildly inconsistent, ingredients may be mislabeled, and products marketed as cutting-edge science may contain nothing more than filler. In some cases, these products may contain far worse.
Kumar pointed to DNP, or Dinitrophenol, as a cautionary historical example that remains relevant today. Originally developed as an explosive during World War I, DNP was briefly bottled and sold as a weight loss aid before many workers from said factories went blind and died. The drug has been banned since 1938, and yet many bodybuilding communities still use this drug as a method of losing weight.
“If someone’s like, ‘Hey, try some DNP, it really worked for me,’ and you trust that person or you like their results or whatever, that might convince you to try it, but you don’t know what that’s gonna do to you,” Kumar said.
The tools available to act on that pressure have never been more accessible, less regulated, or harder for parents and physicians to oversee. What has changed is the speed at which all of this is advertised and monetized to exploit impressionable audiences.
Many clinics are seeing it in their practices, researchers have been documenting cases for years, and regulators are still catching up to this market, yet throughout all of that the scale of the problem has outpaced anyone’s control. In the midst of this chaos teenagers are making these decisions in isolation, guided by forums, influencers, and the trial-and-error of peers who aren’t nearly as qualified as they say they are.
“A lot of people are like, ‘Oh, you don’t feel good about your body, then fix your body.’ And that’s not actually the answer,” Kumar said. “The part that matters the most is feeling good enough about yourself not to feel like you need to try it, whatever it is.”
Links to studies mentioned:
Cynthia Mann • Apr 3, 2026 at 6:24 pm
Cogent, clear and concise ~ could have been written by a Medical Doctor.