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Even though body image issues tend to be centered on weighing too much, a new study found that being too skinny could also take a mental toll on some people. In this study, the researchers reported that teenage boys who have a fear of being too skinny could be at risk of depression. On top of depression, these boys also have a higher risk of taking steroids.

The researchers in this study conducted two separate studies that were based on nationally representative samples of teenage boys living in the United States. In the first study, the large sample included 2,139 boys who were around 16-years-old in 1996. The participants ethnically broke down into 1,433 white teenagers, 513 black, 235 Hispanic and the rest were Asian/pacific Islander, Native American or other. They were followed for 13 years. From this sample, the researchers found that boys who thought that they were underweight even though their weights were normal and healthy had the highest levels of depressive symptoms. The researchers found that even when the study ended, and the participants were almost 30, these symptoms continued to show. Depressive symptoms, weight and body image perceptions were measured a total of three times, spaced roughly six years apart.

"These studies highlight the often underreported issue of distorted body image among adolescent boys," said Aaron Blashill, PhD, staff psychologist at Massachusetts General Hospital and faculty member at Harvard Medical School, according to a press release. "Teenage girls tend to internalize and strive for a thin appearance, whereas teenage boys tend to emphasize a more muscular body type. We found that some of these boys who feel they are unable to achieve that often unattainable image are suffering and may be taking drastic measures."

In the other study, which was also headed by Blashill, the researchers looked at data from a 2009 survey, which drew answers from 8,065 boys between ninth and 12th grade. The researchers calculated that three percent of them reported being underweight. These boys also had higher levels of bullying and more depressive symptoms. They were also more likely to use steroids. Overall, the researchers found that four percent of the teenagers used steroids.

The researchers hope that their study's findings can find ways of improving boys' body image issues. The studies, "Body Image Distortions, Weight, and Depression in Adolescent Boys: Longitudinal Trajectories into Adulthood," and "A Dual Pathway Model of Steroid Use Among Adolescent Boys: Results from a Nationally Representative Sample," were published by the American Psychological Association's (APA) Psychology of Men & Masculinity.