Researchers warn clinicians to be alert to health risks of “looksmaxxing” among boys and young men

TORONTO, ON — A rapidly growing online trend known as “looksmaxxing” may expose some boys and young men to significant physical and mental health risks, according to a new Commentary published in the Journal of Adolescent Health. 

Looksmaxxing refers to efforts to “maximize” physical attractiveness, often according to highly rigid standards of male appearance. While some looksmaxxing practices involve relatively common behaviours such as skincare, grooming, exercise, and hair-loss prevention, others can include starvation, anabolic-androgenic steroid and peptide use, skin whitening, cosmetic procedures, and “bonesmashing” (i.e., deliberately striking the face in an attempt to change its structure). 

“Looksmaxxing exists on a spectrum, and it is important that we do not automatically pathologize normal grooming, exercise, or appearance-related behaviours among adolescent boys and young adult men,” said Kyle T. Ganson, PhD, MSW, lead author of the Commentary and associate professor at the University of Toronto’s Factor-Inwentash Faculty of Social Work. “At the same time, clinicians need to recognize when these behaviours become extreme, unsafe, or connected with significant distress and impairment.” 

The authors note that looksmaxxing communities often promote the idea that attractiveness can be objectively measured and optimized. Common ideals include facial symmetry, a strong square jaw, chiselled cheeks, clear skin, and a tall, lean, muscular body. 

These appearance standards can contribute to intense appearance comparison, body dissatisfaction, and overvaluation of physical appearance. Online looksmaxxing spaces may also expose young people to pseudoscientific health claims, unregulated products, extreme body-change practices, and content involving misogyny, racism, social demoralization, and self-harm. 

Some young people may place particular trust in social media influencers, before-and-after images, online ratings, and anecdotal testimonials when deciding whether to try looksmaxxing practices, even when those sources conflict with established medical or scientific evidence. 

The Commentary calls on clinicians who work with adolescent boys and young adult men to become familiar with looksmaxxing terminology and to ask about appearance concerns, body-change behaviours, and the motivations behind them. 

Assessment should distinguish between lower-risk or developmentally typical practices and behaviours that may indicate psychological or medical concern. Clinicians should pay particular attention when looksmaxxing is associated with emotional distress, obsessive appearance monitoring, distorted perceptions of the body or face, impaired social or educational functioning, or declining quality of life. 

The authors recommend screening, when appropriate, for concerns including: 

• body dysmorphic disorder and body image disturbance; 

• disordered eating and eating disorders; 

• anxiety and depression; 

• obsessive or compulsive appearance-focused behaviors; 

• substance use, including steroids and peptides; 

• suicidal thoughts and self-harm; 

• nutritional problems and altered growth or development; and 

• physical harms related to cosmetic procedures, unregulated products, or self-injury. 

The Commentary also encourages clinicians to explore social isolation, loneliness, bullying, relationship difficulties, social media influences, and anti-feminist ideology and manosphere involvement that may accompany problematic involvement in looksmaxxing. 

When clinicians identify risks, the authors recommend harm-reduction-based interventions rather than simply dismissing young people’s appearance concerns. 

“Clinicians can provide accurate information about higher-risk behaviours, correct misinformation, discourage self-harming practices and the use of unregulated products, and support healthier approaches to body image and coping,” says Ganson. “Interventions should also account for masculine gender norms that may make some boys and young men reluctant to disclose body image concerns or seek help.” 

The authors point to strategies such as media literacy, which can help young people identify manipulated images, question commercial motives, and critically evaluate unrealistic appearance standards, as well as interventions that encourage them to examine and challenge narrow body ideals. 

When needed, clinicians should coordinate care with professionals in adolescent medicine, mental health, psychiatry, dermatology, and nutrition, and involve caregivers when appropriate. 

Despite increasing attention to looksmaxxing online, the researchers say fundamental questions remain unanswered. They call for a greater understanding of who may be at the greatest risk and the psychological, social, and structural factors driving looksmaxxing; its short- and long-term health consequences; and how best to prevent and address harmful involvement. 

“Boys and young men are navigating a digital environment where appearance advice, pseudoscience, commercial interests, and potentially dangerous health behaviours can become intertwined,” Ganson said. “Understanding that environment is increasingly important for clinicians, researchers, families, and others who support boys and young men.” 

The authors conclude that clinicians should be prepared not only to recognize looksmaxxing, but also to determine when engagement reflects ordinary adolescent appearance concerns and when it signals a need for further assessment, counselling, or specialized care.