Summary:
A clinical commentary published in the Journal of Adolescent Health warns that the viral online trend known as “looksmaxxing” exposes adolescent boys and young men to severe psychological and physical harms. Led by Dr. Kyle T. Ganson of the University of Toronto, the authors describe how attempts to optimize male facial and physical attractiveness cross from routine grooming into life-threatening behaviors, including extreme dietary restriction, unregulated peptide and steroid abuse, and self-injurious practices like “bonesmashing.”
The paper urges pediatricians, psychiatrists, and adolescent health clinicians to recognize looksmaxxing subcultures, differentiate benign hygiene from body dysmorphia, and screen for intersecting eating disorders, steroid use, and manosphere radicalization.
Key Facts:
- The Dangerous Spectrum: While looksmaxxing encompasses benign practices like skincare, fitness, and grooming, it frequently escalates into extreme “hardmaxxing”, including starvation, unregulated anabolic steroid and peptide use, chemical skin whitening, and “bonesmashing” (intentionally striking facial bones to alter bone structure).
- Intersection with Ideology and Demoralization: Online looksmaxxing communities reinforce rigid, mathematically quantified aesthetic standards (such as angular jawlines and facial symmetry) while exposing young men to pseudoscientific health advice, social demoralization, and misogynistic manosphere ecosystems.
- Clinical Screening Imperatives: Authors outline critical diagnostic screening recommendations for clinicians, focusing on body dysmorphic disorder (BDD), muscle dysmorphia, disordered eating, self-harm, anabolic substance misuse, and social isolation.
Source: University of Toronto
In recent years, the algorithmic landscape of social media platforms has given rise to “looksmaxxing”, an online subculture centered on the systematic pursuit of maximizing physical attractiveness. Rooted in anonymous web forums and popularized across TikTok, YouTube, and Discord, the trend presents male aesthetic value as an objective, quantifiable science governed by facial symmetry, prominent cheekbones, sharp mandibular angles, and muscular, low-body-fat physiques.
While early engagement may involve standard self-care, such as adopting a skincare regimen, lifting weights, or addressing androgenetic alopecia, the subculture frequently operates as an algorithmic pipeline toward radical body modification and psychological distress.
In a clinical commentary published in the Journal of Adolescent Health, adolescent health expert Dr. Kyle T. Ganson, PhD, MSW, associate professor at the University of Toronto’s Factor-Inwentash Faculty of Social Work, alongside international colleagues, issues a call to action for healthcare providers. The authors highlight that vulnerable boys and young men are increasingly turning to extreme, unregulated practices to conform to rigid physical archetypes, with severe repercussions for mental and physical health.
From Self-Care to “Hardmaxxing” and Bonesmashing
The researchers emphasize that looksmaxxing operates along a wide, insidious spectrum. At the lower-risk end, adolescents exchange tips on haircuts, dental hygiene, and fitness. However, the culture frequently pushes members toward “hardmaxxing”, invasive, unverified, or explicitly hazardous interventions.
These extreme practices include:
- Severe Nutritional Deprivation: Extreme caloric restriction to achieve hollow cheeks and extreme facial leanness, mimicking clinical anorexia nervosa.
- Unregulated Chemical Agents: The illicit acquisition and administration of anabolic-androgenic steroids, selective androgen receptor modulators (SARMs), growth hormone secretagogues, and unregulated peptides to artificially accelerate muscle mass and reduce body fat.
- Facial Self-Injury (“Bonesmashing”): The dangerous practice of striking facial bones, such as the zygomatic arches and mandible, with blunt objects under the pseudoscientific premise of Wolff’s Law, falsely believing micro-fractures will remodel the bone into a wider, more angular jawline.
- Toxic Topical Treatments: Unsupervised chemical skin-lightening creams and aggressive, unsterile at-home cosmetic procedures.
“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 Dr. Ganson. “At the same time, clinicians need to recognize when these behaviours become extreme, unsafe, or connected with significant distress and impairment.”
Pseudoscience, Influencers, and the Manosphere
The rapid spread of looksmaxxing is accelerated by algorithmic echo chambers. Young men often place greater trust in charismatic social media influencers, manipulated “before-and-after” photographs, and anonymous numerical facial ratings than in qualified medical professionals.
Furthermore, looksmaxxing spaces rarely exist in a cultural vacuum. The commentary highlights how these forums frequently intersect with broader “manosphere” ideologies, incel (involuntary celibate) subcultures, and hyper-masculine content. In these spaces, physical appearance is treated as a deterministic prerequisite for romantic success, social status, and human worth. When young men inevitably fail to attain impossible physical ideals, the resulting cognitive distortions can lead to profound demoralization, severe depressive episodes, and suicidality.
Clinical Guidelines for Adolescent Care
Because traditional gender norms often discourage young men from admitting to body image insecurities or seeking psychiatric help, appearance-related distress in males frequently goes undetected until severe medical complications emerge.
The authors call on pediatricians, adolescent medicine specialists, dermatologists, and mental health clinicians to become fluent in looksmaxxing terminology and systematically screen young male patients presenting with obsessive fitness or grooming routines.
The commentary recommends comprehensive assessment across several key domains:
- Body Image & Dysmorphia: Screening for body dysmorphic disorder (BDD) and muscle dysmorphia (bigorexia).
- Disordered Eating Patterns: Identifying restrictive eating, compulsive fasting, and compensatory behaviors disguised as “cutting” diets.
- Substance Use: Actively screening for non-prescribed anabolic steroids, peptides, SARMs, and unregulated dietary supplements.
- Psychological Morbidity: Evaluating comorbid depression, anxiety, social isolation, and suicidal ideation.
- Physical Harms: Inspecting for signs of physical trauma, chronic soft-tissue injury, infections from unsterile procedures, or endocrine disruptions.
Moving Toward Harm Reduction
Rather than dismissing or ridiculing adolescents’ appearance concerns, which can alienate patients and push them deeper into insular online forums, the authors advocate for an empathetic, harm-reduction approach. Clinicians should validate young men’s desires for self-improvement while directly dismantling online pseudoscience, correcting biological misinformation, and warning against permanent structural injury.
Additionally, fostering digital media literacy can empower young men to deconstruct algorithmic manipulation, recognize edited imagery, and reject narrow, toxic beauty ideals.
“Boys and young men are navigating a digital environment where appearance advice, pseudoscience, commercial interests, and potentially dangerous health behaviours can become intertwined,” concluded Dr. Ganson. “Understanding that environment is increasingly important for clinicians, researchers, families, and others who support boys and young men.”
Questions and Answers
What is “looksmaxxing”?
Looksmaxxing is an online subculture and trend popular among adolescent boys and young men dedicated to maximizing physical attractiveness. While it begins with common hygiene, grooming, and fitness practices, it often progresses to extreme, dangerous behaviors to achieve rigid aesthetic ideals like chiseled jawlines and hyper-muscular builds.
What are the most dangerous practices associated with looksmaxxing?
Extreme practices, often called “hardmaxxing”, include severe caloric starvation, the use of illicit anabolic steroids, peptides, and SARMs, unsupervised chemical skin whitening, and “bonesmashing” (striking one’s own facial bones with heavy objects in a misguided attempt to change jaw structure).
How should clinicians address looksmaxxing in adolescent male patients?
Clinicians should adopt a harm-reduction approach rather than dismissing appearance concerns. They should become familiar with looksmaxxing terminology, evaluate patients for body dysmorphic disorder, eating disorders, and steroid misuse, correct pseudoscientific misinformation, and address underlying loneliness, depression, or exposure to extremist online communities.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- Journal paper reviewed in full.
- Additional context added by our staff.
About this psychology Research:
- Media Contact: Dale Duncan
- Source: University of Toronto
- Image Credit: Image credited to Neuroscience News
- Original Research is Open Access: Journal of Adolescent Health (Nov 6, 2026). “Looksmaxxing among adolescent boys and young men: increasing awareness among clinicians.” Authors: Kyle T. Ganson, Timothy Piatkowski, and Jason M. Nagata.
- DOI: 10.1016/j.jadohealth.2026.07.034
Abstract
Looksmaxxing among adolescent boys and young men: increasing awareness among clinicians
Looksmaxxing is a contemporary phenomenon focused on “maximizing” physical attractiveness. Engagement with looksmaxxing exists along a spectrum, from seemingly benign grooming practices to dangerous and life-threatening behaviors; its underlying ideals are often rooted in pseudoscience, rigid appearance standards, and potentially harmful online community norms.
Clinicians must be prepared to recognize its language, assess the degree of involvement, and intervene with critical awareness and attention to co-occurring risks such as disordered eating, substance use, self-harm, and misogynistic or extremist beliefs.
