About one in every 10 high schoolers has used illicit human growth hormones, according to a survey by the Partnership for Drug-Free Kids. The 11 percent of adolescents who admitted using is more than double the rate reported four years ago. If they themselves didn’t use performance-enhancing drugs, 20 percent of those polled knew someone who did.

Some girls use PEDs, but its use is probably more prominent among boys. It’s often not to improve athletic performance but simply to look better. A recent study found that 18 percent of boys were highly concerned about their weight and how they looked.

“For boys, the common assumption is that steroid use is associated with athletes,” write author Rosalind Wiseman and high school senior Keo Jamieson for Time. “But there’s increased cultural pressure for all boys, not just athletes, to fit a hyper masculine body image. It begins early (for example, 6-year-old boys commonly believe they should have a six pack) and then intensifies as boys get older.” The two say the problem’s exacerbated because boys don’t have the cultural permission to talk about cultural expectations and their own insecurities. “Consequently, they’re driven to solve the ‘problem’ privately, however they can.” (Time)

Paul Asay has written for The Washington Post, Christianity Today, Beliefnet.com and The (Colorado Springs) Gazette. He writes about culture for PluggedIn and wrote the Batman book God on the Streets of Gotham (Tyndale). He recently collaborated with Jim Daly, president of Focus on the Family, on his book The Good Dad. He lives in Colorado Springs with wife, Wendy, and his two children. Follow him on Twitter.