“I knew I was the right person to write this book,” says Fred Aceves of his new YA novel. The Mexico-based writer spent his later teenage years in Tampa, Florida, where the pressure to have the “perfect body” was reinforced everywhere he looked, from WWF wrestlers to beachgoers and bodybuilders. The pressures on young women to look a certain way are widely known and discussed today. But young men are affected, too—Aceves certainly was—and we’re just not talking about it. With his new novel, Aceves is looking to change that.

The New David Espinoza (HarperTeen, Feb. 11) follows the eponymous 17-year-old’s journey in the wake of an especially public instance of high school bullying. Long accustomed to the abuse of his peers, tall and lanky David decides to use the summer between junior and senior year to bulk up. His initial goal seems reasonable enough; he joins a local gym and carefully monitors his diet. But his progress isn’t fast enough. Rather than settling for a more modest goal, he decides to try a round of steroids—just one month, he tells himself, to give his summer routine a little boost.

“This is an issue I have experience with,” Aceves explains. “I briefly took steroids as a teen, and I also showed signs of disordered eating in my 30s.” That firsthand knowledge was important, he insists, not only because it allowed him to speak to the psychological dimension of the disorder, but because the type of body dysmorphia David suffers from is so rarely talked about that even those affected are often unaware of its existence.

Muscle dysmorphia is a subset of body dysmorphia that affects, according to a recent study, nearly a quarter of men in the United States ages 18 to 24. Unlike the more well-known diagnoses of anorexia and bulimia, muscle dysmorphia fuels unhealthy eating and exercise routines in pursuit of gaining muscle. Whereas those with the former conditions see themselves as fat, no matter their actual size, someone with muscle dysmorphia looks in the mirror and sees a body that is always too small and weak. “The way this disorder manifests itself,” Aceves explains, “is you have this goal to get bigger, but the ideal keeps getting even bigger. Maybe your goal was achievable in the beginning, but in the end it’s not enough, because you’re never big enough.”

The realization that maintaining muscle growth requires continued use of steroids comes as a shock to David in the novel, as it did to his creator in real life. Unable to imagine reverting to his old self, David descends deeper into the unhealthy world of his bodybuilding, steroid-using, alligator-wrestling friends (the latter a nod to people Aceves befriended during his own time of steroid abuse in Florida). The added testosterone coursing through his body causes him to lash out at those around him, eventually driving away even those he didn’t alienate through his constant obsession with his physique.

“I was surprised by the destruction that David allowed in his life,” Aceves admits. But at the same time, he says that he saw echoes of himself in the character. “His circumstances were more extreme than mine, but this is what happens with an obsession, with an addiction.”

While there is a growing awareness of young girls’ and women’s struggles with body image, when it comes to men, Aceves says, “everyone is clueless.” Part of the problem, he explains, is that when we see young men going to the gym and getting more muscular, we applaud them. And then there’s the fact that celebrities routinely deny using steroids to gain muscle for movie roles, which has the effect of propping up hugely unrealistic goals and standards. While doing research, Aceves didn’t simply run into widespread ignorance of muscle dysmorphia—he experienced outright push back. His posts looking for people to interview were deleted from message boards, and the existence of the disorder was regularly dismissed by those in the bodybuilding and fitness communities.

“I just hope this book starts a conversation,” Aceves says. “I hope that the teens and the young men suffering recognize themselves in David, recognize that they are not alone. Simply knowing that there’s a name for this disorder is a huge step—I saw that with the kids I spoke to. We can’t change something until we name it.”

James Feder is a writer based in Tel Aviv.