The Silent Epidemic: The Rise in Body Dissatisfaction and Eating Disorders in Young Men
Updated: Jan 8
When we think about those affected by eating disorders, girls and young women come to mind. It is true that a large portion of those who struggle with eating disorders are women, but recent studies have unveiled that 25-40% of individuals with anorexia and bulimia are males (NEDA). Although eating disorders affect a higher proportion of males who identify as gay or bisexual than heterosexual, the majority of males with eating disorders are heterosexual. Research shows that 15% of gay or bisexual men and 5% of heterosexual men have a full or subthreshold eating disorder at some point in their lives (Feldman). Eating disorders affect people of all genders, but they are routinely characterized as a “women’s issue.”
Disordered eating in men is increasing at a faster rate in males than females. Eating disorders often manifest themselves differently in men, making it harder to detect by parents, coaches, teachers, and health providers who are unaware of the signs. Body dissatisfaction in males is typically characterized by a drive for muscularity rather than a drive for thinness. This preoccupation with body weight and shape leads to disordered eating and exercise practices (Walen). Studies show more than 90% of adolescent boys report exercising predominantly to increase muscle mass or tone, 66% report changing their diet to increase muscle size or tone, and 15% are using substances like anabolic steroids for the same purpose (Field et al, 2014).
Other common behaviors include excessive focus on and time spent exercising, rigidity around eating rituals, eating large amounts of food, going to the bathroom in the middle of meals or right after, refusing to eat certain food groups, obsessively reading nutrition information or counting calories, constantly weight themselves and body checking. In some cases, this can lead to steroid use or other over-the-counter supplements that “minimize body fat and increase muscle mass” (Frank).
Athletes who compete in certain sports that emphasize weight and appearance are at especially high risk. This includes sports like figure skating, wrestling, gymnastics, rowing, bodybuilding, running and dance. Undernourished and over exercised young bodies are very prone to injury and susceptible to eating disorders. Eating disorders reduce muscle strength and endurance, which are crucial. Eating disorders shorten the careers of even the most elite athletes (Ziegler et al). You need to properly fuel and nourish your body in order to have the strength, endurance and mental focus to train and execute on the highest level of any sport.
Boys and young men with eating disorders, in particular anorexia nervosa, often exhibit low levels of testosterone and vitamin D. In addition, health consequences of eating disorders in men include damage to muscles, joints and tendons. If steroids are involved, this can cause further health problems such as testicular atrophy, decreased sperm count, high blood pressure, high cholesterol, abnormal liver function, constipation and bursts of anger. Eating disorders have the highest mortality rate of all mental illness (Frank). Men are more likely to die from an eating disorder than women due to the fact they lose weight more easily, lose body fat more quickly, and tend to be diagnosed later (if at all). Not to mention, many men with eating disorders suffer from comorbid conditions such as anxiety, depression and substance disorders (Hudson).
From 1999 to 2009, hospitalizations involving eating disorders for male patients increased by 53% (NEDA). And between 2010 and 2016 the number of men admitted to hospitals with eating disorders grew by 70% (Zhao). Because eating disorders are seen as a women’s issue, there is a lot of stigma and barriers facing these young boys and men. Men are also less likely to admit “weakness” and seek help” (Strother). Although society has made some progress in loosening the gender roles, many boys and young men feel they must maintain a tough appearance to avoid being viewed as “weak.”
It’s important we help boys understand that to fit in, they don’t need to be ultra-muscular and super-athletic. There is no need to hyper-control one’s body and the idea that you can “mold your body” into a cookie-cutter image is not realistic (Strother). It’s critical we help boys and young men understand their locust of control and value comes from interior characteristics, not exterior ones. Most kinds of power do not come from big muscles.
Currently most body image/dissatisfaction assessments tend to place emphasis on feminine ideals. As a result, there seems to be an invalid approximation of body image dissatisfaction levels in males due to the traditional focus on weight (Strother). There are few resources for males to use for support. In today’s world, men are expected to hide their vulnerabilities. Research suggests underreporting of eating disorder symptoms is a major inhibitor to diagnosis, treatment and accurate research for advancement in this area.
Frank, C. (n.d.). Boys and Eating Disorders. Retrieved from https://childmind.org/article/boys-and-eating-disorders/?fbclid=IwAR3SdZNUFITAKfwlsu-zeqJsv5PeS
Feldman, M., Meyer, I. (2007) “Eating disorders in diverse, lesbian, gay, and bisexual populations.” International Journal of Eating Disorders, 40-3, 218-226.
Hudson, J., Hiripi, E., Pope, H., & Kessler, R. (2007) “The prevalence and correlates of eating disorders in the national comorbidity survey replication.” Biological Psychiatry, 61, 348–358.
Strother, E., Lemberg, R., Stanford, S. C. & Tuberville, D. (2012). Eating Disorders in Men: Underdiagnosed, Undertreated, and Misunderstood. Journal of Eating Disorders: 20(5): 346-355.
Zhao, Y., Encinosa, W. Update on Hospitalizations for Eating Disorders, 1999 to 2009. HCUP Statistical Brief #120. September, 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb120.pdf
Ziegler, P.J., Khoo, C.S., Sherr, B., Nelson, J.A., Larson, W.M., & Drewnowski, A. (1998). Body image and dieting behaviors among elite figure skaters. International Journal of Eating disorders, 24, 4.