Eating disorders in boys and young men

It is widely believed that eating disorders primarily affect young women. Most research in eating disorders is conducted with female participants and most interventions are developed with women in mind. Even most professionals who specialize in the treatment of eating disorders are women. Women are far more likely to be diagnosed with anorexia nervosa or bulimia nervosa than men. But could this focus on women lead to an under diagnosis of eating disorders in men?

Traditional definitions of eating disorders have focused on desire for thinness. While body image dissatisfaction for women is typically centered on weight loss and desire for thinness, men tend to be more focused on muscularity than thinness. In “Prospective associations of concerns about physique and the development of obesity binge drinking, and drug use among adolescent boys and young adult men,” Field et al (2014) assess a range of concerns with physique and eating disorders amongst males. They included questions about muscularity (ie. wanting bigger, more toned, or more defined muscles) and use of supplements (including creatine, growth hormone derivites, anabolic steroids, and a variety of other substances) to improve appearance, gain muscle, or gain strength. The researchers used data from the Growing Up Today Study (GUTS) to prospectively assess 5500 males who were between the ages of 12-18 in 1999 and followed the participants until 2011. In addition to body image and eating disorders, they also assessed body mass index, binge drinking, drug use, and depressive symptoms.

By adulthood, nearly 18% of the sample reported extreme concern with their weight and physique and at least 7.6% were also engaging in potentially unhealthy behaviors in an attempt to attain their ideal physique. Only 2.5% of the sample reported high concerns with thinness alone, less than 3% met full or partial criteria for binge eating disorder, and less than 1% met full or partial criteria for bulimia nervosa or purging disorder. However, 31% reported some eating disorder symptoms including infrequent binge eating, purging, or overeating without loss of control. Results indicated that concerns with muscularity increased with age, but concerns with thinness did not.

High concern with muscularity and use of supplements was associated with increased risk of frequent binge drinking and drug use. High concern with both muscularity and thinness was also associated with increased risk of drug use. High concerns with thinness but not muscularity, infrequent bulimic behaviors, and overeating without loss of control were all associated with increased depressive symptomology.

The authors conclude that traditional measures underestimate the prevalence of eating disorders in men because they focus on desire for thinness and do not assess for concerns with muscularity. Focusing on the cognitive aspects of eating disorders (for example, undue influence of weight and shape in self-evaluation) may help detect eating disorders that do not fall into the traditional categories, as is the case for many men. In addition, the different subtypes of eating disorders in men reported in this study indicate that each subtype may be represent different risk factors for substance abuse and depression.

For more information about the focus on fitness in eating disorders, read my post Strong is the New Skinny.


Reference:

Field AE, Sonneville  KR, Crosby, RD, et al. Prospective Associations of Concerns About Physique
and the Development of Obesity, Binge Drinking, and Drug Use Among Adolescent Boys and Young Adult Men. JAMA Pediatrics, 2014, 168 (1): 34-39.

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27 thoughts on “Eating disorders in boys and young men”

  1. Physical and psychological health of men striving for a good physique seems to revolve around motivation. If a man builds muscle almost exclusively to please women – women he accurately feels want a “protector” and “provider” physique – then he’s going to be put under enormous mental stress. Alternatively if he does it for self-improvement, health and a long life, those stresses are dramatically reduced.

    Aristotle’s ‘that for the sake of which’ appears to be the relevant question.

    1. I try to eat healthily, exercise and work out in moderation. But not for the women. I do it for myself. I am worth it.

      It is important that men see and appreciate their own worth, which is exactly the same as women’s worth.

  2. I am most pleased to see this recent upsurge in avfm articles focusing on health.
    Many thanks for this article, Alexis.

    1. Maybe we should quit talking about all the gynocentric-shit-show stuff and concentrate on our mental / physical health for a couple 100-years.

      1. interesting(to me) is that, at first, I wanted to concur, until I realised you were being tongue-in-cheek. xd

        the reality is we all need to look after our health first, and awareness of how damaging gynocentrism is to just that, requires that we persist until gynocentrism is openly recognised for the shit-show it is…

        (Paul’s recent seris on “romantic love!, comes to mind…)

        1. Coming from a point of being idealistic .. .. ..

          I have a very strong opinion that; gynocentrism (in women) is a one-sided quest. I also believe that men need something to take care of, whether that be deeply coded in our DNA or is simply a learned behavior I am at a total loss. Hence, I have a dog I care for to fill that need that I feel. Imagine, if men the world over quit getting married, behaved the way Paul suggested in his “Romantic Love” series and men concentrated on their mental, physical, emotional, and spiritual health above all else for several generations. I think we would see a mammoth paradigm shift that would start to lend a hand towards an interdependence with all people. Gynocentrism insists upon domination, I think in most of life we really are interdependent. We need each other. Staunch independence is an illusion, but heavy dependence isn’t healthy, either. The only position of long-term strength is interdependence: win/win.

          1. I have a very strong opinion that; gynocentrism (in women) is a one-sided quest.

            yes. agreed. For sanity to prevail, women (not just feminists) need to see the light on this point. Even the more just, usually conservative, women tend to exploit this, albeit along tradcon lines.

            I also believe that men need something to take care of, whether that be deeply coded in our DNA or is simply a learned behavior I am at a total loss.

            I see it as naturally selected-for, and then socially reinforced.(to the current levels of absurdity)

            if men the world over quit getting married, behaved the way Paul suggested […] and concentrated on their mental, physical, emotional, and spiritual health above all else for several generations. I think we would see a mammoth paradigm shift

            Agreed. However, it need not take generations. (althought it might). I reckon we need to reach just 5-10% of young men. (sadly susceptible to their hormones at that age…xd )
            I may be wrong, but I am seeing more men (and some women) realising the failings of the current system, and openly questioning it. (Although it seems that it will take more women going past their sell-by child-bearing date before a groundswell of sanity arises)

            The only position of long-term strength is interdependence: win/win.

            yep. That will require castrating reprogramming that 400-pound gorilla which, by also exploiting gynocentrism, has entrenched itself as sole judge and executor: the current system of law as implemented by the state. (refers to all countries, even such as Arabia)

            I doubt that gynocentrism can, or need, or even should, be eradicated, as 3.5 million years of its refinement beats, hands-down, the 800 years of chivalry, or 160 years of “the tender years” doctrine. Sane interdependance will only emerge when enough women realise that their “one-sided quest” is self-defeating…

  3. Why on earth would anyone out there care to examine male problems…when there are so many women suffering, and when every single one of us should be obsessing over making females have better health, live even longer, and obtain more rights and privileges? Besides, men are disposable, that is, after their “real man” usefulness to women has expired. Sounds real equal, huh?

    Actually, Ms, Conason, thank you…for noticing the other side of the equal symbol.

  4. Why on earth would anyone out there care to examine male problems…when there are so many women suffering, and when every single one of us should be obsessing over making females have better health, live even longer, and obtain more rights and privileges? Besides, men are disposable, that is, after their “real man” usefulness to women has expired. Sounds real equal, huh?Actually, Ms, Conason, thank you…for noticing the other side of the equal symbol.

  5. I have worked for many years in the mental health field. I am an old man now and have kept my opinions mostly to myself, both personal and professionally, out of fear of being shamed and censored. It doesn’t matter to me anymore. I have watched women take over the mental health field. I have watched the influence of feminist ideology in the mental health field and how it has, in turn, influenced the few remaining male mental health professions who remain. And I have watched as men got mistreated, or treated inadequately, because of feminist professionals and feminist, ideologically inspired, treatments…I woke up midway in my career and realized that I had “taken the bait” and that I was hurting men by promulgating feminism… I have worked in clinics with eating disorder programs. Not once did those programs have male clients. When I was an adolescent and young man, I had an eating disorder. My eating disorder was, at the core, fueled by a sense of inadequacy, poor body image, and-most importantly, wanting to be attractive to females. Something bothers me that this article was written by a female mental health professional.

      1. I also mused on whether there was any innuendo about ‘toxic masculinity’ so prevalent in the mental health industry. There isn’t… its neurally presented data that allows us to flesh out the motivations. As I mentioned below, gynocentrism is a likely motivator and Morgan has confirmed that as a motivator in his own experience of wanting to appear attractive for women.

    1. Completely understand your suspicion of women (and men) writing about men’s mental health issues when most of them tends to denigrate men in theory and practice, loading men up with toxic theory like patriarchy, white privilege, supposed inability to read emotions etc.

      Although we could take some educated guesses I’d be interested to hear what you considered ‘attractive’ in the eyes of women that fueled your eating disorder?

      1. Thanks, Peter…I have grown into a skeptic with age and experiences. Two “failed” marriages and the shame and losses that were experienced as a result (including losses in gynocentric family court and losses of children) have contributed to the me that is. “Red Pill” awareness-especially the concept of gynocentrism, has made sense out of so much of what I have experienced and couldn’t have known about back then. If I had known this stuff when I was younger, I would have been exposed to information and choices that could have made a difference. But, when I was a youngster, I was both intellectual and very idealistic and naive. My eating disorder and body dysmorphia was about constricting food to be skiinny/thin with the sole, primary purpose of attracting females.

  6. Why on earth would anyone out there care to examine male problems…when there are so many women suffering, and when every single one of us should be obsessing over making females have better health, live even longer, and obtain more rights and privileges? Besides, men are disposable, that is, after their “real man” usefulness to women has expired. Sounds real equal, huh?Actually, Ms, Conason, thank you…for noticing the other side of the equal symbol.

  7. Why on earth would anyone out there care to examine male problems…when there are so many women suffering, and when every single one of us should be obsessing over making females have better health, live even longer, and obtain more rights and privileges? Besides, men are disposable, that is, after their “real man” usefulness to women has expired. Sounds real equal, huh?Actually, Ms, Conason, thank you…for noticing the other side of the equal symbol.

  8. maxwell friedman

    Why on earth would anyone out there care to examine male problems…when there are so many women suffering, and when every single one of us should be obsessing over making females have better health, live even longer, and obtain more rights and privileges? Besides, men are disposable, that is, after their “real man” usefulness to women has expired. Sounds real equal, huh?Actually, Ms, Conason, thank you…for noticing the other side of the equal symbol.

    1. I think it’s because MRAs made it somewhat “immoral” for people to ignore men’s issues, and a lot of people started reacting against those who ignore men’s issues thanks to the awareness spreading by MRAs. Now people like Ms Conason are FORCED to look at and acknowledge men’s issues.

      A clear line has been drawn: “nice” feminists and “nice” women who claim to be about equality are forced to acknowledge men’s issues (even though for the most part they are only paying lip service), while the only way to continue to ignore men’s issues is to clearly declare yourself as an “unapologetic” feminist i.e. a feminazi and therefore suffer the public backlash (Jess Philips etc).

  9. I have worked for many years in the mental health field. I am an old man now and have kept my opinions mostly to myself, both personal and professionally, out of fear of being shamed and censored. It doesn’t matter to me anymore. I have watched women take over the mental health field. I have watched the influence of feminist ideology in the mental health field and how it has, in turn, influenced the few remaining male mental health professions who remain. And I have watched as men got mistreated, or treated inadequately, because of feminist professionals and feminist, ideologically inspired, treatments…I woke up midway in my career and realized that I had “taken the bait” and that I was hurting men by promulgating feminism… I have worked in clinics with eating disorder programs. Not once did those programs have male clients. When I was an adolescent and young man, I had an eating disorder. My eating disorder was, at the core, fueled by a sense of inadequacy, poor body image, and-most importantly, wanting to be attractive to females. Something bothers me that this article was written by a female mental health professional.

  10. nicolas rolland

    Completely understand your suspicion of women (and men) writing about men’s mental health issues when most tend to denigrate men in theory and practice, loading men up with toxic theory like patriarchy, white privilege, supposed inability to read emotions etc. Pathologizing narratives all.Although we could take some educated guesses I’d be interested to hear what you considered ‘attractive’ in the eyes of women that fueled your eating disorder?

  11. I think mens health goes deeper then we realize, so I am re-posting a comment from below.

    Coming from a point of being idealistic .. .. ..

    I have a very strong opinion that; gynocentrism (in women) is a one-sided quest. I also believe that men need something to take care of, whether that be deeply coded in our DNA or is simply a learned behavior I am at a total loss. Hence, I have a dog I care for to fill that need that I feel. Imagine, if men the world over quit getting married, behaved the way Paul suggested in his “Romantic Love” series and men concentrated on their mental, physical, emotional, and spiritual health above all else for several generations. I think we would see a mammoth paradigm shift that would start to lend a hand towards an interdependence with all people. Gynocentrism insists upon domination, I think in most of life we really are interdependent. We need each other. Staunch independence is an illusion, but heavy dependence isn’t healthy, either. The only position of long-term strength is interdependence: win/win.

    1. I also believe that men need something to take care of, whether that be
      deeply coded in our DNA or is simply a learned behavior I am at a total
      loss. Hence, I have a dog I care for to fill that need that I feel.

      That’s the bit of DNA the hackers have found a way to exploit beyond its intended design.

      We are wired to look after children – possibly our strongest motivation – but not many people delve into the topic. I often think gynocentrism is little more than adult women hacking that DNA system by feigning childlikeness in thought, gesture, vulnerability, and looks…. and men responding with a triggered parental brain to look after them.

      Does muscling up say “I will be your parent”?

      Well said, all of it.

  12. Maybe we should quit talking about all the gynocentric-shit-show stuff and concentrate on our mental / physical health for a couple 100-years.

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