Eating Disorders

Body Image, Bigorexia, and Eating Disorders in Men and Boys

One in three individuals with an eating disorder is male, yet body image struggles and eating disorders in men and boys often go undiagnosed. The first step to identifying these disorders? Learning how they manifest differently in males.

Body Dissatisfaction in Males

When grappling with eating disorders, we typically think about the disturbing effects on young girls and women.

But as many as one in three individuals with an eating disorder is male. About 10 million males in the United States will struggle with an eating disorder in their lifetime, according to the National Eating Disorders Association.

Watching sculpted male actors on the big screen and seeing fitness magazine covers of muscular men with six-pack abs, boys and young men risk developing body dissatisfaction and body image disorders like bigorexia. Messages about what a male body should look like start arriving early. One study found that modern-day action figures marketed to boys often sport unrealistic body dimensions.

Social media also contributes to males’ body dissatisfaction. One study in 2015 found a correlation between overall social media use and increased attention to the body in ways that led to higher self-criticism and negative evaluation.

[Read: Eating Disorders in Teens with ADHD – Red Flags and Recovery Steps]

Eating Disorders in Men and Boys

Eating disorders often manifest differently in males and females. For example, boys with anorexia tend to see themselves realistically as emaciated, whereas girls with the condition may look in a mirror and still see extra pounds. Boys share the fear of being fat like their female counterparts, but many of them desire weight gain in the form of muscle. In a study I conducted, male college students said their ideal body weight was only eight pounds less of body fat, but 25 pounds more of muscle.

Binge-eating disorders are often overlooked in men, yet men make up about 40 percent of such disorders. Dysregulated eating patterns and disorders occur more often in males with ADHD, autism spectrum disorder, obsessive-compulsive disorder (OCD), and other disorders. One manifestation of OCD, called orthorexia, may cause sensory issues, poor impulse control, contamination concerns, or perfectionism around eating (consuming only organic food or food that is deemed healthy, but eating in obsessive ways, for example).

Muscle Dysmorphia and Excessive Exercise

Muscle dysmorphia, a relatively new diagnosable body image disorder, primarily affects men. Also called bigorexia, it is characterized by a preoccupation with muscle mass and a fear of looking too small or skinny. This can result in compulsive exercise and weight-lifting, and in avoidant behaviors, such as refusing to take off one’s shirt in public or remaining housebound due to feelings of shame about looking too “weak.” Bigorexia also can result in anabolic steroid use, which can cause a host of adverse physical and psychological consequences. Muscle dysmorphia causes significant impairment in social, occupational, and health situations.

[Read: ADHD and Eating Disorders – Research, Diagnosis & Treatment Guidelines]

Males are far less likely than females to seek treatment for an eating disorder due to shame and stigma. There is even bias among medical and mental health professionals who believe that these issues only impact females. Long-term recovery is possible with treatment. It is important to work with an eating disorder specialist who is comfortable treating males. Keep in mind that treatment for eating disorders often involves a team: a therapist, nutritionist, physician, and, sometimes, a psychiatrist.

Body Image and Eating Disorders: Next Steps

Roberto Olivardia, Ph.D., is a clinical psychologist who has been treating eating disorders and negative body image in males for 30 years. He is co-author of The Adonis Complex.

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