Eating disorders can present differently in females than in males. It is important to know the warning signs of a developing condition.
The pressure to hit the gym or lose weight in a new year can be high, especially when it seems like everyone is doing it. As a result, some people can get caught up in obsessively counting calories and getting in just one more lap, pull-up, deadlift, or rep than the next person.
Even unintentionally, ambitions can become restrictions, and the pursuit of perfection can turn unhealthy. While we often talk about eating disorders and body image issues in teen girls, they are prevalent among teen boys as well—and just as harmful.
The Facts About Male Eating Disorders
Male eating disorders are becoming far more common, but they’re often harder to identify for two key reasons: first, because traditional research on eating disorders has been primarily focused on females, and second, because males tend to underreport any eating issues or dissatisfaction with their weight. The American Journal of Men’s Health estimates that up to 10 million men and boys in the US will struggle with an eating disorder in their lifetime.
Difficulty with emotional regulation, impulse control issues, perfectionism, and preoccupation with an ideal body image all play a part in the development of eating disorders in males. As with any condition, genetics and environment can also play a role. Disordered eating can begin as an exercise in control that spirals into an unhealthy relationship with food and exercise that becomes life-disrupting.
Male Eating Disorders Under the Surface
While females focus on leanness, males tend to focus on being both lean and muscular. This can inspire the urge to “bulk up,” which can result in excessive exercise as well as binge eating and purging to attain a certain weight. In fact, males account for 40% of all binge eating disorder (BED) diagnoses, making BED almost as common in males as it is in females.
Moreover, Current Opinion in Pediatrics reveals that 15% of young men considered overweight by their body mass index (BMI) reported fasting, skipping meals, binge eating, and purging. Approximately 8% of young men considered underweight by their BMI also took part in these disordered eating behaviors.
How Media, Peer Pressure, and Stigma
Impact Body Image in Teen Boys
It’s common for teen girls to struggle with body image issues, but teen boys can wrestle with these issues just as often. In fact, The International Journal of Eating Disorders says that media depictions of the “ideal” male body image have changed over time, with boys’ action figures becoming more unreasonably muscular, and superheroes on TV or in movies having higher muscle mass and lower body fat.
Surrounded by these images and filled with the desire to look and feel strong, some teen boys can be drawn to a pattern of increasingly rigorous exercise and muscle-building. There are two important factors that can keep teen boys stuck when it comes to unhealthy exercise patterns and disordered eating:
Peer pressure: Adolescent males often feel pressure to conform to traditional masculine norms like being tough or strong. Therefore, peer pressure can have a strong influence on adolescent boys when it comes to body image. If all their friends are spending multiple hours at the gym every day and boasting about calorie restrictions and cheat meals, they may start creating unhealthy habits and become increasingly dissatisfied with their body.
Stigma: The stigma surrounding eating disorders is another reason why teen boys may underreport any issues they have with weight, body image, or eating. Because eating disorders are more common in females, teen boys may perceive reporting any issues they have as “weak” or “feminine” when they already feel insecure and strongly desire to feel and look more masculine.
Eating Disorder Symptoms in Males vs. Females
One of the reasons why male eating disorders tend to go unseen or underdiagnosed is because the warning signs are not always the same. Eating disorder symptoms can present differently in males than they do in females, which can hide a diagnosis. Moreover, young boys may lack the language necessary to communicate when they have a problem.
In contrast to anorexia, which is more common in females and involves an obsession with being thin, males may develop bigorexia or body dysmorphia, an obsession with bodybuilding and muscularity. Because bulking and cutting are often normalized and disguised in sports and other environments, it can be difficult to recognize when teen boy is struggling. Additionally, adolescent boys are more likely to purge through exercise than through self-induced vomiting. Excessive exercise is often applauded as the fastest way to reach fitness goals, and potential harm can go unnoticed.
Knowing the signs and symptoms of eating disorders in females versus males is critical to helping your teen get early treatment.
Eating Disorder Signs and Symptoms in Teen Girls
Caloric restriction
Excessive exercise
An obsession with being thin or having an ideal body image
Negative view of body image
An idealized perspective of others’ lives or bodies
Skipping meals
Eating a very narrow selection of foods thought to be low calorie, low sugar, or low fat
Eating very small portions
Misuse of laxatives
Throat irritation (from purging)
Eating Disorder Signs and Symptoms in Teen Boys
Heavy or exclusive consumption of protein or protein supplements
Spending much of the day at the gym (overexercising)
Feeling guilty if they’re not at the gym
Obsession with weight or checking weight multiple times a day
Preoccupation with food and body image
Refusal to eat out with family or friends because food doesn’t meet their calorie or protein criteria
Steroid use
Eating Disorders and Steroid Use in Teen Boys
According to national surveys, 30% of adolescent boys in the US have reported trying to gain weight or bulk up, including 40% of boys with a healthy body mass index (BMI). Approximately 22% of young men reported engaging in muscle-enhancing behaviors, including the following:
Eating more or differently to build muscle (17%)
Using supplements (7%)
Androgenic-anabolic steroid use (3%)
StatPearls says that 30% of people who use androgenic-anabolic steroids will become dependent on them. This often escalates into chronic use and misuse that activates the brain’s reward system. In addition to causing severe mood swings, anger, and aggression, steroid use can cause serious cardiovascular risks. This includes high blood pressure, life-threatening cardiac arrhythmia, and even the risk of cardiac arrest.
How to Help a Teen Boy Struggling
with Body Image Issues
Seeing your teen struggle with body image issues can be heartbreaking. There are a few ways you can help:
Create a Balanced Lifestyle
Teen boys are still learning about what’s actually nourishing to their bodies and what builds or breaks down muscle. Media and peers may skew their idea of what’s healthy, but exposure to balanced lifestyles—not just related to food and exercise, but life balance, emotional boundaries, and proper rest—can help steer them back on course.
Understand Self-Image and Identity
The idea that who we are is what we see in the mirror means equating self-image entirely with body image. This is an inaccurate. way to view ourselves. Help your teen develop a self-image and identity that are more comprehensive and encourage teen boys to understand themselves better, explore hobbies, dig into family heritage, and have a spiritual life can be helpful for their development.
Manage Social Media
Images from celebrities, popular content creators, and even friends can manipulate the way that anyone sees the world. Adolescence is an impressionable time; therefore, it is important to unfollow accounts that trigger feelings of unworthiness or negatively impact mental health. Instead, encourage your teen to seek out accounts that make them feel good about themselves. Taking breaks from social media altogether can give teen boys a chance to breathe, reflect, and see the world in a different way.
Build Authentic Relationships
Our connections can make us feel secure, loved, accepted, seen, and known. Supportive relationships are the strongest factor in recovery from addiction and mental health conditions. For teen boys, building relationships with their family and a variety of friends can make them feel more secure and become more well-rounded.
Frequently Asked Questions
What is the most common eating disorder in males?
The most common eating disorder in males is binge eating disorder.
How can I tell if my son has an eating disorder?
Symptoms of an eating disorder in a teen boy may look like this: a preoccupation with food and body image, an obsession with weight, spending lots of time at the gym or feeling guilty for not being at the gym, restricting calories or certain food groups (e.g., primarily eating protein and supplements), and purging behavior. You cannot identify if someone has an eating disorder by simply looking at them.
Is it normal for a 14-year-old to have an eating disorder?
Eating disorders are complex and create chaos in relationships, and often have underlying causes. Seek out your pediatrician and treatment professionals if you believe your 14-year old is engaging in disordered eating behaviors.
What are the early warning signs of eating disorders?
An intense preoccupation with body image, food, and exercise.
Sources
Curr Opin Pediatr. Author manuscript; available in PMC: 2021 Aug 1. Published in final edited form as: Curr Opin Pediatr. 2020 Aug;32(4):476–481. doi: 10.1097/MOP.0000000000000911
Am J Mens Health. 2019 Jun 11;13(3):1557988319857424. doi: 10.1177/1557988319857424
Int J Eat Disord. Author manuscript; available in PMC: 2018 Aug 1. Published in final edited form as: Int J Eat Disord. 2017 May 8;50(8):873–883. doi: 10.1002/eat.22724
Article courtesy of Newport Academy
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