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National Eating Disorder Information Centre

Vol. 23, No. 5                ...
different samples of males             control, strength and problem-       professionals of eating disorders
studied and ...
Myths that increase
2 Andersen, A.E. 2002. Eating disorders in         14 Hudson, J.I., Hiripi, E., Pope, H.G., and
The Bulletin is published five times per year by
(416) 340-4156 or Toll Free: 1-866-NEDIC-20            Subscribe:...
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Male Body Image and Eating Disorders: An Increasing Concern, Gallant 2008


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Invited article. Bulletin, Vol. 23, No 5 of National Eating Disorders Information Centre, NEDIC, CANADA

Published in: Health & Medicine

Male Body Image and Eating Disorders: An Increasing Concern, Gallant 2008

  1. 1. National Eating Disorder Information Centre BULLETIN Vol. 23, No. 5 ISSN 08366845 November 2008 Males’ Body Image and Eating Disorders: An Increasing Concern by Paul W. Gallant, CHE, MHK, BRec (TR) When we hear terms such as problems. Such real life stories of thousands of males who do not bulimia, anorexia, eating help us to understand the range of discuss their struggles with body disorders, or of concerns about experiences facing males who image, eating disorders, extreme body image, we rarely think of have overcome, continue to dieting, and excessive exercise. males. Yet more than 300 years struggle with, or in some cases This silence – indeed, secrecy – ago Dr. Richard Morton succumb to, eating disorders. about their eating disorders needs documented the case of a 16 year to be better understood in order to Stories of males with eating old male with anorexia nervosa21. provide appropriate prevention disorders This is often cited as the first case and treatment for males at risk. The personal disclosures of men of an eating disorder in a male. struggling with an eating disorder Corson and Andersen report that How many – and which – males include those of John Prescott, “historically, shame and fear of have eating disorders? former Deputy Prime Minister of public humiliation drove men Studies suggest a rise in the Britain, David Beckwerment, a with eating disorders number of males with eating Canadian oil CEO, Gary Grahl, underground5.” disorders14. Some research an American school counselor, suggests that this number is likely and U.S. model Ron Saxen23. Dr Yet in the past few years more to be substantially higher among Thomas Holbrook, an eating males have been publicly sharing male athletes, especially those for disorder expert, shares his their experiences and struggles whom there are weight classes or personal struggle and recovery around their own eating aesthetic ideals, e.g. rowers, from an eating disorder as a co- disorders, perhaps in an effort to jockeys, wrestlers, dancers, author of Making Weight3. For gymnasts, and body builders1, reduce the stigma associated with some males such as Michael male models, and gay males13. this illness in males. There is a Krasnow, the ending is tragic. newly heightened awareness of Other research suggests this Michael died shortly after eating disorders in males: Recent somewhat stereotypical view of publishing his autobiography media and online blogs include eating disorders in particular detailing his struggle with personal stories about men’s athletic groups and gay men may anorexia. struggles with eating disorders, be less evident than originally thought12. The differences in excessive exercise, extreme For each of these public dieting, and their body image disclosures there exist hundreds findings may be due to the Funded by Mental Health Programs and Services, Ontario Ministry of Health and Long-Term Care. A Program of the University Health Network. The opinions expressed in the Bulletin do not necessarily reflect those of the above organizations.
  2. 2. different samples of males control, strength and problem- professionals of eating disorders studied and point to the need for a solving as well as to now also be in general, and in males in bigger body of research on males emotionally sensitive and particular. Like health workers, and eating disorders. Regardless, responsive, care-giving and many parents, educators and it is apparent that eating disorders family oriented. Pressure to others working with men and in males - just as in females conform to masculine stereotypes boys lack knowledge and have cross demographic lines of race, including muscularity is also part biases about eating disorders in general and in men in particular6. class, sexual orientation etc, and of the socio-cultural pressures are the outcome of combined that men and adolescent boys Hearing from men with eating face19,8. Muscularity in men is personal, biological, and social disorders factors4,7. seen to denote power, character Recent studies9,10 with small and strength and is thus seen as numbers of British Columbia Recent studies suggest that as desirable. Eating disorders in males with eating disorders many as one in four cases of males thus may begin with over- indicated that most of the male eating disorders occur in males, exercising, which gives the sense participants did not receive and that .3% of males will have individual of achievement and formal eating disorders treatment. anorexia nervosa at some point in self-control, and then include Reasons for this lack of treatment their lives .5% will have bulimia increasingly restrictive or included not disclosing their nervosa and nearly 2% will have otherwise problematic eating, eating disorder, not feeling binge eating disorder14. Canadian leading to an eating disorder. supported and understood when researchers Woodside and Many authors consistently report initially seeking help for eating colleagues previously estimated that men are often reluctant to disorders symptoms, and not that “the overall rate of eating seek help and support for any feeling comfortable in a female disorders in men was about one medical condition and treatment environment. The particularly mental illness12. third that of women.” Binge absence of resources specific to eating is believed to occur about Many may completely isolate males with eating disorders was equally in males and females14. themselves in times when added identified as a problem by most support would be beneficial, such participants. as when experiencing eating What are the risk factors for males for an eating disorder? disorders. Traditional stereotypes Summary Eating disorders are an outcome of men as strong and invulnerable The voices and needs of males of attempts by the person to cope may hamper males with eating with eating disorders remain with problems by manipulating disorders from acknowledging largely unheard in our society. food and weight. Food and and disclosing their eating Little is written on the subject of weight management is used in the disorder in fear of being seen as males suffering from eating absence of healthier coping being an inadequate man. disorders and few services are strategies to regulate emotions Isolation, substance abuse, anger, specifically designed to meet and to feel effective and in and self-harm are sometimes their needs. An increased control. There are many factors coping methods used by males to understanding of the perspectives that increase vulnerability to elude their struggles around body of males with eating disorders developing an eating disorder. image, self-esteem, and eating will add to public and health disorders.9 These include perfectionism, providers’ knowledge of the childhood obesity, genetic challenges males face, provide liability, dysfunctional eating of a Additional reasons why males are further insights into prevention parent, chaotic family underrepresented in eating and treatment, plus contribute environment impulsivity, disorders treatment and research towards added support to males depression, teasing, heightened include the view that it is a who struggle with eating sensitivity, dieting and low self ‘female-only problem’, driving disorders. esteem4,7. Males in western allocation of resources to this References societies are increasingly larger population with eating 1 Anderson, R.E., Barlett, S.J., Morgan, G.D., expected to conform to both disorders. This is compounded by and Brownell, K.D. 1995. Weight loss, psychological, and nutritional patterns in traditionally prized masculinities poor knowledge and competitive male body builders. International such as independence, self- identification by health Journal of Eating Disorders,18(1):49-57.
  3. 3. Myths that increase 2 Andersen, A.E. 2002. Eating disorders in 14 Hudson, J.I., Hiripi, E., Pope, H.G., and males’ vulnerability to males. In CG Fairburn, KD Brownell (eds.). Kessler, R.C. 2007. The Prevalence and Eating disorders and obesity: A Correlates of Eating Disorders in the National food and weight comprehensive handbook, 2nd ed. New York: Comorbidity Survey Replication. Biological preoccupation Guilford Press. Psychiatry, 61:348-358. 3 Andersen, A.E., Cohn, L. and Holbrook, T. 15 Krasnow, M. 1996. My Life as a Male 2000. Making Weight: Men’s Conflicts with Anorexic. New York: Haworth Press. How you look is what you are: Food, Weight, Shape and Appearance. Boys and men are increasingly Carlsbad, CA: Gurze. 16 Langley, J. 2006. Boys Get Anorexia Too: being marketed a narrow physical coping with male eating disorders in the 4 APA-American Psychiatric Association. family. London: Paul Chapman Publishing. ideal of what they “should” look like 2006. Practice Guidelines for the Treatment of Patients with Eating Disorders. Third Edition. in order to “fit in”. Slender, though 17 Mangweth, B., Pope, H. G., Jr, Kemmler, American Psychiatric Association. muscular, bodies are portrayed as G. and Ebenbichler, C. 2001. Body image and psychopathology in male bodybuilders. bringing all sorts of success – in 5 Corson, P. W. & Anderson, A. E. 2002. Psychotherapy and Psychosomatics, Body image issues among boys and men. romance, social desirability, career 70: 38–43. In T. F. Cash, & T. Pruzinsky (Eds.). Body and self confidence. image: A handbook of theory, research, and 18 McCreary, D. R., & Sasse, D. K. 2000. An clinical practice (pp. 192-199). New York: exploration of the drive for muscularity in There’s always room for im- The Guilford Press. Adolescent boys and girls. Journal of provement: Along with an unreal- American College Health, 48: 297–304. 6 Dimitropolous, Gina. 2008. Stigmatization istic body ideal, males are increas- of Eating Disorders. Bulletin, 23(4). National 19 McCreary, D.R., Saucier, D.M., & ingly marketed the idea that for Eating Disorder Information Centre. Courtenay, W.H. 2005. The drive for success – and supposedly health muscularity and masculinity: Testing the 7 Field, A.E., Camargo, C.A., Taylor, C.B., – they should engage in activities associations among gender role traits, Berkey, C.S., Roberts, S.B., & Colditz, G.A. behaviors, attitudes, and conflict. Psychology that will bring them closer to the 2001. Peer, parent, and media influences on of Men and Masculinity, 6, 83-94. the development of weight concerns ideal body – working out, tanning, and frequent dieting among preadolescent and dieting, waxing and cosmetic sur- 20 Morgan, J.F. 2008. A Self-help Guide for adolescent girls and boys. Men with Eating Disorders, Compulsive Pediatrics, 107, 54-60. gery. If they don’t work for this Exercise and Bigorexia. London: Routhledge. ideal body, the message is that 8 Friedman, S. 2007. Just for Boys: a program they are lazy, incompetent and to help boys develop resilience and learn skills 21 Morton, R. 1694. Phthisologica, or, A to deal with the stressors of health risks of Treatise of Consumption. London: S Smith worthless. adolescence. Vancouver: Salal Books. and B Walford. Be a Real Man! Traditionally boys 9 Gallant, P.W. and Birmingham, C.L. 2008. 22 Ryan, D. 2007. The Pain of Manorexia. and men have been expected to Treatment engagement for a community The Vancouver Sun. March 15. B2-B3. http:// sample of males with eating disorders: health be strong, virile, in control, compe- promotion, self-help, and support using story.html?id=ec90796d-fe6b-424d-bf7e- tent and financially successful. collaborative qualitative research. Eating 9e574366794e&p=1 Now they are being asked to also Disorders Research Society (EDRS). 14th Annual Meeting. Scientific Program and be emotionally sensitive, gentle 23 Saxen, R. 2007. The Good Eater: the true Abstracts. Montreal. EDRS. story of one man’s struggle with binge eating and family-oriented. There are few disorder. Oakland, CA : New Harbinger positive role models for this ‘new 10 Gallant, P.W., Birmingham,C.L., Crocker, Publications. P.R.E. and Harbottle, E.J. 2007. Men with man’, especially in contemporary eating disorders: treatment engagement and 24 Vemuri,M. & Steiner, H. 2007. Historical movies and TV shows. This is coping strategies. Eating Disorders Research and current conceptualizations of eating Society (EDRS). 13th Annual Meeting. leaving many boys and men con- disorders: a developmental perspective. In Scientific Program and Abstracts. Pittsburgh. Jaffa, T. & McDermott, B. (editors). Eating fused and unsettled. EDRS. Disorders in Children and Adolescents. Cambridge University Press. Taking control always works: 11 Grahl, G.A. 2007. Skinny Boy: A Young Because boys and men are taught Man’s Battle and Triumph Over Anorexia. 25 Woodside, D.B., Garfinkel, P.E., Lin, E. et Clearfield, Utah: American Legacy Media. – and expected – to ‘take charge’, al. 2000. Men with full and partial syndrome eating disorders: community comparisons with when boys and men with poor cop- 12 Hay, P.J., Loukas, A. ,and Philpott, H. non-eating disordered men and eating 2005. Prevalence and characteristics of men ing skills struggle with issues, they disordered women. Am J Psychiatry, 158: with eating disorders in primary care: how do may displace their anxieties onto 570-574. they compare to women and what features their bodies. Taking control over may aid in identification. Prim Care Comm 26 Yang, .JC., Gray, P. and Pope H.G. 2005. Psych,10 (1): 1-6. their bodies with exercise and diet- Male body image in Taiwan versus the west: ing provides a sense of direction, Vanggang Zhiqi meets the Adonis complex. 13 Hill, M. 2004. Male eating disorders on the Am J Psychiatry; 162: 263-9. control and achievement. rise. Associated Press. May 12. Retrieved February 27, 2005 from pf.asp?news_id=10650
  4. 4. © NEDIC The Bulletin is published five times per year by (416) 340-4156 or Toll Free: 1-866-NEDIC-20 Subscribe: Signs and symptoms of disordered eating in males Boys and men struggling with disordered eating may exhibit some of the following attitudes or behaviours: Excessive concern about weight, shape and calories Tends to be perfectionist and self-critical Guilt, shame or secrecy about eating Turns to ‘health’ supplements to increase bulk or decrease weight Strict avoidance of certain foods, particularly those considered fattening Feeling fat or scrawny regardless of body-size Weight and food control determines how the person feels about his worth Exercise regimes are increasingly longer and more demanding. How to help someone with an eating disorder Learn about eating disorders - the more you know, the more you can help Focus on the person's overall well-being, not food and weight Express your concern without judgement and provide support Find out what services are available in your area- see Be patient and compassionate: overcoming food and weight issues takes time and courage National Eating Disorder Information Centre’s 2009 Conference: Body Image and Self Esteem: Shades of Grey May 11 - 12, 2009 Toronto, Ontario Register at: Topics include: Boys and men Youth engagement Physical activity New media and self representation Obesity Keynote speakers: Niva Piran, Ph.D. Dr Piran puts the real lives of girls and women into the forefront of research and prevention of eating disorders and body image problems. Dianne Neumark-Sztainer, Ph.D., M.P.H., R.D. Dr. Neumark-Sztainer’s award winning work focuses on adolescent nutrition and the prevention of weight- related problems including eating disorders, unhealthy weight control behaviours, body dissatisfaction and obesity. Michael Kaufman, Ph.D. Dr. Kaufman is a founder of the White Ribbon Campaign, the largest effort in the world of men working to end violence against women. He has published widely, including Cracking the Armour: Power, Pain, and the Lives of Men Shari Graydon Shari Graydon has written two best-selling media literacy books for young people, including In Your Face – The Culture of Beauty and You, which won the Norma Fleck prize for non-fiction. Presented by: and In partnership with the Elementary Teachers’ Federation of Ontario and the University of Toronto; Faculty of Physical Education and Health