Boys, Body Image and Eating Disorders
by Cris Haltom
Date: August 31, 2006
Subject: Boys, body image and eating disorders, Vol. 67
EATING DISORDER SURVIVAL GUIDE FOR PARENTS™
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Unfortunately the Y chromosome does not protect boys from developing eating disorders. Males make up one out of nine or ten cases of anorexia and bulimia and about two out of three cases of binge eating disorder (Spitzer et al, 1992).
What a boy thinks of his body at puberty will have a profound effect on his emerging adult body image. Puberty is the time boys begin to see themselves coming into manhood. However, it is a particularly difficult time. Boys lag behind girls' rate of maturation at just the time societal pressure insists they become more masculine in order to be attractive to their female counterparts. Magazines, movies, television, the Internet and advertising in general all dictate an ideal male body image to our growing boys.
Puberty and male media ideals present a true dilemma for boys. They are transitioning into sexual maturity during puberty, increasing their lean body mass over a long period of time as they grow into their full height. In the end, boys lag girls by about two years as they develop. Testosterone levels are increasing during puberty giving boys an interest in sexual activity. However, boys have to wait, during adolescence, for muscular development that often doesn't come fast enough.
What is the significance of muscles? In our culture muscles mean power, domination, and strength. Our culture's definition of maleness is reflected in muscle-bound males in the media and in action figures in games and toys boys grow up with. Boys learn early that to be more male they need more muscles. More muscles also means more sex appeal. Boys learn that big muscles are the way to beat out the male competition. Buff means power to dominate over other males.
Some boys are more prone to eating disorders. There are a variety of environmental and genetic factors that increase the risk of developing an eating disorder for both boys and girls. For example, the absence of fat is a desired state in our culture for both genders. For boys, fat is the antithesis of lean muscles. At the end of puberty, boys only have about 12 percent body fat, on the average. Biological development in boys is focused on development of lean body weight. For girls, puberty ends in a typical body fat percentage of about 25 percent. For girls biological development is very focused on developing body fat deposits. One possible explanation for developing eating disorders in boys is that they perceive they have less distance to travel than girls to lose body fat (Crisp and collaborators, 2006). Paradoxically, in an effort to lose body fat boys may lose the muscle mass they wish for through undereating and nutritional imbalance.
A hallmark of anorexia is loss of lean body tissue, including muscle mass. A net result of anorexia for boys is the return to a regressed, pre-puberty state of reduced muscle mass.
There are many thoughts about why boys might desire a slimmed-down state. Researchers have examined characteristics of males with anorexia. Some boys appear to have doubt about gender identity (an inner sense of being either male or female). Some appear to be threatened by the impulsivity that comes with adolescence. Other boys may not be ready for the demands of adolescent sexual activity. In all these cases, boys may seek refuge in a sexually immature, pre-puberty state. Further, Crisp and colleagues (2006) report that panic about possible homosexuality has presented in clinical samples of males with anorexia over the past fifteen years. For some boys, weight loss may act as a kind of protective barrier to threatening sexual development. It is interesting that weight loss in males can be associated with lower testosterone levels and, therefore, reduced sexual drive.
Crisp and collaborators (2006) found a pattern of parents with weight disorders in boys with anorexia. There is some thought that boys with parents with weight disorders may be fearful of illness in their parents, e.g., related to parental obesity. As a result, they become hyper-conscious of eating what they perceive to be healthy foods. In the Crisp study both boys and girls with anorexia were more likely to have a mother with a history of anorexia.
Boys and girls with anorexia are just as likely to have severe, diet-related, eating rituals. However, Crisp and colleagues (2006) found boys with anorexia are more likely to be vegetarian and vegan than girls with anorexia.
PARENT AND CARETAKERS CAN HELP BOYS WITH BODY IMAGE AND EATING PROBLEMS:
- They can help boys understand that to fit in they don't have to be muscle-bound and super-athletes. Boys need the same help as girls fitting comfortably into their genes.
- Boys need help with the grow-up-fast mentality pedaled by our media. Tell them there is no rush.
- Help boys understand there is no need to hyper-control their bodies. Both boys and girls need to undo mistaken notion that the body can be shaped and molded, at will, to fit a cookie-cutter image of the perfect body.
- Help boys understand their locus of control needs to be more on the inside, not on the outside, when it comes to understanding what is valuable about themselves.
- Help your son with an eating disorder develop age-appropriate autonomy, even if he is dependent on you for guidance around eating and exercise. Help him transition from boyhood to adulthood by encouraging age-appropriate responsibilities and social behaviors. This helps support developing manhood and increasing responsibility in ways that are not focused on looks.
- Help boys understand that most kinds of power do not come with big muscles and a "might makes right" attitude.
- Help boys find relief from agonizing over their appearance around puberty by helping them accept their bodies as they are. Help them focus on developing other aspects of who they are, other than their looks.
- If your son is seeking refuge in anorectic regression to pre-puberty, help him get to professional assistance. Do your best to support a dialog about what is fueling his maturity fears. Sometimes just making time to do activities together provides the best opportunity for dialog and exchange.
SUMMARY:
Boys with eating disorders resemble girls in many of their eating disordered behaviors. However, they face special societal pressures related to what it means to be male. At puberty boys feel pressure to be strong physically, often before their bodies can support the ideal body image they see in the media. To make matters worse, they lag developmentally behind girls at just the time they feel competitive with each other about being sexually attractive. Boys agonize over their looks like girls. They begin to form a lasting image of their bodies at puberty. Sometimes a poor body image leads to an eating disorder. Parents and caretakers can help boys negotiate the "looks-based" pressures of puberty. They can promote acceptance of a child's genetically-given body. They can support ways of becoming mature other than through muscle development and adult-male-like sexual attractiveness.
REFERENCES
Crisp, A. and collaborators (2006) Anorexia nervosa in Males: Similarities and Differences in Anorexia Nervosa in Females. European Eating Disorders Review 14, 163-167.
Spitzer, R.L., Devlin, M. J., Walsh, T.B., Hasin, D., Wing,R., Marcus, M., et al (1992) Binge Eating Disorder: A Multifield trial of the diagnostic criteria. International Journal of Eating Disorders, 11:3, 191-203.
