Men and Eating Disorders

Eating Disorder Treatment Team

Over the past three decades, there has been a change in the way men think about their bodies (Harvey & Robinson, 2003). Once thought to be a “feminine issue”, research is showing that millions of men in the United States are becoming increasingly dissatisfied with their bodies. Historically, issues with body image were associated with women but it is apparent that men experience body image issues related to their weight, body shape, and appearance, which can lead to detrimental physical and emotional consequences (Harvey & Robinson, 2003; Maida & Armstrong, 2005). Furthermore, body dissatisfaction in males has been associated with poor psychological adjustment, eating disorders, steroid use, exercise dependence as well as other health behaviors (McCabe & Ricciardelli, 2004).

This site hopes to provide you with helpful information about psychological consequences of men’s negative body image, will direct you to excellent resources and will reinforce the idea that there are many men who are suffering and are in need of assistance.

Men’s Body Image

The way a person thinks, feels and behaves in relation to his/her physical appearance is known as body image. Researchers have expressed that one’s body image is created from two components, body-image evaluation and body image investment.

Body-Image Evaluation

One’s perception of his/her body size, composition, and beliefs about his/her level of attractiveness. Satisfaction with one’s body is connected to how they evaluate their body to the body ideal. In popular mainstream media, the ideal male body in the United States is portrayed as having large biceps, triceps and chest along with chiseled six-pack abdominal muscles and a V-shaped upper body.

Body-Image Investment

The healthy and unhealthy behaviors that one engages in to improve the way they view their body (Cash, Melnyk & Hrabosky, 2004). The more dissonant the ideal is to the current body, the more likely the individual will feel dissatisfied with their body. With the increasing cultural pressure for men to be fit, lean and muscular, there is evidence that body dissatisfaction and eating disorders in men are increasing (O’Dea & Abraham, 2002). Listed below are some of the more common psychological consequences for men with negative body image.

Psychological Consequences of Body Image Distress

Excessive Exercising and Dieting

Men who have body image disturbances tend to develop compulsive exercising behaviors that have adverse effects to their wellbeing. Increasingly people are engaging in physical exercise with less of an emphasis on fitness and health and more in the pursuit of the cultural body ideal. Researchers have found that 21% of college aged-men are considered to be exercise dependent (Garmen, Hayduk, Crider & Hodel, 2004). Moreover, these men also endorse many psychological and social disruptions as a result of their compulsive exercising behavior.

Below are the following specific features of individuals for whom physical exercise becomes compulsive and dependent (Yates, 1991).

  • The person maintains a high level of activity and is uncomfortable with states of rest or relaxation
  • The person’s physical activity/exercise becomes a key feature in self-definition
  • Excessive exercising becomes a self-perpetuating process that is highly resistant to change. Often the person will report feeling unable to control or stop the behavior.
  • Excessive exercises is used for the physiological effects (i.e. endorphin release) or for the sensation of extreme exertion
  • The person will often use rationalizations and other defenses to protect involvement in the activity
  • The person engages in physical exercise despite injury or illness.

People who have compulsive exercising behaviors also tend to be achievement oriented, independent, and endorse perfectionism (Costin, 2007). Often, these compulsive exercising rituals disrupts relationships, vocational obligations, and daily activities (Pope et al., 2000). Compulsive exercisers put themselves at risk for a wide array of physical ailments including muscle strains and tears, cartilage damage, stress fractures and other injuries (Costin, 2007).

Furthermore, young men are engaging in dieting behaviors with the purpose of controlling body size and/or shape. In particular, college men may engage in more health risk behaviors often for the intention of losing body fat and/or increasing muscle mass. Currently, research is showing that 17% of male college students’ diet for the specific purpose of increasing lean muscle mass (McCreary, Saucier & Courtenay, 2005). Also, more college aged men are engaging in ultra low-fat, high protein diets and are consuming so-called dietary/performance-enhancing substances (e.g., creatine, protein powders, and other so-called muscle enhancing substances; Cafri et al, 2005).

Eating Disorders and Men

Once considered a “female disease”, research is showing that more men are suffering from symptoms of an eating disorder. Estimates show that roughly 10 million men in the United States will suffer from a clinically significant eating disorder (e.g., anorexia nervosa, bulimia nervosa) at some time in their life. There are some distinct gender differences related to eating disorders. First, men who suffer from symptoms related to an eating disorder are more likely to have a history of being medically overweight compared to women (Costin, 2007). Secondly, some men also endorse engaging in eating disorder behaviors to avoid medical conditions found in other family members (Andersen, Cohn, & Holbrook, 2000). Thirdly, an important difference between eating disorders in women and men is the age of onset. Men tend to have a later age of onset for eating disorders (average age is 21 years) compared to women (Harvey & Robinson, 2003). Finally, it is important to note that although males who identify as gay comprise 5% of the general population, they comprise 45% of males suffering from eating disorders. For more information on eating disorders and men, click on the below links.


Muscle Dysmorphic Disorder

In 1990’s, the term “muscle dysmorphia” was coined for a form of body dysmorphic disorder (BDD) previously referred to as “reverse anorexia” or “bigorexia” (Olivardia, 2001). Muscle dysmorphic disorder (MDD) is characterized by a preoccupation with body size and musculature. Men with MDD are convinced that their body size is small and that they do not have sufficient leanness. Due to this perceptual distortion, many men with MDD will spend long hours exercising (e.g., mostly lifting weights) frequently engaging in body checking behaviors, and will often have rigid diets (Murray, Reiger, Touz & Garza Garcia, 2010). Furthermore, men who are struggling with MDD will give up important social, occupational, or recreational activities because of a compulsive need to maintain his workout routine (Murray et al. 2010). Finally, the individual will avoid situations where his body is exposed to others, or endures such situations only with marked distress or anxiety (Murray et al. 2010).

It is estimated that between 5-10% of weight lifters suffer from symptoms of MDD (Grieve, 2007). Additionally, MDD has a strong co-morbidity with eating disorders, obsessive-compulsive disorder, and major depressive disorder (Olivardia, 2001). Those who are diagnosed with MDD are at a high risk of abusing anabolic steroids and other muscle enhancing substances (e.g., growth hormones). Below are identified factors that contribute to MDD (Grieve, 2007). When combined together, these factors may facilitate the onset of MDD in men.

  • Socio environmental factors (e.g., media influences and sports participation)
  • Emotional factors (e.g., negative affect, aggression, anger)
  • Psychological factors (e.g., body dissatisfaction, low self-esteem, body distortion and perfectionism)
  • Physiological factors (e.g., body mass).

Anabolic Steroid Use

In an attempt to obtain a lean and muscular body, many men may resort to using supplements and steroids, which may put their physical health in jeopardy. Researchers have reported that anabolic steroid use has become a prevalent problem among adolescent boys and men with a lifetime estimated prevalence of one to three million Americans (Kanayama, Pope, Cohane, & Hudson, 2003). When men use anabolic steroids, they may experience detrimental consequences to both health and wellness. Research has shown that steroid use increases the risk of coronary artery disease, stroke, myocardial infarction, cardiomyopathy, and liver disease (Cafri, Thompson, Ricciardelli, McCabe, Smolak & Yesalis, 2005). Moreover, the same researchers demonstrated that anabolic steroid use can cause negative mood changes such as mania, aggression and depression while also causing cognitive impairments to attention and memory (Cafri et al., 2005).