Male Body Image
distorted views can affect everyone
by Heather Hawkins
In a society dominated by images of the perfect body and unrealistic standards for beauty, it’s easy to become dissatisfied with your looks and strive for an unattainable appearance. Combined with psychological and biological factors, the most dramatic cases can lead to eating disorders.
Often thought of as a “woman’s issue,” many people forget about the men who are obsessed with body image and suffer from eating disorders.
The National Eating Disorders Association estimates 10 percent of people with eating disorders are males, which is about 500,000 to 1 million boys and men in the United States.
Dr. Steve Ross, a clinical psychologist with the University Counseling Center (UCC) at Colorado State University, said the actual number of men with eating disorders is rising.
“It’s a cohort that’s growing for men and women. It’s a disease that’s not going away. If anything, it’s escalating as far as the numbers go,” Ross said. “So men probably still make up 10 percent of the pie while it’s growing.”
Clinically defined, there are three types of eating disorders. Anorexia nervosa is a disorder in which people refuse to eat. A person with bulimia nervosa eats large quantities of food in short periods of time and purges the food with compensatory behavior such as vomiting, laxatives, exercise or diuretics. Other people suffer from binge eating disorder, which is similar to bulimia, but there is no compensatory behavior.
Dr. Danielle Oakley, a clinical psychologist at the UCC, said few people meet the clinical classification for anorexia nervosa, bulimia nervosa or binge eating disorder, but there are a lot of people who have “disordered eating.”
“It’s something that is very common on campus,” she said. “Approximately 80 percent of college students meet criteria for some type of disordered eating.”
This means people may skip meals, over exercise, or vomit every now and again, but their behaviors don’t meet the criteria for an eating disorder. For instance, someone with anorexia must maintain less than 85 percent of his or her natural body weight, so someone who maintains 90 percent of his or her body weight isn’t classified, but could still have disordered eating.
Perhaps one reason there are fewer men than women with eating disorders is that men have traditionally had other avenues besides their looks upon which to base their self-perceptions.
“Men are usually praised for wealth and power in society and women for their beauty and what size they are, so I think it will probably always be more of a female issue,” Oakley said.
However, both doctors agree that men have become more focused on how they look as a result of media representations emphasizing male body image and the perfect male body.
Ryan Kahanu, a junior health and exercise science major, said in an e-mail interview that he also thinks the media have an affect on body image and persuade guys, as well as girls, to look perfect. Although he does not have an eating disorder, he said he can see how TV and magazine images can influence the disorders.
There is evidence that the pressures to have and maintain a certain body type are influencing men, particularly the value of having a muscular body. In 2006, the North American Journal of Psychology found men’s body satisfaction decreases as they are exposed to advertisements depicting muscular male models. The ads they used are similar to those that men see in magazines like Men’s Health.
One way men suffering from eating disorders may differ from women with the disorders is that many of them are less concerned about actual weight and more concerned with muscular bodies.
Ross said this anxiety can lead to a kind of body dysmorphic disorder in which people are preoccupied and distressed about a perceived physical irregularity that has no basis in reality. The Harvard Review of Psychiatry calls this muscle dysmorphia. It involves a chronic preoccupation with a specific body shape and size, which leads to an obsession with weight lifting and dieting. Although not specific to men, people with muscle dysmorphia report body dissatisfaction, anxiety, disordered eating and in some cases anabolic steroid use.
It’s sometimes referred to as “bigorexia” in males, because they focus on getting big as a way to gain control over their lives much like people with anorexia gain control over food, Ross said. However, muscle dysmorphia has the reverse effect because they are trying to gain muscle mass rather than decrease it.
“They look at their 26-inch biceps and see them as tiny,” Ross said. “They can never get big enough, just like a person with anorexia can never get small enough.”
When they are unable to lift weights or work out, people with muscle dysmorphia may wear baggy clothing to hide their bodies or avoid social settings all together.
Kahanu said he works out a lot. It’s not to please other people but more for his own satisfaction, to know that he is taking care of his body.
“Going to the beach or performing with my shirt off is just a side bonus that I don't look much in to,” he said. “It’s just a great motivation to work out and keep my body in good shape in case I do need to look good for something.”
He is a member of Club Kulturang Pilipino, the Filipino student club at CSU, and he often participates in dance performances without a shirt.
Some studies have shown that particular groups of men are more likely to develop eating disorders than the general male population, including athletes and gay men, Ross said.
Male runners, gymnasts, jockeys and wrestlers have been affected by eating disorders because their size makes a difference in the quality of their performance. For instance, runners have said their times are thrown off if they carry extra weight.
“Wrestlers are dieting down – crash dieting down – to their weight because they usually wrestle at weights that are under their normal weight,” Ross said, adding that this doesn’t mean wrestlers have eating disorders, but it can be the beginning of disordered eating.
Sports that are scored based on judges ratings can also influence the way athletes feel about their looks. Kahanu is a member of CSU’s gymnastics club and said there is a certain optimal physique.
“Since I'm only doing gymnastics for fun, my body shape doesn't matter,” he said. “There are people of all shapes and sizes at gym practice. However, if I was training at the elite level or training for competitions, then yes, my body shape would matter.”
Research has also found that gay men constitute a large number of males with eating disorders. According to the International Journal of Eating Disorders (IJED), samples have shown 14 to 42 percent of men with symptoms of eating disorders are gay, while gay men make up about 3 percent of the U.S. population. The IJED said there have been suggestions that the gay male community places high value on physical appearance, which the psychologists say can contribute to disordered eating.
It is common for people with eating disorders to have an external locus of control, so they are more likely to look to friends, family and the media to tell them how they should be, feel and act, Ross said.
“They look toward society, toward the group to tell them how they feel about themselves,” he added.
But Oakley said social settings aren’t the only reason people develop eating disorders. There are also psychological and biological contributions. Often times, people with eating disorders are perfectionistic, have poor coping skills and difficulty expressing their emotions, so they use food to cope. Many are “all or nothing” thinkers and may have some traits of obsessive-compulsive disorder.
Biologically, there may be chemical imbalances and perhaps even specific genes involved in development. Oakley said current studies are looking at blood relatives for the possibility of an eating disorder gene.
“The way we kind of think about it is genetics loads the gun and stress pulls the trigger,” Ross said.
Although there aren’t hard data on young boys, Oakley said there is evidence that girls are developing negative body images at the age of 6 and that typical onset of eating disorders for females is between 14 and 18.
The Colorado High School Youth Risk Behavior Survey suggests that boys are also affected by body image at a young age. In 2005, 5.9 percent of male respondents said they had gone without eating for 24 hours or more to lose weight or to keep from gaining weight in the previous 30 days.
Also in the CHS survey, 23.9 percent of male respondents said they had eaten less food, fewer calories or food low in fat to lose weight or keep from gaining weight during the previous 30 days.
“The number one risk factor for students developing eating disorders is dieting,” Oakley said. “There are no good foods and no bad foods. All foods are good; it’s just the quantity we eat them in.”
People with eating disorders will label food as good or bad, so they prohibit themselves from having it and later end up eating too much because they have been deprived. Oakley said everybody should see a dietitian to learn how to eat healthfully, regardless of whether they have disordered eating.
But the likelihood of males with eating disorders seeking treatment is low because they have the idea that this is a woman’s issue, Ross said. While early treatment has better outcomes, the UCC sees very few male clients, because they tend to hide their symptoms and are more hesitant to come forward.
“Often you won’t see men in settings like counseling centers,” he said. “They’ll show up first time out of the gate in hospitals when they’re in physical crisis.”
Of the people who don’t seek treatment for clinical eating disorders, Oakley said 20 percent eventually die.
“We don’t want anybody to feel like they’re getting in trouble; we want them to get the help they need,” she said.
Helping someone with an eating disorder
Dr. Danielle Oakley and Dr. Steve Ross, psychologists at the University Counseling Center, suggest the following tips if you suspect a friend or family member is suffering from an eating disorder.
- Offer support and show the person you care.
- Talk about the behaviors you have witnessed – like an emphasis on weight or shape, fear of eating in public, skipping meals, an obsession with counting calories or fat grams, exercising out of guilt or frequent weighing – but don’t be judgmental and remember that lots of people do these things, it’s when these behaviors are taken into context that they are considered an eating disorder.
- Be patient and expect to be rejected because people don’t want to give up the control they’ve established.
- Remember that the person has to be invested in his or her own treatment, you can’t force it.
- If they decide they want help, offer to go with them or give them the phone number for a physician or therapist.