Body Image, Eating Disorders, & Boys

Body image concerns and eating disorders affect boys too.

As many as 75% of adolescent boys are dissatisfied with their bodies. 3% are now using steroids in an attempt to alter their bodies, 7% use supplements, and a 2019 study found that 1 in 5 guys aged 18-24 had an eating disorder due to a desire to enhance muscles.

Boys, like girls, need help developing a healthy body image and healthy habits.

Eating Disorders May Be Missed in Boys

To date, the “vast majority of body image and eating disorder research has focused on thinness and weight loss, particulary in females. Very few people are doing research on or have a great understanding of body image pressures for boys, which often drive young people to be more muscular, bigger, and bulkier,” says Jason Nagata, MD, MSc, associate professor of pediatrics in the division of adolescent and young adult medicine at UC – San Francisco.

While still in medical school, Nagata met a 16 year old boy who was a wrestler.

“He’d been suffering for years, checking his weight and himself in the mirror several times a day. His parents thought something wasn ‘t right, so they brought him in to his primary care pediatrician, who eventually brought him into the eating disorder clinic,” Nagata said.

Two-and-half-years, however, had elapsed before the boy was diagnosed with an eating disoder, and during that time, he “suffered a lot and had some pretty serious medical complications that required hospitalization,” Nagata says.

At the time, there was “almost nothing in the literature” about boys & eating disoders, and the guidelines for medical management of eating disorders focused on girls & women.

Eating disorders in boys & men may also be missed because many unhealthy behaviors — such as fasting for 24 hours or sweating off water weight — are “completely normalized” in certain sports

How Eating Disorders Present in Boys

“Because the masculine ideal has become increasingly large and muscular, many boys are doing muscle-enhancing behaviors” to try to achieve that, Jason says.

Signs of an eating disorder in boys may include:

Overconsumption of protein while restricting carbs & fat
Using supplements to increase muscularity
Excessive or compulsive exercise

Finding Help for Eating Disorders & Body Image Concerns

If you suspect your son may struggle with disordered eating or excessive exercise, schedule an appointment with your son’s primary care provider.

Unfortunately, “there’s a lack of training on eating disorders in general, and even more so for eating disorders in boys and men,” so you may need to very explicitly share your concerns and suspicions with your provider, and advocate for appropriate assessment.

In this episode, Jen & Jason discuss:

The 3 biggest influences on boys’ body image
How eating disorders present in boys
Conditions that may predispose boys to muscle dysmorphia and eating disorders
Seeking help for eating disorders
Protein overconsumption
Dietary supplements
Supporting healthy habits
Long-time health impact of eating disorders

Links we mentioned (or should have) in this episode:

nagatalab.ucsf.edu — Nagata Lab website (includes links to research & news articles about eating disorders in boys & men, screentime in adolescents & young adults, & much more)

Helping Boys Develop Healthy Body Image — ON BOYS episode

Boys & Body Image — ON BOYS episode

Boys Get Eating Disorders Too — ON BOYS episode

National Eating Disorder Association — includes links to help