By Najeeb Riaz, M.D.
Eating disorders are often characterized as conditions affecting young girls and women, but statistics show these conditions also impact a significant number of boys and men.
However, due to stigma and cultural biases associated with eating disorders, boys are often less likely to seek treatment.
The Princeton Center for Eating Disorders at Penn Medicine Princeton Medical Centertreats people of all genders, from age 8 to adults, for the physical, psychological and nutritional aspects of their condition.
Overcoming Misconceptions
As the National Eating Disorders Association notes, eating disorders such as anorexia nervosa and bulimia nervosa will affect at least 10 million males in the United States at some point in their lives.
While the signs and symptoms of eating disorders are similar for boys and girls, boys face an added hurdle to diagnosis and treatment – overcoming the misconception that their condition is a girls’ disorder.
Like girls with eating disorders, boys may also have a distorted sense of body image. While some boys might focus on losing weight, others are determined to bulk up, which can lead to steroid use and reliance on protein shakes and other supplements to enhance muscle development.
Risk Factors
Risk factors for eating disorders in boys include a range of biological, psychological and sociocultural issues. Chronic body dissatisfaction, exposure to trauma, depression and anxiety can all contribute to the development of an eating disorder.
No age group is immune from developing an eating disorder, but boys age 10 to 14 are most at risk as they go through growth spurts and sexual development. Psychological injuries, including injuries caused by physical or sexual abuse, may also trigger attempts to delay or stop a growth spurt by reducing food intake.
Additionally, society’s preoccupation with body image and appearance can play a role in eating disorders.
According to the American Academy of Pediatrics, one-quarter of teenage boys are dissatisfied with their bodies.
Other risk factors include:
- Family history of eating disorders.
- Low self-esteem.
- Substance abuse.
- Personality traits such as perfectionism.
- Parental eating behavior and weight.
- History of excessive dieting, frequently skipped meals, or compulsive exercise.
Further, high school athletes, including wrestlers, dancers and gymnasts, as well as models, are also at greater risk for developing an eating disorder.
Signs of Eating Disorders
No matter their gender, people with eating disorders are often unusually concerned with weight loss, dieting and control of food. They may also:
- Make frequent trips to the bathroom around mealtimes.
- Cut their food into tiny pieces and rearrange it on their plate.
- Hide their body with baggy clothes.
- Seem concerned about eating in public.
- Withdraw from friends and activities.
- Maintain an excessive exercise regimen.
And while the outward signs of an eating disorder may be obvious, malnutrition associated with an eating disorder can have serious hidden health complications, including:
- Low blood pressure, heart rate and breathing rate.
- Poor growth in height and weight.
- Interrupted sexual development.
- Heart problems that can lead to abnormal heart rhythms.
- Brittle bones and risk of fracture.
- Dehydration and abnormal electrolytes.
- Constipation and other digestive problems.
- Inability to concentrate.
- Skin conditions and hair loss.
Moreover, boys usually experience low levels of testosterone and vitamin D, putting them at greater risk for osteopenia and osteoporosis. The risk of death for males with eating disorders is higher than it is for females, according to the National Eating Disorders Association, partly because they are often diagnosed later due to the misconception that males don’t have eating disorders.
Early Intervention and Treatment
Early intervention is key to treating eating disorders and preventing long-term complications.
Treatment at the Princeton Center for Eating Disorders includes a comprehensive medical assessment, nutritional counseling, medical monitoring, and individual and family therapy. Individuals learn everyday skills with activities such as family-style meals that teach healthy eating habits.
The treatment team includes board certified psychiatrists, registered nurses, licensed psychotherapists, registered dietitians, mental health associates, board certified physicians and certified teachers to provide private tutoring for school-age patients.
Prevention
Helping boys develop a positive sense of self can help prevent eating disorders and encourage a healthy body image. As a parent, keep in mind these dos and don’ts:
- Don’t discuss your own or others’ dieting efforts and body image concerns around children.
- Don’t focus on personal qualities that are linked to appearance.
- Do encourage physical activity, but don’t link exercise to weight control.
- Don’t use food as a reward or punishment.
- Don’t label foods as good or bad or overemphasize portion sizes.
- Do avoid media exposure to negative body ideals.
- Do engage children in meal planning and family meals.
For more information about the Princeton Center for Eating Disorders call 888.437.1610 or visit princetonhcs.org/eatingdisorders.
Najeeb Riaz, M.D., is board certified in child and adolescent psychiatry and is medical director of the Princeton Center for Eating Disorders at Penn Medicine Princeton Medical Center.
