Boys Develop Eating Disorders, Too

As a culture, we’ve seen adolescent girls struggle with their perceptions of their bodies. This can lead to common eating disorders like anorexia and bulimia, excessive exercising, and an unhealthy interest in plastic surgery. 

But boys are not immune to cultural pressures to look a certain way. Their thinking and behaviors are just different — and often less noticeable but no less self-destructive — than their female counterparts.

“The rate of eating disorders in males is actually increasing faster than that of females,” says Christy Gardner, M.S., R.D., LD/N, a clinical pediatric dietitian with the University of Miami Health System.

“Male body image issues or dysmorphia manifest typically in a culture obsessed with health and emphasis on muscularity.” Some boys and teens start comparing themselves to body standards in fitness magazines, fashion and perfume ads, and amongst elite professional athletes.

In an attempt to appear big, strong, and athletic, males are more likely to develop avoidant restrictive food intake disorder or binge eating disorders than anorexia or bulimia.

In addition, “the onset of body dysmorphia in males typically occurs in later adolescence, whereas it occurs in early adolescence for females,” Gardner says.

Because they have higher bone density and muscle mass, teenage boys are much more difficult to diagnose with types of eating disorders. They don’t typically fall below a healthy weight for their height.

How does disordered eating affect developing bodies?

“The preferred source of energy for our brains and most cells in our body is carbohydrates. When young men restrict their intake of carbohydrates or starches, the result is a feeling of tiredness and being cranky,” Gardner says. “With unnecessary eating restrictions, muscle gain and performance will also be compromised, as the muscles require carbohydrates for storage and growth.” 

While limiting their intake of carbs, males with disordered eating may compensate with excessive amounts of protein to gain lean muscle mass. 

“Consuming exceedingly high levels of protein (and other supplements commonly used in muscle building) for prolonged periods of time places a high burden on the kidneys to process these levels of nitrogen. Over time, this high nitrogen burden can cause kidney damage,” Gardner says. 

“Often, food avoidances occur at the expense of necessary micronutrients like calcium and vitamin D, as reliance on protein shakes can hinder bone health. Resistance exercise does help with bone formation, but if blood levels drop below normal and insufficient intake in the diet, calcium will be leached from the bones to maintain cardiac functioning.” 

Is your son suffering from body dysmorphia or an eating disorder?

Parents need to pay attention to their son’s behaviors and language regarding his body. If you notice that your child is restricting his diet based on weight, that’s a red flag.

In fact, Gardner recommends getting rid of the bathroom scale at home. 

Frequent weighing, or any weighing at all, should be discouraged.

Christy Gardner, M.S., R.D., LD/N

Other causes for concern include:

• becoming overly focused on his weight
• frequently speaking about/criticizing his own body
• obsessing over examples of the “perfect” male physique 
• isolating from friends to go to the gym instead
• intensely restricting his calories or his diet to only “healthy” foods (signs of disordered eating) 
• taking his own meals to social gatherings or avoiding events due to the food being served
• punishing himself with more exercise after eating “bad” foods

How can you help your child recover?

If you see signs of problematic eating behaviors, start by talking to your son. Ask them if they’re concerned about bulking up. Help them question appearance ideals presented by the popular culture.

Emphasize the usefulness of their body (beyond how it looks) and how food and calories make it possible for their body to function and perform properly.

“Speak to your teen about normalizing foods,” Gardner says. “This means there is no moral compass with what we eat. A cookie and a salad are both food and provide nutrition. Even though one will provide more vitamins and minerals, do not call one ‘junk’ or ‘clean.’

“The only dirty foods are those that have yet to be washed.” 

Have conversations at the dinner table. 

“This is a great place to learn about what is going on in the life of your teen,” she says. “Provide them with praises about their abilities rather than their body.” 

Discuss the pitfalls of admiring what they see on social media.

“The high level of filtered social media usage is detrimental to mental health,” Gardner says. “This is especially bad for young people, making them strive for something that does not exist.” 

Don’t hesitate to seek professional help. 

“If you feel that your child won’t listen to you, consider taking them to a registered dietitian who is uniquely trained to discuss nutrition in a manner that prevents further body dysmorphia or disordered eating habits.” 

Visit the National Alliance for Eating Disorders treatment directory to find a provider.

Dana Kantrowitz is a contributor for UMiami Health News.

Tags: ARFID, binge eating, body dysmorphic disorder, boys and eating, Christy Gardner, eating disorders, muscle dysmorphia, nutrition care in Miami