by Brian Pollack, LCSW, CEDS
Eating disorders in males are becoming part of the general discussion and an issue that no longer can be ignored. This is great progress because boys do get eating disorders. Just like females, and eating disorders are dangerous both physically and emotionally. They are complicated and require treatment as early as possible. There are a number of misconceptions to clear up surrounding how different types of eating disorders present in males, including:
Misconception: boys are naturally skinnier
It is generally more accepted for a male to be skinny without anyone second guessing it. People tend to assume that a skinny adolescent boy has just hit a growth spurt, or his metabolism ramped up. This assumption can complicate eating disorder diagnosis in boys.
Misconception: sports are always healthy for boys
We see a lot of male eating disorders integrated with sports. There are wrestlers who want to weigh a certain amount to make a weight class and there are runners who overeat protein and starch before a race. This can lead to accepted vomiting at the finish line. We see a lot of boys who are overly-attached to sports and they pursue achievement to an unhealthy degree. Sports are also where we often see perfectionism expressed in boys.
Misconception: boys aren’t body-conscious
Boys are definitely body conscious. It presents in a different way. They want to be lean and muscular. Most don’t want to be skinny or underweight. We are seeing a lot more focus on the lean/muscular body such as what we see on Men’s Health Magazine or sports covers. It’s not just females who get Photoshopped, and the adolescent boys are reacting, by seeking to achieve the ideal male look.
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Misconception: boys don’t diet
Boys are definitely restricting foods, even as they may be over-emphasizing “healthy” foods. They develop a complicated, rigid relationship with what they consume, often making rules about what they eat and don’t eat. They will also take supplemental additives and protein shakes with the goal of building muscle even as they lose weight.
Warning signs parents should consider:
If you suspect your son may have an eating disorder, you may consider the following signs as a reason to consult a qualified eating disorder specialist:
- Obsession with lean muscle – discussions about dietary changes to “lean out” and “get lean” combined with a focus on muscular development
- Compulsion to work out/build muscle – going to the gym every day, having rigid rules about how much, where and when exercise needs to happen
- Diet supplementation – the use of supplements and meal replacements may be an early sign of increased focus on body image
- Isolation – as an eating disorder grows in intensity, it becomes hard for the person suffering to integrate with friends and family. You may notice some isolation from typical groups.
- Attitude – as an eating disorder worsens, nutritional health can decrease, and you may notice your son developing a “bad attitude” in response.
Finding someone who is specifically qualified in eating disorders is critical. What I often tell people is “If you went to a specialist for gallbladder surgery, would you trust him or her to know general health? On the reverse, if you went to a general practitioner for your gallbladder surgery would you trust them to execute the surgery?”
Despite everything we know today about male eating disorders, most mainstream medical practitioners are not aware of the warning signs and how to treat the behaviors. They may not even recognize a problem if there is one.
Brian Pollack, LCSW, CEDS is on the Board of The National Association for Males with Eating Disorders. He is the only male Certified as an Eating Disorder Specialist in the State of NJ. He earned his Bachelor’s degree at Syracuse University and his Master at New York University where he developed a strong clinical acumen. He offers psychotherapy in person and online. You can find him on Facebook, Twitter, and his website where he blogs weekly.