Disordered Eating in High School Boys
I wouldn’t have admitted to this back then, but I was ashamed of my body when I was in high school. I would suck my belly in whenever people would take photos or whenever I thought people were giving me attention (which, for a high schooler, was ALWAYS). How could I not be ashamed of my body? My body was changing into the same general body shape as my dad, and he was ashamed of his body. And my mother was always trying to lose weight because she was ashamed of her body. And round and round it goes. So I got a membership to the gym, hired a personal trainer and got a subscription to “Men’s Health” magazine with advice on how to achieve the perfect body (“Just follow these 5 tips!”). I put my body and mind through incredible discomfort and pain and convinced myself my body instincts were wrong. And thus began my journey with disordered eating, which would turn into an eating disorder a decade later.
It has taken me years of unlearning the things I was taught by society, my family, and media. To be honest, I’m still on that journey of unlearning, and I’m not sure that will ever end, because society is still insidiously promoting harmful messages.
In my journey, it has been difficult to find resources that cater to men, because most of what is written about eating disorders is directed towards women, specifically thin, affluent, white, adolescent girls. Many of us have even been convinced that boys either don’t or can’t have eating disorders. While it is true that the criteria for certain eating disorders, like anorexia nervosa, is almost exclusively based on research with cisgender girls and women, experts are beginning to find that boys and men have higher rates of eating disorders and disordered eating than previously thought. And unfortunately, the research on trans and gender expansive people is paltry. The more we as a society are aware of disordered eating behaviors in boys and speak about it, the more likely they are to seek help and treatment.
What’s the difference between an eating disorder and disordered eating?
Like most mental health diagnoses, this all falls on a spectrum. There are plenty of ways of eating that are accepted (or even encouraged) by mainstream society that are actually disordered eating. In fact, people with eating disorders are often praised by others for their self-control or body shape. Disordered eating behaviors become an eating disorder when they begin to harm mental and physical health.
In general, disordered eating behaviors are those primarily driven by a desire to change one’s body shape or weight, often as a way to exert control over their emotions.
One of the most pervasive types of disordered eating are diets: Atkins, Low-carb, Intermittent Fasting, Keto, Paleo, Mediterranean, you name it. It is estimated that 80% of Americans have been on a diet, and almost half of Americans are currently on a diet. If the purpose of the diet is to change your body shape or weight, it’s disordered.
Other types of disordered eating include:
a preoccupation with body weight and shape
food restriction
binge eating
vomiting
abuse of diuretics, laxatives and diet pills
compensatory exercise
Here’s why this is important: the single biggest predictor of development of an eating disorder is a history of disordered eating behaviors. And there is an increased risk for depression, anxiety, substance use and suicidality among people who engaged in disordered eating behavior.
High School Boys
There is immense stigma for boys dealing with disordered eating. Without taking away from the stigma and pressures other high schoolers can face, the pressure for boys to look a certain way has always been heightened in high school, where they are confronted with body changes, team sports, dating, sex and bullying. Combine that with the rise of superhero movies and the age of social media, where we see rampant cyberbullying, pressures to post and send photos, and millions of influencers promoting the latest diet, “health” products and “get shredded quick” schemes–it’s no surprise the rates of male disordered eating is on the rise. In a 2015 study, 45% of high school boys engaged in disordered eating.
And because of this stigma, boys are MUCH less likely to seek treatment than their female counterparts, which has led to an increase in hospitalizations for boys with eating disorders
Muscle Dysmorphia
The current societal male ideal body is that of being both lean AND muscular, and there is a considerable overlap between excessive exercise and disordered eating among boys. Whereas thinness is the goal in traditionally female sports (e.g. running, gymnastics, or dance), in traditionally male sports (e.g. football, basketball, wrestling or body building) the goal is to be big and muscular. Muscle Dysmorphia is a condition where a person is overly focused on muscle mass or body size. It’s a subtype of Obsessive Compulsive Disorder (OCD) where the obsession is on the level of muscularity or leanness.
This is not the same as vanity. Vanity is people wanting to look great or feel good in their body. Muscle Dysmorphia (or any kind of Body Dysmorphia) occurs when people do not believe the current form of their body is acceptable to others (peers, society, etc.).
According to a study in the Journal of Adolescent Health, in boys and men ages 16 to 25, a quarter of the 4,489 participants told researchers they were worried about not having enough muscle.
This frequently leads to abusing steroids and growth hormones, over-exercising to the point of injury, spending significant money on supplements, and harmful eating patterns.
So, what do we do?
At the end of the day, the goal is to help boys change their body image ideal.
This is done by helping them:
Recognize how they’ve been conditioned by society to praise a certain type of male body
Challenge beliefs associated with power and control
Recognize how that body is generally unattainable without extreme damage done to their physical body and mental health.
Form a new understanding of masculinity
Place more value on personal qualities rather than appearance
Eat regular meals, especially with others present,
Additionally, its important to encourage vulnerability in boys through empathy. If one boy in a room can share that they struggle with trying to maintain or attain a certain body type, others may be willing to open up about this very common experience.
Depending on the severity of the symptoms, it may be necessary to get treatment at a hospital or an inpatient treatment facility. Discussing this with a therapist, dietician, or physician familiar with disordered eating would be a great first step.
High school boys are at an especially vulnerable phase of life where the risk for developing eating disorders is high. Speak openly with boys about these topics and you may be able to head them away from more dangerous behaviors in their lives.