Does Your Son Hate His Body? Sadly He Isn’t the Only One

My friend’s first crush, Danny, seemed too good to be true.

He was thoughtful, well-spoken, and cute, but there was something she couldn’t put her finger on. Ever protective, her brother Eric warned her off but wouldn’t explain why. In hindsight, I don’t think he could fathom what was happening to his oldest friend.At fifteen, the teens joined a gym, triggering the first step in Danny’s saga. He developed anorexia, which, in the nineties, was a disease striking girls only. Soon Eric wasn’t the only one awkward with his friend’s painful slide into the debilitating eating disorder. Slowly, Danny lost his mates; they couldn’t cope with the emaciated version of the boy they once knew.

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How many men and boys are affected by eating disorders?

Medical experts identify three main types of eating disorders:

• anorexia (calorie restriction)
• Bulimia: when a patients purges calories by either being sick, excessive exercising, taking laxatives, or a combination of the above.
• Binge eating- eating when not hungry, or eating lots of food at once.

With less than 1% of all research on eating disorders focusing specifically on males, it’s no surprise that boys struggling with body issues are underdiagnosed. However, 10 million males in the US alone will be affected, according to the NEDA. And, both Canadian and UK data point to a 20–25 % male proportion of all eating disorders patients.

Male eating disorders are on the rise. In 2017, the British NHS reported an increase of 70% in eating disorders in males. The 13 to 15-year-olds saw the sharpest increase, from 565 to 1,383. Prof Helen Stokes-Lampard provides one of the reasons for the spike.

“Increased awareness among sufferers and health professionals has likely meant that men are starting to recognise their symptoms more and are being diagnosed more, meaning that they are more likely to be referred to eating disorders services.”

Covid has boosted this surge. Oona Hanson, parent coach in private practice and family mentor at Equip, an eating-disorder treatment program, explains why. She said Covid is:

“the perfect storm: social isolation, disruption in routine, empty grocery store shelves.”

Also, extended exposure to social media and news reports on how overweight people were more susceptible to the virus can’t have helped matters.

So why have boys been underdiagnosed?

The diagnostic criteria were gender-based until 2013, when the loss of a menstrual period was removed from the symptoms’ list, allowing boys, men, and the small group of women who keep having their period to miss out on a critical diagnosis.

Lauren Smolar, director of programs at the National Eating Disorders Association (NEDA), explains another important reason:

“Because of stigma and stereotypes, males often have a harder time being diagnosed and receiving treatment for an eating disorder,”

The lack of research on males means low awareness, feeding into a gender bias by medics less likely to attribute significant weight loss or excessive exercise in boys to diagnose an eating disorder.

Something which Ashley, a Nevada-based mum of Jordan, can confirm. When her 10-year-old, Jordon, began working out excessively and stopped eating snacks, she became concerned something was amiss. But it didn’t dawn on her that an eating disorder was behind his behavior. As he lost weight, Jordan’s parents sought help but didn’t get the correct diagnosis, with an ER doctor jumping to the wrong conclusion. Ashley tells WebMD:

“He basically told my son to add smoothies to his diet, and he jumped to cancer as a possibility,”

Eventually, a pediatric oncologist put them out of their misery.

“He pulled my husband and I aside and said, ‘Your son doesn’t have cancer. He has an eating disorder.’”

Finally, Jordon received treatment, and after a two-month residential program, he is now recovering at home.

Muscle dysmorphia (‘bigorexia’) is becoming more prevalent

Anorexia isn’t the only disorder affecting males; there is a growing concern the fear of not being muscular enough or muscle dysmorphia is more common than previously thought. While some researchers argue it’s a male eating disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, bigorexia is a type of body dysmorphic disorder.

When boys suffer from this, they tend to restrict their diets, exercise often, take protein and other supplements, and sometimes use steroids.

Research reveals that men who were either bullied for being too thin or had parents or friends encouraging them to build up muscles are more inclined to suffer from the disorder.

A US study showed that around 25% of boys and teens were concerned about their muscularity and leanness by wishing for more toned and defined muscles. In another US study of over 15.000 High school students, 30% of male teens indicated they would like to gain weight to have bigger muscles.

Is society to blame?

From playing with ridiculously pumped G.I. Joe Extreme action figures (boasting a real-life 55-inch chest) to watching action figures in the Marvel films and following films stars like the Rock on Instagram, images of strong, and successful men with big muscles are part of the fabric of your son’s life.

And just like girls, whose mental wellbeing is negatively affected when exposed to images of thin girls on social media, boys aren’t immune to the pressures of the perfect body.

With 95% of US teens owning a smartphone, they carry social media and video games in their pockets, exposing them to near-constant physical perfection. In fact, research shows that boys who use muscular avatars in video games have lower self-esteem about their bodies.

Also, mainstream media should be held to account with publications like Men’s Health magazine glorifying the male physique and tabloids attacking ‘fat’ (sports)men. A case in point is Freddie Flintoff, a former top English cricketer and now tv personality, who blames hateful headlines for triggering his bulimia. See below.

How can we spot signs in our sons?

As with all mental disorders, early diagnosis can save lives, so take these signs seriously.

Early signs to watch out for:

• Lack of weight gain or growth
• Weight loss or weight gain
• Fixation on eating
• Increase in exercise to the point of obsession
• Frequent mood change
• Pre occupation with a particular part of his body (for instance, he might believe his arms are too thin)

Tips for parents: what to do if you feel your son might be suffering?

• Contact your pediatrician and explain what signs you have noticed in your son.
• Have a gentle conversation with your son about his behavior.
• Take an interest in what media he consumes and the body-related content it contains.
• Have a conversation about how we all come in different shapes & sizes.
• Talk to his teacher to check if other kids are teasing him.

Final thoughts

The pandemic proved a fertile ground for boys developing eating disorders. When you add up social isolation, loss of routine, unrelenting social media pressure, and anxiety about overweight people being at risk, it’s no surprise Covid-19 triggered a spike.

While eating disorders, such as anorexia, binge eating and bulimia are all on the rise, ‘bigorexia’ or the fear of not being muscular enough is gaining ground too. A study showing 30% of male teens indicated they would like to gain weight to have bigger muscles shows how we can’t afford to ignore this disorder.

Thanks to a lack of research, stigma, and criteria that focused only on teenage girls, clinicians underdiagnose boys and men, however, that’s slowly changing.

So what should you do if you suspect your son might be suffering from an eating disorder? Check the signs outlined above and contact your pediatrician. Don’t let ignorance or stigma be an excuse for your son to waste away as Danny did. Instead, be alert and take action. Your son deserves it.

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This post was previously published on Medium.

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