Eating disorders and negative body image in boys! What do you need to know?

Written by Danni Rowlands

Eating disorders and negative body image in males are unfortunately still very much misunderstood. At the Butterfly Foundation, we recently heard from a mother who told us about an experience she had with their trusted health professional. Her eleven-year-old son had been experiencing anxiety and was also displaying behavioural problems, which they had been seeking professional support for. Over a number of months, the mother had become increasingly worried about her son’s eating behaviours.  She was also concerned about his increased volume of training and his growing negative preoccupation about his body, in particular his distress about his lack of a ‘six pack’. The mother decided to raise her concerns with their health professional as she felt that something was not right. Sadly, her concerns were met with prompt reassurance, ‘you don’t need to worry about that, He is a boy. He can’t get an eating disorder’.  Fortunately, the mother trusted her instincts and went on to seek another opinion, open to diagnosing and treating her son’s eating disorder.  

When it comes to males and those who identify as male, this type of experience is sadly far too common.  Dismissal, judgement, misunderstanding and stigma continue to be the significant barriers preventing males from seeking much-needed help and support.  Eating disorder research to date, has largely focused on females and yes, the prevalence of eating disorders and body dissatisfaction amongst females is higher but the common myth, that eating disorders occur in privileged, white, adolescent girls is not something that is helping anyone outside that profile to reach out and seek help – particularly males.  Fortunately, in more recent times, research in this area has become more gender inclusive and the findings confirm that these issues are sadly being experienced by more males than once thought. Is this due to eating disorders, generally, being better understood? Given the greater awareness surrounding mental health issues are males just becoming more comfortable talking about their experiences?   Whilst we can’t be sure of the exact reasons we do know that 25% of people experiencing Anorexia Nervosa and Bulimia Nervosa are male, almost half of binge eating disorder cases are in men and that as with all eating disorders there is significant underreporting.  The figures we are seeing are likely to be the tip of the iceberg.      

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Eating disorders are complex mental and physical illnesses. They are not a lifestyle choice and develop due to a range of biological, socio-cultural and psychological reasons. Eating disorders often present with other mental illnesses, such as depression, anxiety, obsessive compulsive disorder and addictions. Males who are gay and also male athletes are understood to be at greater risk, research to date has been limited with these groups but fortunately this is changing. What we do know is that low self-esteem, body dissatisfaction, trauma, bullying, family history of eating disorders and the unrealistic and toxic masculinity and muscularity ideals are risk factors that underpin the development of these potentially life-threatening illnesses in males. 

While eating disorders are complex in their development and a single cause is unknown, body dissatisfaction and unhealthy behaviours with food and exercise are significant, modifiable risk factors and when it comes to prevention, working with what can be modified is key!  

Never before has our society been so image obsessed and never before has the volume of idealistic imagery been so high.  Sadly, the value placed on appearance, beauty and thinness outweigh the value of most other attributes.  The narrow, unrealistic and perfectionistic beauty ideals that have been so problematic for women for many years, are extending at a greater intensity to males and with the surge of social media, body comparisons are rife.  As research and our experience confirms, males are feeling the pressure, feeling equally dissatisfied and reacting in harmful ways, when they don’t measure up by comparison.    

The male appearance ideal and the perceived strength of a man is tightly connected.  The role of muscularity in relation to masculinity is a complex one, but it is an important aspect that shouldn’t be overlooked as we work to better support our adolescent boys. Males who do not measure up to the stereotypical ideal may feel ‘less of a man’ and this can have a huge impact on their self-esteem, which can contribute to a range of mental health problems.  

For males, the reported areas of focus in relation to their appearance include their height, level of body fat; particularly on their abdominals, their muscle size; arms and legs, complexion, hair and also genitals.  Just like with females, boys who are dissatisfied with their body; weight and shape, are more likely to engage in restrictive dieting, over-exercise/training and amongst boys specifically, there is increased use of supplements, including steroids.  This in itself places them at a much higher risk of developing an eating disorder. 

So, what can you do as an educator to help? Firstly, it’s important to accept that eating disorders and negative body image issues do develop in boys and that if concerning behaviours are witnessed, or less likely but possibly expressed, they need to be taken seriously. Restrictive behaviours with food and over-training in males are often seen as ‘disciplined’ and are therefore celebrated, however they can also mark a sign of something more serious and it’s important that they are not overlooked.  I invite you to attend my session in the Free Seminar Program at the National Education Summit Melbourne on Friday 31 August @ 11.00am.

While there are a number of body image programs designed for females, there aren’t as many for males – Butterfly Education has recently helped with that and has developed Australia’s first digital body image program for boys called RESET: a conversation about boys’ body image. Talking to boys during the development of this program it became clear that many simply didn’t know that there were services out there to support them.  We also learned that in the event they were experiencing a problem, they were most likely to talk to their parents, specifically their mums.  This points to the need for schools to have established referral pathways and for parents to be aware of the warning signs in both males and females.  Alongside this, it is really important that health promotion, positive body image programs, that are evidence based and address the modifiable risk and protective factors are made available and offered to boys too.  Helping boys to positively navigate and use social media platforms, so that they don’t have a detrimental impact on their body and self-confidence is also really important. 

The school environment is a powerful environment and while schools do have bullying policies in place, it is vital that there is specific mention to appearance and weight-based bullying and teasing (online and face to face) and a zero-tolerance approach to it. Challenging toxic masculinity, celebrating and encouraging diversity and encouraging males to share and voice concerns is really important to the development of a healthy and balanced self-image. 

On an individual level, role modelling balanced behaviours with food and exercise and being mindful of language around males appearance and body shapes – just as we need to be for females – provides the much needed real-time influence that can help negate some of the intense messaging that they are receiving from their environment.  Helping boys’ to talk through and voice their feelings is no doubt more challenging, however it can be done and by providing a safe, engaging and empowering platform to do this can help the many boys’ who are struggling with their body image, to feel less alone and more likely to reach out to ask for help, which is vital for their potential and wellbeing. 

Danni Rowlands,
National Manager, Prevention Services, The Butterfly Foundation

 I invite you to attend my session in the Free Seminar Program at the National Education Summit Melbourne on Friday 31 August @ 11.00am.

To find out more about body image programs, designed specifically for boys, please contact education@thebutterflyfoundation.org.au  

For further information about eating disorders in males please visit the National Eating Disorder Collaboration website www.nedc.com.au  

If you are concerned about someone, please contact the Butterfly National Helpline 1800 33 4673 (1800 ED HOPE) or visit www.thebutterflyfoundation.org.au