Perception and Genetics

Mental health problems can often run in families and disorders such as depression, eating disorders or obsessive-compulsive disorder could predispose a child to an increased risk for body image problems. It is important to remember that a genetic factor does not suggest that a body image problem will definitely develop; in a similar light, it is quite possible for a body image problem to develop without the existence of a genetic risk factor (Veale, Willson & Clarke, 2009).

A child with particular personality traits can be more vulnerable to developing a body image problem. Adolescents who tend to be perfectionist, excessively shy or withdrawn have a greater risk for developing a body image problem if these personality traits are coupled with triggers. It has been suggested that healthy adolescents assess their body image in a more positive light; this has a tendency to result in better relationships with their family members and peers.

Adolescents with a poorer body image appear to have problems with their perception; they tend to perceive their bodies as larger than they are and attach a high degree of importance to their physical appearance. Life experiences that make an adolescent vulnerable to body image problems include emotional neglect, rejection, bullying or sexual abuse, leading to feelings of worthlessness.

In Beck (1985) it is suggested that body image problems are caused, primarily, by negative thought patterns, which he labeled the ‘cognitive triad’.

Orthorexia Nervosa

The term ‘Orthorexia’ was first coined in 1997 by Dr. Steven Bratman. The combination of the Greek words ‘orthos’ meaning correct or right and ‘orexis’ meaning appetite gives the lose definition of correct eating; prior to coining the term Bratman previously referred to Orthorexia as “righteous eating”. Predominantly, the primary focus is eating healthy food. In addition to healthy eating, it is purported that orthorexics “obsess” over the quality of the food they eat more than the quantity.

Not uncommon to many ‘diet plans’, the orthorexic places high importance on large quantities of fruit and vegetables in his eating plan, but often will fixate on eliminating what he deems ‘bad’ foods; with some sufferers trying to completely eliminate fat, sodium and carbohydrates from their diet. Dr Bratman affectionately refers to orthorexics as ‘health food junkies’, unfortunately this rather tongue-in-cheek term does little to relay the seriousness and potentially life-threatening nature of the disorder.

Binge Eating Disorder

It is proposed that binge-eating disorders (BED) seem almost as common among men as among women, with a ratio of about 40% male to 60% female. A large number of authors in the field of binge eating suggest that overweight young people have a lower self esteem than their normal weight male peers. Many men who binge eat are not overweight, or are only a little overweight, but still they are constantly concerned about their body shape and their level of fat. These men often feel distressed over their body image (body image dissatisfaction) in addition to their shame, secrecy and self-depreciation occurs in conjunction with the most severe eating disorders.

Treatment & Prevention

Treatment

Eating disorders and exercise related problems, including muscle dysmorphia require expert help. Due to the complex nature of the illness a therapist who is an expert in this field should be utilised. It is comforting to see that boys are becoming more open to getting treatment and seem less traumatized about having a ‘girl’s’ disease than they were in the past.

The first step in getting assistance with an eating disorder should be a visit to the family doctor, who would probably take some blood samples, administer an ECG and possibly a Dexa Scan to measure bone density. One indication of general fitness in men is the waist-to-hip ratio. Measuring the waist and dividing it by the measurement of the hips will give a ratio value; values of 0,90 to 0,95 are associated with better health.

The goal of treatment for eating disorders should be a multidisciplinary approach that incorporates medical management as an integral part of the overall care of the client.

South African Stats

Research conducted among Grade 8-12 children during the course of 2009 – 2011 gleaned the following information. Initial research was conducted into the prevalence of supplement and/or steroid use among adolescent males, gathering information on the use and more importantly the motivation for use of these products. This research was conducted among male respondents only.

Male Depression

Young boys are taught to suppress their emotions and instead they use their body to express their unconscious feelings. His body often becomes the vehicle for performances that lift his self-esteem. Not only does society frown upon boys and men talking about their feelings of vulnerability and inadequacy, but it also indoctrinates our young males that only women should be bothered about their physical appearance. Boys and men who do focus on their appearance are often viewed as being vain, narcissistic or 'feminine'.

Males find it extremely difficult to seek help when they are aware that their disordered eating habits have become uncontrollable. One of the most common symptoms of eating disorders is depression. Over half the males with Muscle Dysmorphia have suffered from major depression; studies at Cornell University found that 54% of all men with eating disorders were diagnosed as clinically depressed.

Supplements & Steroids

It is still debated as to whether mass building supplement use is a 'gateway' into steroid abuse but the general consensus indicates an increased risk. The common belief that 'supplements' are not dangerous has resulted in a considerable lack of research into their use among adolescent males.

Estimations in 2005 by the National Centre for Education Statistics, suggested that some 5,4% of school children 14-17 years old had used or were using steroids. Adolescent anabolic steroid use is an international problem, with prevalence rates among high school boys ranging from 5-11%.

Performance enhancing drugs have been around for centuries; the ancient Greeks used strychnine and hallucinogenic mushrooms in preparation for the original Olympic Games - the first associated death of an athlete occurred in 1886. The initial use of performance enhancing drugs was related to sporting achievement but today we see more males utilizing supplements for non-sporting gains.

Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) is a 'psychiatric' illness in which patients become obsessively preoccupied with perceived flaws in their appearance. The perceived flaw causes significant emotional distress and difficulties - the disorder of imagined ugliness. BDD is an under recognised, yet relatively common and severe psychiatric disorder; often misdiagnosed by doctors as a low self-esteem.

The predominant feature of Body Dysmorphic Disorder is a preoccupation with an imagined defect and actions taken to reduce the feeling of distress generated by the perceived flaw.

The intrusive thoughts (obsessions) around the area of defect can cause significant compulsion that may have a negative effect on the sufferer. Many boys and men are becoming dissatisfied with their own bodies and are paying incredible costs in supplements and cosmetic surgery to achieve the 'perfect' body.

Muscle Dysmorphia

Muscle Dysmorphia

Muscle Dysmorphia, Bigorexia or Reverse Anorexia, is an obsession with being muscular and is seen primarily in males. It is characterized by excessive working out, mass building supplement consumption and a constant worry of not being 'big' enough.

Muscle Dysmorphia is a sub-type of Body Dysmorphic Disorder (BDD).

Sufferers of Muscle Dysmorphia (MD) see part(s) of their body as defective. The excessive preoccupation with body size and muscularity causes the sufferer to feel 'small' even when they're actually quite muscular.

Male Anorexia & Bulimia

Anorexia Nervosa (AN) is an eating disorder characterized by an excess desire to limit food intake, accompanied by body image disturbance.

Adolescent boys often use AN to solve a developing crisis at home/school or to help deal with a problem in a relationship or gain a sense of control over their lives.

Bulimia Nervosa (BN) is an eating disorder characterized by episodes of binge eating followed by some form of purging or restriction.

Boys with BN are more likely to be preoccupied with 'shape' than 'weight' and are harder to spot. They hide the illness well, maintaining a normal or slightly above normal body weight. Males are less likely than females to resort to the use of laxatives and rather over-exercise as a method to rid themselves of excess calories.

Eating Disorders Overview

Estimated prevalence rates for males with eating disorders ranges from 10-33%. However, fewer than 5% of all referrals to eating disorder clinics are male. Research at Harvard Medical School discovered that there is increasing evidence to suggest that men and boys are becoming more obsessed with their bodies. Men are beginning to diet in unprecedented numbers with an estimated one million of them suffering from eating disorders - this figure is perceived to be underestimated.

In Psychology Today magazine, in 1997, an alarming 43% of men in the survey reported that they were dissatisfied with their overall appearance; 63% dissatisfied with their abdomen, 52% with their weight, 55% with their muscle tone and 38% with their chest.

Body Image Dissatisfaction Overview

A positive or negative perception of our body counts for up to a third of our self-esteem, with physical appearance being an important determinant of peer acceptance for an adolescent male. In recent years our culture has helped to increase the prevalence of body image dissatisfaction among our youth. It is clear that society's view of a good-looking male is tall, broad shouldered and muscular.

Research conducted in 1972 indicated that 36% of men reported dissatisfaction with their mid-torso; by 1996 this figure had risen to 63%. Discontent with the overall appearance rose from 15 to 43% in males.

Men with eating disorders tend to display a perfectionist attitude with a strong fixation on appearance and athletic performance.

Body Image Dissatisfaction and Disordered Eating

An eating disorder is any form of disordered eating ranging from not eating to binge eating and purging, with numerous variations falling in between these extremes.

There is a profound preoccupation with food and anxiety related to food and eating.

This site is dedicated to the male perspective on this historically 'female' illness. Body image dissatisfaction is an important predictor of disordered eating habits among males.

An adolescent's body image is based on his perception. His perception of how he is viewed by others, in conjunction with his own evaluation of how attractive/unattractive his physique appears is integral in creating a sense of body image satisfaction/dissatisfaction. Adolescence is the time in the young male's life when he is most likely to develop dissatisfaction with his physique - giving rise to a poor self-esteem.