Doctors and parents may miss the signs of disordered eating in younger men because ED assessment tools are geared towards women.
Eating disorders are typically thought of as a struggle faced by girls and women.
However, according to Reuters, teen boys are also susceptible—eating disorders may just present differently for them, as the goal is often to build muscle rather than lose weight.
Dr. Jason Nagata of the University of California San Francisco and his colleagues explore the topic in a recent commentary in the Lancet Child & Adolescent Health, and stated that often the most well-known eating disorder symptoms like restricting calories and purging are signs of the disorder in females, not males.
“Many assessment tools that are currently standard practice to diagnose eating disorders are geared toward females and are based on weight loss behaviors with the goal to become thin,” Nagata said via email.
Because of this, he says, doctors and parents may miss the signs of disordered eating in younger males. These signs often include eating too much protein, cutting carbs and fats, and going back and forth between too many calories and too few. Steroids or supplements and excessive exercise may also come into play, Nagata states.
“Exercise is an under-recognized component of eating disorders,” Nagata said, according to Reuters. “Teenagers who excessively exercise can have energy deficits and become malnourished if they do not increase their food intake to match their energy needs.”
Nagata and his colleagues add that teen boys have also been known to take part in “biohacking,” which has to do with attempting to build muscle via methods like elimination diets, steroid use, supplements and intermittent fasting.
Dr. Trine Tetlie Eik-Nes, a researcher at the Norwegian University of Science and Technology in Trondheim, was not involved with Nagata’s team but states that disordered eating in males can be hard to diagnose since there is little research about them.
“We are basically not asking the right questions for boys,” Eik-Nes said. “Consequently, boys do not get access to treatment and they do not themselves see their problems as an eating disorder. Moreover, boys may be less familiar with talking about negative feelings, body image ideals and eating disorders.”
According to Nagata, there are some telltale signs to watch for in males.
“Disordered eating may develop when a boy becomes preoccupied with his appearance, body size, weight, food, or exercise in a way that worsens his quality of life,” Nagata said. “He may withdraw from his usual activities or friends because of concerns with body size and appearance.”
Dr. Antonios Dakanalis, a researcher at the University of Milano-Bicocca in Italy, was not involved in Nagata’s commentary but adds that it can be harder for boys to reach out and ask for help.
“Males can face a double stigma—about having a disorder characterized as feminine or gay, and seeking psychological help,” Dakanalis said via email.
