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Eating Disorders In Men

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Body Ideals

Body dissatisfaction is a well-established risk factor in the pathogenesis of an ED and often manifests through internalisation of body ideals; whilst women aspire to be slim, men pursue a physique characterised by high muscularity and leanness (low body fat mass). Despite this distinction, the current diagnostic frameworks used to classify ED psychopathology have been constructed upon the foundation that the only body type overvalued is the thin ideal. Thus whilst they are sensitive to the malpractices more commonly reported by females (namely dietary restraint, self-induced vomiting and laxative abuse), they fail to be inclusive of behaviour not driven by the desire to lose weight. As such, this would include that common to men.

The muscular ideal has unique implications upon male body and eating related attitudes, and of recent has received increasing media representation. Male models presently depict a hypermesomorphic standard and there is a larger range of fitness advertisement specifically targeted towards men. Not only has this aided to reinforce their body image concerns through the opportunity for greater social comparison, but it has also enlightened them of the methods available to correct their perceived defects. Of concern, is that when equivalent media changes to the female form were made, the rates of AN and BN accelerated. Similarly in men a rise in ED’s has been observed, yet more so there has been an emergence of muscle-oriented malpractices. Of which, it is these not accommodated by the existing ED guidelines.

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Methods of weight control

In parallel with the changing portrayal of the male form, the dietary practice known as ‘bulk and cut’ has gained popularity. Used with the intent to build muscle whilst simultaneously losing body fat, the ‘bulking phase’ is characterised by the overconsumption of protein and the ‘cutting phase’, the restriction of all macronutrients. Additionally within the latter, a concept known as ‘cheat meals’ may be intermittently incorporated. Involving the intake of large quantities of calorific (ordinarily prohibited) foods, their purpose is to prevent metabolic adaption to a low energy state; they maintain ketosis and thus the use of fat as the primary metabolic substrate. Essentially, this ensures muscle catabolism does not occur during intervals of ‘cutting’ when nutrition is insufficient.

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