Body dysmorphia and men

While conversations around body positivity have increased in popular culture, they have been mostly centered on women and girls. In the media, on the sidelines of sports fields and even in the advertising campaigns of international cosmetic companies, we have begun a collective discussion about how to boost girls’ and women’s self-esteem and challenge conventional beauty stereotypes.

This, of course, is a welcome change. However, men and boys also experience anxiety about their bodies and little is being done to address it.

“It’s important to look at the influence of societal pressure to be physically perfect, which is no longer just a female issue,” says Linda Santangelo, PhD, lead clinical psychologist at the eating disorders program at Sharp Mesa Vista Hospital. “Men and boys are bombarded with magazines, social media posts and action figures of male bodies that are absurdly muscular. Six-pack abs, muscular chests, wide shoulders, slim hips — in other words being ‘cut and buff’ or ‘lean and fit’ like male models — are held up as the ideal for men. It’s no wonder, then, that when men and boys compare themselves to these images, the result is body dissatisfaction.”

The dangers of chasing the “ideal body”
According to Dr. Santangelo, in order to combat these feelings of “less than,” boys and men are engaging in extreme dieting and exercise, overuse of supplements and, in some cases, even steroids, which can have dangerous health consequences. These behaviors can also result in the development of serious eating disorders, such as anorexia, bulimia and orthorexia, and lead to compulsive exercise and body dysmorphia — a preoccupation with perceived bodily defects and flaws — specifically, muscle dysmorphia.

“When body dysmorphia — in both men and women — results in an obsession with trying to achieve what they perceive as the ‘ideal body,’ which is usually an unrealistic standard, it often leads to compulsive exercise and extreme dieting,” Dr. Santangelo says. “These behaviors can be inadvertently reinforced or overlooked by others, including medical providers, as a healthy interest in being fit.”

Eating disorders on the rise among men and boys
In fact, recent trends indicate that there is a rise in anorexia, bulimia and binge-eating disorder in males. Boys as young as 8 years old are being diagnosed with anorexia and 40% of those struggling with binge-eating disorders are male. Furthermore, while some data indicates that 25% to 40% of people with eating disorders are male, only about 10% seek treatment.

“Being able to talk openly about eating disorders can help minimize the shame often associated with the illnesses, especially in males,” Dr. Santangelo says. “Parents and loved ones should pay attention to any sudden changes in diet, exercise routine or increased negative comments about themselves or their bodies.”

Other signs to watch for include the following:

• Inability to keep a steady job, maintain relationships or participate in activities because exercise routines and painstaking food preparation take up too much time

• Continuing to exercise when injured

• Exercising multiple times during the day, even in the middle of the night

• Layered clothing to both camouflage the body and appear larger

• Increased body checking — feeling areas of the body to determine size — mirror checking, and measuring of muscle size and weight

• Desire to undergo plastic surgery, such as muscle implants or liposuction

These behaviors can have serious health consequences. Along with the emotional and mental strain the all-consuming thoughts about food, weight and appearance can cause, physical health can also be affected. This includes anemia, gastrointestinal problems, slow blood pressure, chronic pain, muscle and bone damage, and damage to the reproductive system and heart. Those with body dysmorphia also experience increased rates of suicidal thoughts.

“If you notice an increase in these warning signs, open up a dialogue that conveys your concern and compassion, and provide resources,” Dr. Santangelo says. “Treatment by professionals specifically trained in eating disorders can provide the support and help needed to treat these potentially life-threatening illnesses.”

Sharp Mesa Vista Hospital offers specialized eating disorder treatment programs.