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4 November 2013
Eating disorders surprisingly prevalent in boys

Parents think that eating disorders very rarely affect boys, but a new study in the journal in JAMA Pediatrics directly challenges this belief. The study was conducted by Boston Children's Hospital researcher Alison Field, who analyzed responses to questionnaires completed by more than 5,000 adolescent males. Her analysis focused on how eating disorders might be linked to obesity, drug use, and depression in males.

She found 18 percent of adolescent boys were extremely concerned about their weight and physique. These boys were more likely to start engaging in risky behaviors, including drug use and frequent binge drinking.

"Males and females have very different concerns about their weight and appearance," says Field, ScD. "Evaluations for eating disorders have been developed to reflect girls' concerns with thinness but not boys' concerns, which may be more focused on muscularity than thinness."

The study showed that boys tended to be more interested in muscularity than thinness, with 9 percent of males reporting high concerns with muscularity, compared with 2 percent concerned about thinness and 6 percent concerned with both aspects of appearance.

Males concerned about muscularity and who used potentially unhealthy supplements, growth hormone and steroids to enhance their physique were approximately twice as likely to start binge drinking frequently and much more likely than their peers to start using drugs. Boys concerned with thinness were more likely to develop depressive symptoms.

A total of 3 percent of all respondents had full or partial criteria binge-eating disorder, and nearly one-third reported infrequent binge eating, purging or overeating.

Most eating disorder assessments reflect this desire for thinness and may overlook boys concerned about their weight and shape but who want to be more muscular. This may be the male equivalent of girls who are very concerned with their weight and who use vomiting or laxatives for weight control, according to Field.

"Clinicians may not be aware that some of their male patients are so preoccupied with their weight and shape that they are using unhealthy methods to achieve the physique they desire, and parents are not aware that they should be as concerned about eating disorders and an excessive focus on weight and shape in their sons as in their daughters," she concluded.

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Source: Boston Children's Hospital

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