Eating Disorders Common Among Young Men

According to the results of a recent study, concerns over weight and physique are more common among adolescent boys and young men than previously realized.

Further, these individuals may have traditional eating disorders or may use drugs and supplements to achieve their desired physique, and are at an increased risk of adverse outcomes, such as depression, binge drinking, and recreational drug use.

As most research on eating disorders has been focused on female patients, the prevalence of eating disorders and concerns with physique among male individuals and their relation to future adverse outcomes is largely unknown. The current study examined how psychiatric symptoms related to eating disorders and concerns about physique are associated with subsequent obesity, drug use, binge drinking, and depression in adolescent males and young adult men.

Researchers analyzed questionnaires that were answered every one to three years by 5527 male individuals from 1999 through 2011 as part of the Growing Up Today Study, a prospective US cohort study. The subjects were between the ages of 12 and 18 when the study began.

“This study is, to our knowledge, the largest longitudinal sample of males with repeated assessments of eating disorder and weight and physique concerns,” the authors write.

“Moreover, it is the first study to prospectively examine the association between eating disorder subtypes, including high concerns with muscularity, and the risk of developing a range of adverse outcomes.”

Researchers found that 9.2% of participants had high concerns with muscularity but did no exhibit bulimic behaviors and that 2.4% had high concerns with muscularity and had used supplements, growth hormone derivatives, or anabolic steroids to achieve their desired physique. The use of those products rose to 7.6% when the researchers looked only at 16- to 22-year-old individuals.

In addition, 2.5% reported high concerns with thinness but no bulimic behaviors, and 6.3% reported high concerns with both thinness and muscularity. In addition, 31% of individuals reported infrequent binge eating or purging or overeating, 0.8% had partial- or full-criteria bulimia nervosa or purging disorder, and 2.9% had partial or full-criteria binge eating disorder.

Finally, those who were highly concerned about thinness but not muscularity were more likely to develop high depressive symptoms, those who were highly concerned about both muscularity and thinness were more likely to use drugs, and those who were highly concerned about muscularity who used supplements or other products to achieve their desired physique were more likely to start binge drinking frequently and using drugs.

Some limitations of the study include the fact that most of the cohort (more than 90%) was white and few respondents were of a low socioeconomic status.

“We cannot be clear whether the results are generalizable to males of color or from a lower socioeconomic level,” the authors write. Also, because validated self-report questionnaires were used to assess eating disorder behaviors and cognitions, “we may have slightly overestimated the number of cases of eating disorder and slightly underestimated the associations with adverse outcomes.”

Finally, researchers noted that they did not measure whether the study participants played on sports teams. Funding for the study was provided by the National Institutes of Health. The complete study is published in the November issue of JAMA Pediatrics.

-Meredith Edwards White

Reference

Field AE, Sonneville KR, Crosby RD, et al. Prospective associations of concerns about physique and the development of obesity, binge drinking, and drug use among adolescent boys and young adult men. JAMA Pediatr. 2013 Nov 4. doi: 10.1001/jamapediatrics.2013.2915. [Epub ahead of print]