Understanding male teens with eating disorders
One of the most significant and damaging stereotypes surrounding eating disorders is the belief that these disorders only occur in adolescent girls and women. Yet, around one in three Americans who struggle with an eating disorder are male. (4) In addition, some behaviors – such as purging, binge eating, and laxative abuse – are almost as common in males as for girls and women. (3)
Teen boys sometimes deny that anything is wrong or that they are suffering from an eating disorder. Some experience the very fact that they have an eating disorder as embarrassing or even humiliating. Since eating disorders are incorrectly thought of as a female condition there is tremendous shame around teen boys acknowledging the condition and/or seeking help.
Another common misconception is that eating disorders are a choice. These disorders are complex illnesses influenced by environmental, biological, and social elements. Males and teen boys are not exempt from the experience of pressure to have a body of extremely low body fat, and/or pressure to conform their body to unrealistic standards.
Men are not exempt from internalizing these pressures, nor are they exempt from the consequence of dieting and restriction. Teen boys have a greater risk of developing an eating disorder if they have:
- A close relative that suffers from an eating disorder
- A close relative with a mental health condition
- A personal history of an anxiety disorder
- Experienced trauma
- A history of being bullied, especially about their weight or appearance
- Obsessional, intrusive thoughts about their appearance, size or shape
- Few friends or limited social interaction
- Participation in sports or other activities such as boxing or wrestling, where there is pressure around weight
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Stats & trends in male teens with eating disorders
Due to stigma in diagnosing practices, before 2013, it was even more difficult for male teens to be diagnosed with an eating disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM) was first published in 1968. Medical professionals use the DSM to diagnose individuals who have a mental illness.
Previously, a lack of an ability to make a diagnosis of anorexia nervosa due to female-oriented criteria, made it challenging to enroll teen boys in eating disorder treatment programs. The DSM-5, published in 2013, made a critical change to how eating disorders were diagnosed and treated by removing the amenorrhea condition, which is missing at least three consecutive menstrual cycles. (7) This former criterion made it difficult for these disorders to be diagnosed in male teens and further reinforced the idea that eating disorders are disorders of female conditions.
Additionally, this change made it easier for researchers to create and track trends of eating disorders among male teens. Today, those statistics and trends include: (4)
- Hospitalization among men and boys with eating disorders increased by 53 percent between 1999 and 2009
- It’s estimated up to 36 percent of eating disorder diagnoses are for men and male teens
- The majority of males with eating disorders are heterosexual, but these disorders affect a more significant proportion of gay and bisexual males
- Eating disorders are more likely to develop in teens and young adults
- The mortality rate for males with eating disorders are more elevated than females
- Children as young as five can begin to develop an eating disorder
Male teens signs & symptoms of eating disorders
The signs of an eating disorder in teen boys can be different than their adult counterparts. These signs may include: (5)
- Distorted body images
- Frequent weighing
- Extreme weight changes
- Unusual eating habits
- Insomnia
- Loss of nail quality or hair
- High interest in exercise
- Dental cavities or the erosion of tooth enamel
- Changes in mood, including depression and anxiety
- Withdrawal from friends and family
- Perfectionism
Treating male teens with eating disorders
Treatment for eating disorders is not a one-size-fits-all. There are many eating disorder treatment programs for teens that can help, but a sparse number accept boys and male teens. (8) Knowing your options will help you get the best care for your child. The most effective treatment options for male teens include a combination of:
- Psychological therapy
- Dietitian nutrition education
- Medications to treat associated mental disorders, including depression and anxiety
- Hospitalization when indicated
- Higher levels of care including IOP/PHP and/or residential treatment programs if indicated
How male teens cope with eating disorders
Working on adding on and bolstering effective coping skills can help male teens remain resilient in the face of daily stressors and while undergoing treatment for their eating disorder. Which coping skills are most helpful can vary between one person and another. Some of the best coping skills that teens can learn during this challenging time include:
- Practicing self-care and taking time to do the things they love, such as journaling, watching movies, leisurely walks, and playing games
- Combating negative thought patterns with positive affirmations that promote self-worth and value
- Discovering new hobbies and learning about new activities to find enjoyment in
- Leaning on family and friends for support
- Listening to music that helps relieve high-stress levels
- Spending more time outdoors
- Practicing mindfulness and meditation
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How to help someone with an eating disorder
Learning that your teen boy has an eating disorder can be an emotional, confusing, and distressing time. You may worry about how to help them with their disorder or struggle to understand it. But there are many things that you can do to help someone with an eating disorder, including:
- Learning more about their eating disorder
- Knowing the common signs and symptoms of an eating disorder
- Addressing your concerns with your teenager in a loving and supportive way
- Reviewing treatment options for your teen
- Providing support, positive feedback, and reinforcement during their treatment and recovery
- Reinforcing that their struggle is valid and serious
- Introducing and reinforcing the idea that eating disorders occur in people of all shapes, size, color and gender
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How to parent teen boys with an eating disorder
After their child is diagnosed with an eating disorder it’s common for parents to blame themselves or wonder if they could have done something differently. However, research has shown that parents do not cause eating disorders. (9)
Enrolling your child in eating disorder treatment programs for teen boys is one of the first steps you can take as a parent. However, you can prepare yourself for a potentially lengthy recovery process. Your child may struggle to stick to their treatment plan and may experience setbacks or relapses. This is all to be expected during a course of treatment, and will require your care, attention and involvement. Staying in close contact with the treatment team, asking questions, and being aligned in your communication with the team, will all help move your teen in a direction toward healing and recovery.
Supporting your child as they undergo treatment is a critical part of their success. As a parent, you will play a pivotal role in your child’s recovery. Offering gentle encouragement and staying involved in your child’s treatment will help you support your child in their time of need. Finding an effective treatment plan can take time, and there’s not always a simple solution.
Express your concern for your child, but avoid behaviors that encourage shame or anxiety about their eating disorder. Instead, try to understand and empathize with your child’s experiences while cultivating an accepting and positive body image.
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