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Eating Disorders and Body Image Concerns Among Male Athletes

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Abstract

Many men are as obsessed as women with counting calories. They are preoccupied with their weight, diet frequently, exercise excessively, and binge and purge. Some subgroups of men have eating disorder rates higher than those of the general male population. One subgroup consists of men who participate in competitive athletics. Although there is increasing awareness of eating disorders in men, male athletes may continue to elude identification and be difficult to treat. Their subculture promotes the use of unhealthy measures, such as restrictive eating, binging and purging, and consuming steroids and other performance enhancing drugs. Professionals involved with the male athlete may not recognize these behaviors as problematic. In fact, they may not even look for the behaviors when dealing with men. Consequently, men’s eating disorders are missed and misdiagnosed. Male athletes face a combination of cultural, political, and financial pressures that is unique and represents an added risk factor that could have long-term irreversible effects. It is imperative that mental health professionals be aware of the unique-to-men risk factors associated with disordered eating. This article illustrates how eating disorders as well as body image dissatisfaction manifest themselves in male athletes, how difficult it can be to engage them in psychotherapy, and how clinicians can address these concerns.

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References

  • Andersen, A. E. (1990). Diagnosis and treatment of males with eating disorders. In A. E. Andersen (Ed.), Males with eating disorders (pp. 133–162). New York, NY: Brunner/Mazel.

    Google Scholar 

  • Andersen, A. E. (1992). Follow-up of males with eating disorders. In W. Herzog, H.-C. Deter, & W. Vandereycken (Eds.), The course of eating disorders: Long-term follow-up studies of anorexia and bulimia nervosa (pp. 53–68). New York, NY: Springer.

    Chapter  Google Scholar 

  • Andersen, R. E., Barlett, S. J., Morgan, G. D., & Brownell, K. D. (1995). Weight loss, psychological, and nutritional patterns in competitive male body builders. International Journal of Eating Disorders, 18(1), 49–57. doi:10.1002/1098-108X(199507)18:1<49:AID-EAT2260180106>3.0.CO;2-C.

    Article  PubMed  Google Scholar 

  • Andersen, A. E., Cohn, L., & Holbrook, T. (2000). Making weight: Healing men’s conflicts with food, weight, & shape. Carlsbad, CA: Gürze Books.

    Google Scholar 

  • Andersen, A. E., & DiDomenico, L. (1992). Diet vs. shape content of popular male and female magazines: A dose-response relationship to the incidence of eating disorders? International Journal of Eating Disorders, 11(3), 283–287. doi:10.1002/1098-108X(199204)11:3<283:AID-EAT2260110313>3.0.CO;2-O.

    Article  Google Scholar 

  • Anorexia Nervosa and Related Eating Disorders. (2015). Males with eating disorders [On-line]. http://www.anred.com/males.htm

  • Barth, F. D. (2008). Hidden eating disorders: Attachment and affect regulation in the therapeutic relationship. Clinical Social Work Journal, 36(4), 355–365. doi:10.1007/s10615-008-0164-2.

    Article  Google Scholar 

  • Barth, F. D. (2014). Integrative clinical social work practice: A contemporary perspective. New York, NY: Springer.

    Book  Google Scholar 

  • Blashill, A. J., & Vander Wal, J. S. (2009). Mediation of gender role conflict and eating pathology in gay men. Psychology of Men and Masculinity, 10(3), 204–217. doi:10.1037/a0016000.

    Article  Google Scholar 

  • Bonci, C. M., Bonci, L. J., Granger, L. R., Johnson, C. L., Malina, R. M., Milne, L. W., & Vanderbunt, E. M. (2008). National Athletic Trainers’ Association position statement: Preventing, detecting, and managing disordered eating in athletes. Journal of Athletic Training, 43(1), 80–108. doi:10.4085/1062-6050-43.1.80.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bydlowski, S., Corcos, M., Jeammet, P., Paterniti, S., Berthoz, S., Laurier, C., & Consoli, S. (2005). Emotion-processing deficits in eating disorders. International Journal of Eating Disorders, 37(4), 321–329. doi:10.1002/eat.20132.

    Article  PubMed  Google Scholar 

  • Carlat, D. J., Camargo, C. A., Jr, & Herzog, D. B. (1997). Eating disorders in males: A report on 135 patients. American Journal of Psychiatry, 154(8), 1127–1132. doi:10.1176/ajp.154.8.1127.

    Article  PubMed  Google Scholar 

  • Cash, T. F., Morrow, J. A., Hrabosky, J. I., & Perry, A. A. (2004). How has body image changed? A cross-sectional investigation of college women and men from 1983–2001. Journal of Consulting and Clinical Psychology, 72(6), 1081–1089. doi:10.1037/0022-006X.72.6.1081.

    Article  PubMed  Google Scholar 

  • Chatterton, J. M., & Petrie, T. A. (2013). Prevalence of disordered eating and pathogenic weight control behaviors among male collegiate athletes. Eating Disorders, 21(4), 328–341. doi:10.1080/10640266.2013.797822.

    Article  PubMed  Google Scholar 

  • Clinton, D. (2006). Affect regulation, object relations and the central symptoms of eating disorders. European Eating Disorders Review, 14(4), 203–211. doi:10.1002/erv.710.

    Article  Google Scholar 

  • Cobb, K. L. (2008). Eating disorders in athletes: A review of the literature. In S. R. Bakere (Ed.), Hot topics in sports and athletics (pp. 17–50). New York, NY: Nova Science Publishers.

    Google Scholar 

  • Corson, P. W., & Andersen, A. E. (2002). Body image issues among boys and men. In T. F. Cash & T. Pruzinsky (Eds.), Body image: A handbook of theory, research, and practice (pp. 192–199). New York, NY: Guilford Press.

    Google Scholar 

  • Corstorphine, E., Mountford, V., Tomlinson, S., Waller, G., & Meyer, C. (2007). Distress tolerance in the eating disorders. Eating Behaviors, 8(1), 91–97. doi:10.1016/j.eatbeh.2006.02.003.

    Article  PubMed  Google Scholar 

  • Currie, A. (2010). Sport and eating disorders—Understanding and managing the risks. Asian Journal of Sports Medicine, 1(2), 63–68.

    Article  PubMed Central  PubMed  Google Scholar 

  • Engel, S. G., Johnson, C., Powers, P. S., Crosby, R. D., Wonderlich, S. A., Wittrock, D. A., & Mitchell, J. E. (2003). Predictors of disordered eating in a sample of elite Division I college athletes. Eating Behaviors, 4(4), 333–343. doi:10.1016/S1471-0153(03)00031-X.

    Article  PubMed  Google Scholar 

  • Erlanger, D. M., Kutner, K. C., Barth, J. T., & Barnes, R. (1999). Forum: Neuropsychology of sports-related head injury: Dementia Pugilistica to post concussion syndrome. Clinical Neuropsychology, 13(2), 193–209. doi:10.1076/clin.13.2.193.1963.

    Article  Google Scholar 

  • Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41(5), 509–528. doi:10.1016/S0005-7967(02)00088-8.

    Article  PubMed  Google Scholar 

  • Goossens, L., Braet, C., Van Vlierberghe, L., & Mels, S. (2009). Loss of control over eating in overweight youngsters: The role of anxiety, depression and emotional eating. European Eating Disorders Review, 17, 68–78.

  • Gordon, R. A. (2000). Eating disorders: Anatomy of a social epidemic (2nd ed.). Malden, MA: Blackwell.

    Google Scholar 

  • Hawkins, R. C., I. I., & Clement, P. F. (1984). Binge eating: Measurement problems and a conceptual model. In R. C. Hawkins II, W. J. Fremouw, & P. F. Clement (Eds.), The binge purge syndrome: Diagnosis, treatment, and research (pp. 229–251). New York, NY: Springer.

    Google Scholar 

  • Hepp, U., & Milos, G. (2002). Gender identity disorder and eating disorders. International Journal of Eating Disorders, 32(4), 473–478. doi:10.1002/eat.10090.

    Article  PubMed  Google Scholar 

  • Hildebrandt, T., Langenbucher, J., & Schlundt, D. G. (2004). Muscularity concerns among men: Development of attitudinal and perceptual measures. Body Image, 1(2), 169–181. doi:10.1016/j.bodyim.2004.01.001.

    Article  PubMed  Google Scholar 

  • Johnson, C., Crosby, R., Engel, S., Mitchell, J., Powers, P., Wittrock, D. A., & Wonderlich, S. (2004). Gender, ethnicity, self-esteem and disordered eating among college athletes. Eating Behaviors, 5(2), 147–156. doi:10.1016/j.eatbeh.2004.01.004.

    Article  PubMed  Google Scholar 

  • Kaminski, P. L. (2004). The male eating behaviors and body image evaluation, version 2 (MEBBIE-2). Unpublished instrument available from the author: P. L. Kaminski, Department of Psychology, P.O. Box 311280, University of North Texas, Denton, TX 76203-1280 or Kaminski@unt.edu.

  • Kearney-Cooke, A., & Steichen-Asch, P. (1990). Men, body image, and eating disorders. In A. E. Andersen (Ed.), Males with eating disorders (pp. 54–74). New York, NY: Brunner/Mazel.

    Google Scholar 

  • Knowlton, L. (2009). Eating disorders in males. In K. J. Mayberry (Ed.), Everyday arguments: A guide to writing and reading effective arguments (3rd ed., pp. 100–102). Boston, MA: Houghton Mifflin (Reprinted from Psychiatric Times, 12(9), 1995).

  • Lanzieri, N., & Cook, B. J. (2013). Examination of muscularity and body fat depictions in magazines that target heterosexual and gay men. Body Image, 10(2), 251–254. doi:10.1016/j.bodyim.2012.12.003.

    Article  PubMed  Google Scholar 

  • Littleton, H. L., & Ollendick, T. (2003). Negative body image and disordered eating behavior in children and adolescents: What places youth at risk and how can these problems be prevented? Clinical Child and Family Psychology Review, 6(1), 51–56. doi:10.1023/A:1022266017046.

    Article  PubMed  Google Scholar 

  • Mangweth, B., Pope, H. G., Jr, Kenmler, G., Ebenbichler, C., Hausmann, A., De Col, C., & Biebl, W. (2001). Body image and psychopathology in male bodybuilders. Psychotherapy and Psychosomatics, 70(1), 38–43. doi:10.1159/000056223.

    Article  PubMed  Google Scholar 

  • Mayo, C., & George, V. (2014). Eating disorder risk and body dissatisfaction based on muscularity and body fat in male university students. Journal of American College Health, 62(6), 407–415. doi:10.1080/07448481.2014.917649.

    Article  PubMed  Google Scholar 

  • McCabe, M. P., & Ricciardelli, L. A. (2001). Body image and body change techniques among adolescent boys. European Eating Disorders Review, 9(5), 335–347. doi:10.1002/erv.389.

    Article  Google Scholar 

  • Mendez, M. F. (1995). The neuropsychiatric aspects of boxing. International Journal of Psychiatry in Medicine, 25(3), 249–262. doi:10.2190/CUMK-THT1-X98M-WB4C.

    Article  PubMed  Google Scholar 

  • Mickalide, A. D. (1990). Sociocultural factors influencing weight among males. In A. E. Andersen (Ed.), Males with eating disorders (pp. 30–39). New York, NY: Brunner/Mazel.

    Google Scholar 

  • Mitchell, J. E., & Goff, G. (1984). A series of twelve adult male patients with bulimia. Psychosomatics, 25(12), 909–913.

    Article  PubMed  Google Scholar 

  • Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., & Ljungqvist, A. (2014). The IOC consensus statement: Beyond the female athlete triad—Relative energy deficiency in sport (RED-S). British Journal of Sports Medicine, 48(7), 491–497. doi:10.1136/bjsports-2014-093502.

    Article  PubMed  Google Scholar 

  • Mussap, A. J. (2008). Masculine gender role stress and the pursuit of muscularity. International Journal of Men’s Health, 7(1), 72–87. doi:10.3149/jmh.0701.72.

    Article  Google Scholar 

  • Neumark-Sztainer, D., & Eisenberg, M. E. (2014). Body image concerns, muscle-enhancing behaviors, and eating disorders in males. JAMA, 312(20), 2156–2157. doi:10.1001/jama.2014.5138.

    Article  PubMed  Google Scholar 

  • Olivardia, R., Pope, H. G., Jr., Borowiecki, J. J., I. I. I., & Cohane, G. H. (2004). Biceps and body image: The relationship between muscularity and self-esteem, depression, and eating disorder symptoms. Psychology of Men and Masculinity, 5(2), 112–120. doi:10.1037/1524-9220.5.2.112.

    Article  Google Scholar 

  • Olivardia, R., Pope, H. G., Jr, & Hudson, J. I. (2000). Muscle dysmorphia in male weightlifters: A case control study. American Journal of Psychiatry, 157(8), 1291–1296. doi:10.1176/appi.ajp.157.8.1291.

    Article  PubMed  Google Scholar 

  • Omalu, B. I., Hamilton, R. L., Kamboh, M. I., DeKosky, S. T., & Bailes, J. (2010). Chronic traumatic encephalopathy (CTE) in a National Football League player: Case report and emerging medicolegal practice questions. Journal of Forensic Nursing, 6(1), 40–46. doi:10.1111/j.1939-3938.2009.01064.x.

    Article  PubMed  Google Scholar 

  • Ousley, L., Cordero, E. D., & White, S. (2008). Eating disorders and body image of undergraduate men. Journal of American College Health, 56(6), 617–621. doi:10.3200/JACH.56.6.617-622.

    Article  PubMed  Google Scholar 

  • Parks, P. S., & Read, M. H. (1997). Adolescent male athletes: Body image, diet, and exercise. Adolescence, 32(127), 593–602.

    PubMed  Google Scholar 

  • Polivy, J., & Herman, C. P. (1993). Etiology of binge eating: Psychological mechanisms. In C. G. Fairburn & G. T. Wilson (Eds.), Binge eating: Nature, assessment, and treatment (pp. 173–205). New York, NY: Guilford Press.

    Google Scholar 

  • Pope, H. G., Jr, Gruber, A. J., Choi, P., Olivardia, R., & Phillips, K. A. (1997). Muscle dysmorphia: An underrecognized form of body dysmorphic disorder. Psychosomatics, 38(6), 548–557. doi:10.1016/S0033-3182(97)71400-2.

    Article  PubMed  Google Scholar 

  • Pope, H. G., Jr, Gruber, A. J., Mangweth, B., Bureau, B., deCol, C., Jouvent, R., & Hudson, J. I. (2000a). Body image perception among men in three countries. American Journal of Psychiatry, 157(8), 1297–1301. doi:10.1176/appi.ajp.157.8.1297.

    Article  PubMed  Google Scholar 

  • Pope, H. G., Jr, Phillips, K. A., & Olivardia, R. (2000b). The Adonis complex: The secret crisis of male body obsession. New York, NY: Free Press.

    Google Scholar 

  • Pruzinsky, T., & Cash, T. F. (2002). Understanding body image: Historical and contemporary perspectives. In T. F. Cash & T. Pruzinsky (Eds.), Body image: A handbook of theory, research, and clinical practice (pp. 3–12). New York, NY: Guilford Press.

    Google Scholar 

  • Raevuori, A., Keski-Rahkonen, A., & Hoek, H. W. (2014). A review of eating disorders in males. Current Opinion in Psychiatry, 27(6), 426–430. doi:10.1097/YCO.0000000000000113.

    Article  PubMed  Google Scholar 

  • Reel, J. J., Petrie, T. A., SooHoo, S., & Anderson, C. M. (2013). Weight pressures in sport: Examining the factor structure and incremental validity of the weight pressures in sport—females. Eating Behaviors, 14(2), 137–144. doi:10.1016/j.eatbeh.2013.01.003.

    Article  PubMed  Google Scholar 

  • Ricciardelli, L. A., & McCabe, M. P. (2003). Sociocultural and individual influences on muscle gain and weight loss strategies among adolescent boys and girls. Psychology in the Schools, 40(2), 209–224. doi:10.1002/pits.10075.

    Article  Google Scholar 

  • Sanford-Martens, T. C., Davidson, M. M., Yakushko, O. F., Martens, M. P., Hinton, P., & Beck, N. (2005). Clinical and subclinical eating disorders: An examination of collegiate athletes. Journal of Applied Sport Psychology, 17(1), 79–86. doi:10.1080/10413200590907586.

    Article  Google Scholar 

  • Schore, A. N. (1994). Affect regulation and the origin of the self: The neurobiology of emotional development. Hillsdale, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  • Shafran, R., & de Silva, P. (2003). Cognitive-behavioural models. In J. Treasure, U. Schmidt, & E. Van Furth (Eds.), Handbook of eating disorders (2nd ed., pp. 121–139). Southern Gate, Chichester, UK: Wiley. doi:10.1002/0470013443.ch7

  • Stice, E. (2002). Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin, 128(5), 825–848. doi:10.1037//0033-2909.128.5.825.

    Article  PubMed  Google Scholar 

  • Symbaluk, D. G. (1996). The effects of food restriction and training on male athletes. In W. F. Epling & W. D. Pierce (Eds.), Activity anorexia: Theory, research, and treatment (pp. 147–159). Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Thompson, R. A., & Sherman, R. T. (1993). Helping athletes with eating disorders. Champaign, IL: Human Kinetics Publishers.

    Google Scholar 

  • Thompson, R. A., & Sherman, R. T. (2010). Eating disorders in sport. New York, NY: Routledge.

    Google Scholar 

  • Wade, T. D., Keski-Rahkonen, A., & Hudson, J. I. (2011). Epidemiology of eating disorders. In M. Tsuang, M. Tohen, & P. B. Jones (Eds.), Textbook in psychiatric epidemiology (3rd ed., pp. 343–360). New York, NY: Wiley.

    Chapter  Google Scholar 

  • Weltzin, T. E., Cornella-Carson, T., Fitzpatrick, M. E., Kennington, B., Bean, P., & Jefferies, C. (2012). Treatment issues and outcomes for males with eating disorders. Eating Disorders, 20(5), 444–459. doi:10.1080/10640266.2012.715527.

    Article  PubMed  Google Scholar 

  • Wheeler, G. (1996). Exercise, sports, and anorexia. In W. F. Epling & W. D. Pierce (Eds.), Activity anorexia: Theory, research, and treatment (pp. 159–176). Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Woodside, D. B., Garfinkle, P. E., Lin, E., Goering, P., Kaplan, A. S., Goldbloom, D. S., & Kennedy, S. H. (2001). Comparisons of men with full or partial eating disorders, men without eating disorders, and women with eating disorders in the community. American Journal of Psychiatry, 158(4), 570–574. doi:10.1176/appi.ajp.158.4.570.

    Article  PubMed  Google Scholar 

  • Yager, Z., & O’Dea, J. A. (2014). Relationship between body image, nutritional supplement use, and attitudes toward doping in sport among adolescent boys: Implications for prevention programs. Journal of the International Society of Sports Nutrition, 11, 13. doi:10.1186/1550-2783-11-13.

    Article  PubMed Central  PubMed  Google Scholar 

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  1. The Center for the Study of Anorexia and Bulimia, 152 Madison Avenue, Suite 1000, New York, NY, 10016, USA

    Lisa DeFeciani

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  1. Lisa DeFeciani
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DeFeciani, L. Eating Disorders and Body Image Concerns Among Male Athletes. Clin Soc Work J 44, 114–123 (2016). https://doi.org/10.1007/s10615-015-0567-9

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