My 16-year-old son has embraced fitness during the pandemic. I think it’s great! He’s not getting into trouble, he eats better than he used to, and he’s slimmed down. He doesn’t seem overly focused on his diet or weight, and he seems to be eating all the time.
But when I hear him talk about trying to get a personal best on the rower, or how he is not going to have chips at his Nana’s house, something in me tweaks. How can I know if disordered eating is beginning? How can I talk about food with him in a helpful way?
Signed, Boys and Body Image
Dear Boys and Body Image,
I am so glad you asked this question. We hear so much about girls and their body image issues that we often forget that our boys can struggle, too. While girls tend to focus on thinness, boys are constantly seeing images of men with chiseled six-pack abs. They can feel self-conscious about their body shape and want to achieve this unrealistic male body ideal.
It’s estimated that about one quarter to one third of those diagnosed with eating disorders are males, but boys often go unnoticed because it has a different presentation. Being a gym rat and working out constantly are status behaviours that make a boy seem more “masculine” and “competitive.”
There are also more forms of disordered eating than just anorexia and bulimia. Orthorexia, as an example, is a lesser-known disorder. It involves the obsession with healthy eating, so much so that it can compromise one’s health and well-being. Here is a list of behaviours from the National Eating Disorders Association associated with orthorexia:
- Compulsive checking of ingredient lists and nutritional labels
- An increase in concern about the health of ingredients
- Cutting out an increasing number of food groups (sugar, carbs, dairy, meat, animal products)
- An inability to eat anything but a narrow group of foods that are deemed “healthy” or “pure”
- Unusual interest in the health of what others are eating
- Spending hours every day thinking about what food might be served at upcoming events
- Showing high levels of distress when “safe” or “healthy” foods aren’t available
- Obsessive following of food and “healthy lifestyle” blogs on Twitter and Instagram
Clearly there’s a vigilance and rigidity that feels compulsive: if someone with orthorexia doesn’t follow their eating protocols, they act as if it’s a dire situation. From the short description you shared, it doesn’t seem seem he has crossed the line into disordered eating, but it’s good that it’s on your radar!
You might want to alert your son to the fact that people’s thoughts and behavioural patterns around food can move along a continuum until they cross a line where they become more harmful than helpful. Share with him that you are concerned he could potentially cross a line into the unhealthy zone. Ask if he’s thought about that, and if he’s concerned? He may not even know that men can have disorders of this type. At this point, it can just be a friendly check-in to share information.
Another behaviour of your son’s that you were concerned about was his competitive need to beat a personal best. That, too, is part of training/gym culture. Many gyms make use of leaderboards, tracking apps, or social apps that allow people to post and track their progress.
So, just as girls in ballet and dance are more likely to have eating disorders, men in certain sports programs — like body building — also have higher likelihoods. When does it cross the line into a disorder? The major flag for any disorder is whether it is interfering with functioning. So here is another list from NEDA you can check from:
- Exercise that significantly interferes with important activities, occurs at inappropriate times or in inappropriate settings, or when the individual continues to exercise despite injury or other medical complications
- Intense anxiety, depression, irritability, feelings of guilt, and/or distress if unable to exercise
- Maintains excessive, rigid exercise regimen despite weather, fatigue, illness, or injury
- Discomfort with rest or inactivity
- Exercise used to manage emotions
- Exercise as a means of purging (needing to “get rid of” or “burn off” calories)
- Exercise as permission to eat
- Exercise that is secretive or hidden
- Feeling as though you are not good enough, fast enough or not pushing hard enough during a period of exercise; overtraining
- Withdrawal from friends and family
If you are concerned, share this list with your son and see if he feels that he ticks a few too many of criteria. Ask him to consider pulling back on his workouts until they are in the normal, healthy zone. Perhaps consider working with a skilled trainer who could set him up on a program that doesn’t overtax him. And if you’re still concerned, speak to your family doctor and seek counselling support.
The bigger issue is convincing a boy with an eating disorder to get help. Because it’s supposedly a “girl’s issue,” the stigma can be intense. Sadly, there are fewer all-male programs to treat eating disorders, and being in a mixed class with mostly girls might be uncomfortable for boys. Men are less likely to seek treatment for mental health issues in general, because having issues that need help is seen as a sign of weakness, which is a violation to the social code that men must be strong and independent. It’s just another example of toxic masculinity and how our boys can suffer quietly. I’m so glad you are paying attention and keeping a keen eye out for him.