Abstract
Purpose of Review
There is growing recognition that eating disorder (ED) symptoms, particularly those of a muscularity-oriented nature, are more common in men than previously understood. The purpose of the current review is to describe contemporary directions and implications of research on traditional and muscularity-oriented ED symptoms among males.
Recent Findings
Evidence indicates that ED symptoms occur in a substantial minority of men. Importantly, recent research has focused on muscularity-oriented body image and disordered eating in males, demonstrating the prevalence, correlates, and consequences of maladaptive muscularity-oriented attitudes and behaviors. A growing number of assessments are available to measure these constructs in males, and preliminary treatment considerations have begun to be addressed in the literature.
Summary
Research on male EDs and body image is increasingly focusing on muscularity-oriented manifestations. Continued empirical work will be critical to improve our understanding of the onset, maintenance, and treatment of muscularity-oriented disordered eating in males.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
Wooldridge T. Understanding anorexia nervosa in males: an integrative approach. New York: Routledge; 2016.
Hudson JI, Hiripi E, Pope HG, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey replication. Biol Psychiatry. 2007;61:349–58.
Mitchison D, Hay P, Slewa-Younan A, Mond JM. The changing demographic profile of eating disorder behaviors in the community. BMC Public Health. 2014;14:943.
•• Murray SB, Griffiths S, Mond JM. Evolving eating disorder psychopathology: conceptualizing muscularity-oriented disordered eating. Br J Psychiatry. 2016;208:414–5. This article addresses the diagnostic and clinical implications of the distinctive nature of disordered eating presentations in males
Drewnowski A, Yee DK. Men and body image: are males satisfied with their body weight? Psychosom Med. 1987;49:626–34.
Furnham A, Calnan A. Eating disturbance, self-esteem, reasons for exercising and body weight dissatisfaction in adolescent males. Eur Eat Disord Rev. 1998;6:58–72.
Pope HG, Phillips KA, Olivardia R. The Adonis complex: the secret crisis of male body obsession. New York: Free Press; 2000.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.
Murray SB, Rieger E, Touyz SW, De la Garza García Y. Muscle dysmorphia and the DSM-V conundrum: where does it belong? A review paper. Int J Eat Disord. 2010;43:483–91.
Eisenberg MA, Wall M, Nuemark-Sztainer D. Muscle-enhancing behaviors among adolescent girls and boys. Pediatrics. 2012;130:1019–26.
Murray SB, Rieger E, Hildebrandt T, Karlov L, Russell J, Boon E, Dawson RT, Touyz SW. A comparison of eating, exercise, shape, and weight related symptomatology in males with muscle dysmorphia and anorexia nervosa. Body Image. 2012;9:193–200.
Murray SB, Rieger E, Touyz SW. Muscle dysmorphia symptomatology during a period of religious fasting: a case report. Eur Eat Disord Rev. 2011;19:162–8.
Murray SB, Touyz SW. How do clinicians in the field conceptualize muscle dysmorphia? Adv Eat Disord. 2013;1:207–12.
Calzo JP, Horton NJ, Sonneville KR, Swanson SA, Crosby RD, Micali N, Eddy KT, Field AE. Male eating disorder symptom patterns and health correlates from 13 to 26 years of age. J Am Acad Child Adolesc Psychiatry. 2016;55:693–700.
Compte EJ, Sepulveda AR, Torrente F. A two-stage epidemiological study of eating disorders and muscle dysmorphia in male university students in Buenos Aires. Int J Eat Disord. 2015;48:1092–101.
Griffiths S, Murray SB, Touyz SW. Disordered eating and the muscular ideal. J Eat Disord. 2013;1:15.
Murray SB, Maguire S, Russell J, Touyz SW. The emotional regulatory features of bulimic episodes and compulsive exercise in muscle dysmorphia: a case report. Eur Eat Disord Rev. 2012;20:68–73.
Murray SB, Griffiths S, Hazery L, Shen T, Wooldridge T, Mond JM. Go big or go home: a thematic content analysis of pro-muscularity websites. Body Image. 2016;16:17–20.
Pila E, Mond JM, Griffiths S, Mitchison D, Murray SB. A thematic content analysis of #cheatmeal images on social media: characterizing an emerging trend. Int J Eat Disord. doi:10.1002/eat.22671.
Cash TF. The multidimensional body self-relations questionnaire user’s manual. Available from the author’s website at www.body-images.com; 2000.
Tylka TL, Bergeron D, Schwartz JP. Development and psychometric evaluation of the male body attitudes scale (MBAS). Body Image. 2005;2:161–75.
Brown TA, Cash TA, Mikulka PJ. Attitudinal body-image assessment: factor analysis of the Body-Self Relations Questionnaire. J Pers Assess. 1990;55:135–44.
Pickett TC, Lewis RJ, Cash TF. Men, muscles, and body image: comparisons of competitive bodybuilders, weight trainers, and athletically active controls. Br J Sports Med. 2005;39:217–22.
Blashill AJ, Vander Wal JD. The Male Body Attitudes Scale: a confirmatory factor analysis with a sample of gay men. Body Image. 2009;6:322–5.
Smith AR, Hawkeswood SE, Bodell LP, Joiner TE. Muscularity versus leanness: an examination of body ideals and predictors of disordered eating in heterosexual and gay college students. Body Image. 2011;8:232–6.
Hildebrandt T, Langenbucher J, Schlundt DG. Muscularity concerns among men: development of attitudinal and perceptual measures. Body Image. 2004;1:169–81.
McCreary DR, Sasse DK. An exploration of the drive for muscularity in adolescent boys and girls. J Am Coll Heal. 2000;48:297–304.
Smolak L, Murnen SK. Drive for leanness: assessment and relationship to gender, gender role and objectification. Body Image. 2008;5:251–60.
Rhea DJ, Lantz CD, Cornelius AE. Development of the Muscle Dysmorphia Inventory (MDI). J Sports Med Phys Fitness. 2004;44:428–35.
Mayville SB, Williamson DA, White MA, Netemeyer RG, Drab DL. Development of the Muscle Appearance Satisfaction Scale: a self-report measure for the assessment of muscle dysmorphia symptoms. Assessment. 2002;9:351–60.
McCreary DR, Sasse DK, Saucier DM, Dorsch KD. Measuring the drive for muscularity: factorial validity of the drive for muscularity scale in men and women. Psychol Men Masc. 2004;5:49–58.
Pope HG, Gruber AJ, Choi P, Olivardia R, Phillips KA. Muscle dysmorphia: an underrecognized form of body dysmorphic disorder. Psychosomatics. 1997;38:548–57.
Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. 1994;16:363–70.
Stanford SC, Lemberg R. Measuring eating disorders in men: development of the eating disorder assessment for men (EDAM). Eat Disord. 2012;20:427–36.
•• Forbush KT, Wildes JE, Pollack LO, Dunbar D, Luo J, Patterson K, Petruzzi L, Pollpeter M, Miller H, Stone A, Bright A, Watson D. Development and validation of the Eating Pathology Symptoms Inventory (EPSI). Psychol Assess. 2013;25:859–78. This study describes the development of a new measure that addresses both traditional and muscularity-oriented eating symptoms
Berg KC, Peterson CB, Frazier P, Crow SJ. Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature. Int J Eat Disord. 2012;45:428–38.
Lavender JM, De Young KP, Anderson DA. Eating disorder examination questionnaire (EDE-Q): norms for undergraduate men. Eat Behav. 2010;11:119–21.
Reas DL, Øverås M, Rø Ø. Norms for the eating disorder examination questionnaire (EDE-Q) among high school and university men. Eat Disord. 2012;20:437–43.
Smith KE, Mason TB, Murray SB, Griffiths S, Leonard R, Wetterneck C, Smith B, Farrell N, Riemann B, Lavender JM. Male clinical norms and sex differences on the Eating Disorder Inventory (EDI) and Eating Disorder Examination Questionnaire (EDE-Q). Int J Eat Disord. Forthcoming 2017.
Forbush KT, Wildes JE, Hunt TK. Gender norms, psychometric properties, and validity for the eating Pathology symptoms Inventory. Int J Eat Disord. 2014;47:85–91.
Thompson KJ, Pasman L. The Obligatory Exercise Questionnaire. Behav Ther. 1991;14:137.
Taranis L, Touyz S, Meyer C. Disordered eating and exercise: development and preliminary validation of the Compulsive Exercise Test (CET). Eur Eat Disord Rev. 2011;19:256–68.
Hildebrandt T, Walker DC, Alfano L, Delinsky S, Bannon K. Development and validation of a male specific body checking questionnaire. Int J Eat Disord. 2010;43:77–87.
Pasman L, Thompson JK. Body image and eating disturbance in obligatory runners, obligatory weightlifters, and sedentary individuals. Int J Eat Disord. 1988;7:759–69.
Goodwin H, Haycraft E, Taranis L, Meyer C. Psychometric evaluation of the compulsive exercise test (CET) in an adolescent population: links with eating psychopathology. Eur Eat Disord Rev. 2011;19:269–79.
Walker DC, Anderson DA, Hildebrandt T. Body checking behaviors in men. Body Image. 2009;6:164–70.
Watson HJ, Joyce T, French E, Willan V, Kane RT, Tanner-Smith EE, McCormack J, Dawkins H, Hoiles KJ, Egan SJ. Prevention of eating disorders: a systematic review of randomized, controlled trials. Int J Eat Disord. 2016;49:833–62.
Brown TA, Keel PK. A randomized controlled trial of a peer co-led dissonance-based eating disorder prevention program for gay men. Behav Res Ther. 2015;74:1–10.
Kilpela LS, Blomquist K, Verzijl C, Wilfred S, Beyl R, Becker CB. The body project 4 all: a pilot randomized controlled trial of a mixed-gender dissonance-based body image program. Int J Eat Disord. 2016;49:591–602.
Brown TA, Forney KJ, Pinner D, Keel PK. A randomized controlled trial of the body project: more than muscles for males with body dissatisfaction. Int J Eat Disord. Forthcoming 2017.
Lammers MW, Vroling MS, Ouwens MS, Engels RC, Strien T. Predictors of outcome for cognitive behaviour therapy in binge eating disorder. Eur Eat Disord Rev. 2015;23:219–28.
Le Grange D, Lock J, Agras WS, Bryson SW, Jo B. Randomized clinical trial of family-based treatment and cognitive-behavioral therapy for adolescent bulimia nervosa. J Am Acad Child Adolesc Psychiatry. 2015;54:886–94.
•• Weltzin TE, Cornella-Carlson T, Fitzpatrick ME, Kennington B, Bean P, Jefferies C. Treatment issues and outcomes for males with eating disorders. Eat Disord. 2012;20:444–59. This study describes important issues related to treatment of males with eating disorders, and presents outcome data from a sample of males that received residential eating disorder treatment
Weltzin T, Bean P, Klosterman E, Lee HJ, Welk-Richards R. Sex differences in the effects of residential treatment on the quality of life of eating disorder patients. Eat Weight Disord. 2015;20:301–10.
Shingleton RM, Thompson-Brenner H, Thompson DR, Pratt EM, Franko DL. Gender differences in clinical trials of binge eating disorder: an analysis of aggregated data. J Consult Clin Psychol. 2015;83:382–6.
Lock J, Le Grange D. Treatment manual for anorexia nervosa: a family-based approach. 2nd ed. New York: Guilford Press; 2013.
Murray SB, Griffiths S. Adolescent muscle dysmorphia and family-based treatment: a case report. Clin Child Psychol Psychiatr. 2015;20:324–30.
Murray SB, Griffiths S, Mitchison D, Mond JM. The transition from thinness-oriented to muscularity-oriented disordered eating in adolescent males: a clinical observation. J Adolesc Health. 2017;60:353–5.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
This article is part of the Topical Collection on Eating Disorders
Rights and permissions
About this article
Cite this article
Lavender, J.M., Brown, T.A. & Murray, S.B. Men, Muscles, and Eating Disorders: an Overview of Traditional and Muscularity-Oriented Disordered Eating. Curr Psychiatry Rep 19, 32 (2017). https://doi.org/10.1007/s11920-017-0787-5
Published:
DOI: https://doi.org/10.1007/s11920-017-0787-5