I was at a dinner party a few weeks ago when a mother of a boy in his late teens expressed concern about his gym-going routine, strict high-protein diet and his current “shredding”. (That’s the rapid weight loss efforts body builders do before a competition, not what one does with confidential documents!)
The other mums present reassured her that he was pursuing a healthy hobby - surely there were far worse things he could be doing than going to the gym and eating healthy food.
Therein lies a danger of 'bigorexia', the colloquial label for body dysmorphic disorder causing boys and young men to think they are too small.
Most people think only girls and young women are affected by eating disorders. It may surprise many to learn that of the approximately three million Australians who have an eating disorder, 25% of those, or about 750,000, are male.
Body image issues among young men remain hidden under the radar of public attention because an active interest with muscularity is not necessarily perceived as a problem.
But the red flags go up when bodybuilding starts to impinge on other areas of a boy’s life: they won’t go out and eat with friends because they don’t know the nutritional value of the food they may have to eat, they become anxious or agitated if they have to miss a training session for a family event or they train through injury out of worry their muscles will shrink.
Perth psychologist Scott Nodwell of Claremont’s Elizabeth Clinic says a major problem is that body dysmorphia is the only socially sanctioned mental health issue, with ‘ripped’ bodies common in advertising and social media especially.
Interestingly, eating disorder expert Scott Griffiths, from the University of Melbourne School of Psychological Sciences, adds the action figures of 30 years ago are significantly less muscular and less disproportionate than those marketed to young boys today.
Mr Nodwell, also sees the problem as a reflection of shifts in what it now means to be male. While the move towards greater gender equality is welcome, the changes have taken away some of the sense of belonging and security for men, including young men. He says boys must now place much more focus on the intellectual and emotional spheres of their lives.
“The expectations on boys can be crushing, especially towards the end of school,” Mr Nodwell says.
“The only way to differentiate yourself beyond school grades is to put on size.
“Guys often feel powerless and seek to compensate by trying to be, or at least look, powerful, with sport and activities such as bodybuilding now the only socially endorsed way to reconnect with ‘the primitive brain’.”
Another hurdle is that boys and young men are less likely to recognise those problems in themselves.
Even if they do think it’s a problem, going to seek help from a GP or a psychologist is at odds with the traditional view of the self-reliant male. Meanwhile, health professionals are less likely to recognise or ask boys about body dysmorphia. Girls with eating disorders, on the other hand, tend to have more obvious symptoms.
From his clinical experience, Mr Nodwell says feelings of self-worth can often come into play, with the inner-critic voice, parents and society.
“Therapy can involve looking at what things - the wounds, feelings of insufficiency, failure and lack - in their past made them doubt themselves.”
He says that when boys do come into therapy, what also works is helping them determine a sense of how their past has led them to where and who they are now. This means helping boys to see themselves as the hero in their journey instead of a victim - whatever their body type.
For general information and support about eating disorders and body image issues, contact The Butterfly Foundation on their National Helpline: 1800 33 4673 (1800 ED HOPE) or email firstname.lastname@example.org
Dr Griffiths has found the treatment that has already been developed for other eating and body image disorders such as anorexia and bulimia is generally effective for muscle dysmorphia.