Cultural Implications Of Male Anorexia

Introduction

For years the media have beckoned us to achieve a certain physical ideal. As the male physique increasingly becomes in demand for selling every product from soda to underwear, so too does the pressure to conform to a specific body type.

One reason for the misdiagnosis of male anorexia is due to the criteria used in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994). Anderson stated, "The diagnosis of males with eating disorders is usually a straightforward process, but as with appendicitis, you have to first think of it as a possibility" (p. 133). One of the hallmark features used to diagnose anorexia is amenorrhea, but currently there is no analogous criterion for males. Instead the endocrine disturbance males encounter is a general decline in the levels of testosterone production, which results in diminished sexual desire and performance (Carlat et al., p72; Herzog, p 72). Research has examined hypogonadism and has discovered that a reduction in gonadotropin secretion in anorexic males may be a corresponding feature to amenorrhea (Burge, p783).

Goldfield, Harper, and Blouin (p. 133) suggested that an increase in body-building and weightlifting has paralleled sociocultural norms with a meso-morphic build as the new ideal male body type. They further attested that individuals with eating disorders are likely to gravitate towards this type of sport to compensate for their body image disturbances and achieve personal and societal standards of attractiveness.

It is estimated that males generally account for 5% to 10% of reported cases of anorexia nervosa (Alexander-Mott, p101; Anorexia Nervosa and Related Eating Disorders, Inc., 1998). These figures must be viewed with caution however, because this disorder is likely underreported and misdiagnosed in the male population.

Dorian and Garfinkel (p187) reported:

Anorexia nervosa and bulimia nervosa have been considered to be influenced by cultural forces; as these forces change, the disorders themselves may be altered. ... Awareness of the impact of sociocultural forces is critical to enhancing the understanding of the etiology and pathogenesis and to informing models of care. (p.187)

Current literature is saturated with numerous explanations, causes, treatments, and prevention of anorexia nervosa. Despite voluminous articles, papers, and books written on this topic, little mention is ever made to males. Keel, Fulkerson, and Leon (p 203) reported their search of the literature revealed no studies of eating disorders in early adolescent males, and most research on predictors of eating disorders has been based on female samples. As a result, these findings may not generalize to males. In fact, there may be other factors present in predicting poor body image, low self-esteem, and resulting eating disorders in males. It is essential to determine the existence of any gender differences that might be affecting body image as a means of providing more appropriate prevention and intervention in this population. Kinzl, Mangweth, Traweger, and Biebl (p, 131) lamented the lack of studies performed with males. Keel et al. (p 203) suggested how boys feel about their bodies can influence ...