Eating disorders in adolescent males

Professional School Counseling, Oct, 2004 by Shannon L. Ray

Sexual Identity

The relationship between sexual identity and eating disorders remains unclear; however, several studies posit that male homosexuals are at increased risk for developing eating disorders (Buroughs & Thompson, 2001; Walcott et al., 2003). Sexual isolation, sexual inactivity, and disturbed sexual identification have also been linked to the clinical population of eating disordered males. Buroughs and Thompson examined the sexual orientation of anorexic and bulimic males and found that the prevalence of homosexuality in the sample population was significantly higher than that of the general male population. The authors suggested that one possible explanation for their findings was the subversion of sexual conflict resulting from the side effect of decreased libido. Additionally, homosexual males may be more at risk for the development of eating disorders due to a heightened emphasis on physical attractiveness (Walcott et al.).

Manley, Rickson, and Standeven (2000) reported that boys present with anorexia at a significantly higher percentage than adult males, although they point out that the reasons for the growing prevalence in boys remains unclear. They comment on this possibly resulting from burgeoning sexual conflict emerging in the adolescent period. The lack of knowledge regarding the sexual characteristics of boys and men with eating disorders underscores the need for further research (Scheider, 1991; Walcott et al., 2003). Knowledge of the existing research in this area can benefit school counselors by providing them with an awareness of the additional risk that homosexual youth may face for the development of an eating disorder. This knowledge assists the school counselor with identification and represents the first step in the treatment process.

Mental Disorders

Co-morbid mental disorders that may provide warning signs for adolescent males at risk for the development of an eating disorder include: Mood Disorders, Substance Abuse and Dependence, and Personality Disorders (American Psychiatric Association, 2000). Specifically, a plethora of research studies displayed a predisposition to eating disorders among those diagnosed with depression (e.g., Fischer et al., 1995; Lyon & Chatoor, 1997; Moreno & Thelen, 1995; Nassar & Hodges, 1992; Pratt, Phillips, Greydanus, Pratt, & Patel, 2003; Pryor & Weiderman, 1998).

Features of Obsessive Compulsive Disorder are frequently seen in individuals suffering from anorexia and bulimia. The obsessive-compulsive behaviors focus on food, body image, and weight. Also, impulse control issues remain prevalent in males with bulimia; this links with Substance Abuse and Cluster B Personality Disorders such as Borderline, Histrionic, and Narcissistic as individuals with these diagnoses also display poor impulse control (American Psychiatric Association, 2000).

As with Personality Disorders and Mood Disorders, low self-esteem is often reported in eating disordered clients. This has been demonstrated in both subjective and objective accounts (American Psychiatric Association, 2000; Nassar & Hodges, 1992). School counselors aware of the link between eating disorders and the diagnoses enumerated in this section will have relevant information to assist them with accurate identification of students at risk.