Since last century, the American model of manhood has morphed from the iron-hatted John Wayne or irascibly hard-drinking Zorba the Greek to something more like Batman—hard, muscular, and well-read. Real men are batmen. More than ever, boys and men grown in America obsess over their weight and physique; beyond mere concerns about strength and fighting fitness, it is about image.

Although presumed the reserve of teenage girls, eating disorders among adolescent boys continues to rise with nearly one in five described as inordinately concerned about weight and physique, an obsession linked to a greater propensity for risky behaviors such as drinking and drugging. In a new look across the United States, researchers from Boston Children’s Hospital say 17.9 percent of adolescent boys report unhealthy self-perceptions—with a twist.

Whereas girls mostly focus on thinness and “thigh gap,” boys tend to idealize muscularity over thinness for an ideal male body type closer to Adonis than standard metrics for the physically fit male form. In a longitudinal study of more than 5,500 adolescent boys from across the country, 9.2 percent reported high concerns with muscularity, compared with only 2.5 percent who worried about thinness. Six-point-three percent worried about both aspects of appearance.

"Males and females have very different concerns about their weight and appearance," lead investigator Alison Field, says. “Evaluations for eating disorders have been developed to reflect girls' concerns with thinness but not boys' concerns, which may be more focused on muscularity than thinness.”

Those differences make sense, as both sexes strive for idealized images of sexual dimorphism, boys bigger than girls—though the updated versions might include, for both sexes, a strong core and nice quads. Far more than girls, boys reported using nutritional supplements, growth hormone, and steroids to enhance their physique. A smaller minority of boys concerned primarily with thinness, researchers observed, were more likely to become depressed, whereas the others tended toward riskier, outward-looking behaviors.

Nearly a third of boys studied reported at least some unhealthy eating behaviors, including infrequent rates of overeating, binge eating, or purging. But 2.9 percent of adolescent boys acknowledged symptoms indicating a full or partial binge-eating disorder.

"Clinicians may not be aware that some of their male patients are so preoccupied with their weight and shape that they are using unhealthy methods to achieve the physique they desire, and parents are not aware that they should be as concerned about eating disorders and an excessive focus on weight and shape in their sons as in their daughters," Field says.

Overall, 10 million American men have experienced some semblance of eating disorder during their lives, according to the National Eating Disorders Association, referring to the phenomenon as a “silent epidemic.” A 2011 study of college students reported eating disorder prevalence at a 3 to 1 ratio of women to men, with 4-10 percent of young men experiencing an eating disorder. However, as many as 43 percent of college men expressed dissatisfaction with their bodies, according to two other studies.

Similarly, a French study published late last month shows as many as 17 percent of young men ages 18-30 acknowledge an eating disorder, with 1.5 percent meeting diagnostic criteria for a serious clinical disorder.

Little wonder the rise in eating disorders among boys and men, some say, as mass media shapes our self-perceptions increasingly more—images of ripped abs, quads, and chiseled facial features ingrained in the mind. Whether normative or not, for good or bad, that now ubiquitous jar of chocolate whey protein lurks within the kitchen cupboard. More study is needed.


Eisenberg, D., Nicklett, E.J., Roeder, K., Kirz, N.E. Eating Disorder Symptoms Among College Students: Prevalence, Persistence, Correlates, And Treatment-Seeking. Journal of American College Health. 2011.

Valls, M., Callahan, S., Rousseau, A., Chabrol, H. Eating Disorders And Depressive Symptoms: An Epidemiological Study In A Male Population. 2013.