Eating disorders are equal opportunity invaders. Current research shows that eating disorder hospitalizations for children younger than 12 increased by 119% between 1999-2006. The sharpest increase in treatment was seen in boys and minority youths. Even though 5-10% of those with diagnosable eating disorders are boys, it may in fact be higher due to underreporting rates and current diagnostic criteria (current criteria includes amenorrhea, or lack of menstrual cycle). Many more boys have “partial syndrome,” meaning they only exhibit some of the symptoms and behaviors of the disorder.
Ten years ago, there were virtually no magazines geared towards males, and now more than 20 can be easily found in your local grocery aisles. New media influences (including “six pack” abs, thin male models, body building or fitness competitions, diet advertising on platforms such as Facebook) are creating an environment where being physically fit is expected. A lot of this activity is occurring outside the home, out of parental watch, fueled by social pressures.
On school campuses, discussions of steroid use for muscle growth and enhancement are common. According to the National Institute on Drug Abuse, more than half a million 8th graders are using anabolic steroids, unaware of theassociated risks. Boys are encouraging each other to “work out hard” during practices and weight training at school, and there is a competition to see whom can lift the most. Male “weaklings” are ridiculed and ostracized in front of their peers, and most are desperate to avoid the embarrassment of being publicly humiliated. Still, this type of bullying behavior is usually dismissed by school officials as “guy talk.”
With the current obesity epidemic, pediatricians are becoming more weight sensitive to their patients. A simple suggestion to lose weight, can turn into a deadly quest to be thin, and these kids are not monitored closely enough. Because much of the research regarding boys is still in progress, and we are learning more about this underserved population each year. You should seek professional help if you notice and of the following in your tween: concerning changes on their growth chart, dieting behaviors, comments regarding their appearance, reports of being bullied at school about their size/shape, disappearing after meals or overexercising. The sooner you receive proper treatment, the more likely you are to combat and diffuse the disordered behaviors, and enhance recovery from this deadly illness.