One's body image is based on how one feels about his or her appearance. People ascribe meaning to various body images and what it means to be masculine and feminine, and then one tries to align one's desired body image with the corresponding body type.
Having a negative or distorted body image is a central feature in an eating disorder and is a symptom of deeper underlying problems, such as low self-esteem and identity issues. Even when the eating disordered individual has no apparent obsession with appearance, there are reasons, although perhaps sub-conscious ones, why one strives for a certain body image.
Due to the meaning and value people give to body image, it is difficult to help clients move from negative to positive beliefs about self. The client needs to learn new, healthier, positive ways of thinking about self, such as to learn to accept his or her body's flaws and to value internal worth over external appearance.
Current research suggests the following about males with eating disorders:
While women tend to be "fixated on weight" and "thinness," men tend to be more concerned with building a muscular body "shape" (Roloff, 2004).
Males tend to manage weight by fasting and exercising. Men are not as likely as women to lose weight through dieting and abusing diet pills, laxatives, and diuretics (Roloff, 2004).
Boys tend to form an image of their body and self-worth based upon the comments of peers, such as through nicknames and teasing. Halperin (1996) explained that through the socialization and camaraderie of sport teams, males form a concept of their body image.
Boys and men's body images are formed by the attitudes and beliefs the culture attributes to the meaning of masculinity, including the traits of independence, competitiveness, strength, and aggressiveness. Those who do not conform to the culture's ideal image tend to have a lower self-esteem than those who do conform. When males fail to live-up to these masculine expectations, they feel emotionally isolated, and this leads to problem behaviors (Kearney-Cooke and Steichen-Asch, 1990). These problem behaviors may take the form of eating disordered beliefs and behaviors.
Males tend to start dieting in response to actually being overweight, while females tend to diet because they "feel" fat despite not being overweight (Andersen, 1992).
While females diet to improve physical attractiveness (- thinking thinner is better), men tend to diet to achieve sports-related goals, reap health benefits, and avoid future medical problems (Andersen, 1992).
Maintaining a thin, toned body and exercising makes many men feel more masculine and in control. They believe their reward for working out will be greater admiration and respect from others (Andersen, 1992).
Andersen, A. E. (1992) Eating Disorders in Males in "Controlling Eating Disorders with Facts, Advice, and Resources" by ed. R. Lemberg (Phoenix, AZ: The Oryx Press) pp. 21-28.
Halperin, E. N. (1996) "The Role of Socialization in Male Anorexia Nervosa: Two Cases" in Child Psychiatry and Human Development, 26 (3), pp. 159-168.
Kearney-Cooke, A. & Steichen-Asch, E. (1990) "Men, Body Image, and Eating Disorders" in Males and Eating Disorders by ed. A. E. Andersen (New York: Brunner/Mazel) pp. 54-74.
Roloff, Mark (2004) Males and Eating Disorders presentation at 2004 National Eating Disorders Association Conference.