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The obesity epidemic has helped point a well-deserved spotlight on the food and diet of growing kids. But it’s also important to remember that eating disorders are the third most common chronic illnesses among adolescents. Although primarily impacting young women, eating disorders do afflict young men; up to 10 percent of people with eating disorders are boys. Given our culture’s focus on thinness and physical appearance, it’s not surprising that a number of boys want to be thinner and many are actively trying to lose weight. A recent study found that one-third of adolescent boys want a leaner body.
The factors associated with eating disorders—issues of low self esteem, perfectionism, drug use, perceived pressure from parents and peers to lose weight, participation in sports that focus on leanness—are remarkably similar in boys and girls. But because eating disorders are rarer in boys, family members and clinicians can often miss critical early warning signs. While a boy going to the gym and lifting weights constantly may be deemed normal behavior, a girl performing the same activities may raise a red flag. Pediatricians should observe patients for signs of an eating disorder, which include over-exercising; becoming obsessive about food; constant thinking, planning and anxiety about food; and not wanting to eat around others, as these may suggest the patient should be evaluated.
It can be especially hard for male patients to talk about having an eating disorder because of the stigma attached to it. During routine physicals, it’s important to ask both your male and female patients about their dietary habits. This can offer them a chance to talk about their eating and any related issues. You should also carefully track growth curves. Kids should be growing and gaining weight through adolescence. If a patient is growing taller but not gaining weight, that is a sign he might have an eating disorder.
If you’re referring a male patient for an eating disorder, remember that many eating disorder clinics don’t accept boys. At Children’s Hospital Boston’s Eating Disorders Program, we offer evaluation and treatment to male and female adolescents with anorexia nervosa, bulimia and related eating disorders.
Families of young men with eating disorders might need additional support. Many programs, ours included, have family support groups where members can talk and connect.
—Sara F. Forman, MD,
Director of Children’s Eating Disorder Program
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