Building Resilience to Eating Disorders in Boys
It used to be that eating disorders and body image disturbances affected mainly girls. Today about 10–15% or more of people with eating disorders are male. Of these 4–6% have anorexia nervosa, 10–13% have bulimia nervosa and 79–83% are binge or compulsive eaters (ANRED). A growing number of boys and young men are also using steroids and body-manipulating supplements. While the numbers are on the increase, there are few prevention programs that are developed specifically for boys. Programs that include both boys and girls fail to address the impact of gender.
Even before birth, boys and girls are wired to march to different drummers because of differences in the structure of their brains. Male brains are more compartmentalized and specialized than female brains. They are task oriented and therefore activity is more important than interpersonal connection. Because the male brain is designed for logical problem-solving, it can often take boys longer than girls to process emotional data. Boys smell, taste and hear less well, and get less input and soothing feedback from tactile information. Boys are more aggressive and impulsive because they receive more testosterone and less serotonin than girls.
Socialization also plays a major part in how boys interact with the world. Until they are 9 or 10 years old many can readily access a wide range of feelings. As they mature and enter puberty, societal pressures to conform to a rigid ideal of masculinity are intensified. Boys are rewarded for showing their action-oriented side and for demonstrating physical prowess. They become skilled at masking feelings of vulnerability, weakness and depression and avoid expressing sadness, grief, fear, loneliness, anxiety, and hurt. In adolescence many boys hide their feelings behind a mask of bravado in order to appear confident, tough, and in control. Soon the mask defines the only way of being that they know.
Boys who can’t express their feelings directly do so indirectly. Some boys externalize their distress. They react to situations with anger and blame that they direct against the perceived source. This can turn into aggression and violence. Some boys internalize their distress. They redirect their feelings against themselves, talk about themselves in a negative way, and blame themselves. They say things like “I’m such a loser, I’m so stupid, I’m too fat.” Boys who focus on body size as a way of coping are at risk of developing eating disorders and body image disturbances. Worrying about and trying to transform body shape and size becomes a way for them to turn their concerns about something real on the inside into something artificial on the outside. Boys believe that if they can change their bodies they can change how they feel about themselves.
Preventing eating disorders and body image disturbances is about helping boys develop resilience and learn skills so that they can deal with stressors in a healthy way.
What You Can Do
• Help boys expand their definition of masculinity and of being “cool.”Include such characteristics as caring, nurturing, and cooperation. Provide boys with opportunities to develop relationships where these characteristics are valued and where they feel connected to others.
Practical Suggestion: Create a group program for boys. Group programs can create a safe structure where boys can learn from and interact with one another and where they can practice new behaviors. These programs can provide them with support in a boy-friendly environment that is congruent with their development and how they learn and interact with the world. Where possible, groups should be facilitated by male mentors and role models who can model a broad and inclusive range of masculinity, who have dealt with and/or are aware of their own issues around male socialization, and who can appreciate the struggles that boys go through and the difficulties they must deal with.
• Help boys build a strong sense of self that includes a broad array of aspects other than appearance. Recognizing the different parts of the self helps them create balance in how they see themselves so that their self-worth is not dependent solely on how they look.
Practical suggestion: Use props to make a point. In a group setting, fill a bottle full of beans. The bottle represents a young man and the beans represent the different parts of his self. Remove beans to demonstrate how he loses his beans (or his sense of self) when he starts to doubt himself, say mean things about himself, hits out by blaming others, worries about what other people are thinking, or tries to live up to an image that is not him. Every time he says “I” and makes a positive statement about his self, add beans to the bottle. Have everyone give an example of statements about their self and talk about their likes, dislikes, abilities, feelings, hobbies, interests, opinions, and ideas. With each positive statement put beans back into the bottle to show how you build or strengthen the sense of self.
• Help boys expand their range of feelings and develop emotional literacy— the ability to read and understand their emotions and the emotions of others. Teach boys strategies to deal with their feelings and teach them anger management skills so that they can express their anger in a healthy and constructive way. Teach them communication skills so that they can learn to “use their words” instead of their fists or their behaviors to communicate what they feel.
Practical Suggestion: Engage boys by making it fun. Write a list of feelings on flip chart paper and discuss each feeling with a group of boys. Blow up ten balloons and write the name of a feeling on each of the balloons. Throw several different colored balloons into the air and have the boys bat them to each other. Call out the color of a balloon. The person who has that balloon reads out the feeling and uses it in a sentence about himself. Keep throwing balloons into the air and repeat the process until all the feelings are used.
• Help boys accept their bodies and feel good at whatever size they are. In elementary school, weight is the main body image issue for boys (who are often teased and bullied about being fat.) Boys need to learn about the growth spurt that takes place during puberty and about how genes and metabolism work in order to understand why they have the bodies they do and why it is so hard to change them. Work with schools to address and end bullying.
• Help boys examine their beliefs about what it means to be male and that this impacts how they perceive and relate to their bodies. Look at the ways in which cultural attitudes regarding ideal male body shape, masculinity, and sexuality are shaped by the media. In middle school and high school, boys deal with feelings of powerlessness by transforming them into the drive for muscularity. They believe that if they are strong in their bodies, they will be in control in their lives.
• Encourage women who work with boys to learn about male development and socialization so that they can understand and speak “male” and adapt their style of communication and interaction to suit the needs of boys.
By Sandra Friedman, MA
Reprinted with permission from Eating Disorders Recovery Today
Spring 2008 Volume 6, Number 2
©2008 Gürze Books
About the Author
Sandra Friedman, MA, is an educator, counsellor, and author. This article is adapted from her new workbook, Just for Boys (Vancouver: Salal Books, 2007) She has facilitated professional training workshops and her programs are used in Canada and the United States. Please visit www.salal.com.
Dr. Gnap website editor eatingdisordersrecoverytoday.com. Dr. Gnap is a family practice physician and behavioral medicine specialist in suburban Chicago. Dr. Gnap developed the Inner Control™ Program in 1970 and has worked with thousands of people to improve and correct medical, emotional, behavioral and learning problems including performance.