Body image issues on the rise among men

Body image issues and resultant eating disorders, traditionally thought to be exclusive to teenage girls and women, are now increasingly affecting adolescent boys and men

When 16-year-old Aryan returned from the summer vacation looking all buffed up, he became the ideal for all boys in his class. His high-protein-low-calorie diet, which includes six eggs a day, protein supplements and no sweets, began to be replicated at friends’ homes, giving their mothers sleepless nights. It took a great deal of coaxing and convincing and even a session by a dietician to help the students see that they had to go out onto a field and play and not get weighed down by calories and proteins. But this was a school with a limited number of children, and aware parents. Many children may not be identified with a problem until it turns severe.

Nutritionist Naini Setalvad, from Mumbai, explains, “The fad high-protein diet causes constipation, bloating, elevated uric acid and lipids and can lead to multiple long-term health issues.” The over-emphasis on protein is not advisable for adults, let alone younger males, she warns.

When boys want to be men

“Recent studies point out that 30-40% of people with eating disorders are male,” says Dr John Vijay Sagar, Additional Professor, Child and Adolescent Psychiatry, Nimhans, Bengaluru. He treats children below 18 years and says most of his patients are in the 14 to 16-year-old category, about the time boys hit puberty. They feel the pressure to look a certain way, not only generated by the media, but also by their peer group. They often lag behind girls of their age in physical development and begin to compete with each other for attention.

Their role models are adults, who are either lean and muscular (often sports stars) or beefed up (often film stars). At this age, however, their bodies can’t physically support this, nor do they have an understanding of what is achievable or appropriate for their particular body structure and age. “Youngsters often confuse being fit with being thin. When probed about how much they think they should weigh, they have absolutely no idea,” says Dr Senthil Reddi, Additional Professor, Department of Psychiatry, Nimhans, Bengaluru.

“Most stars have a body that is suited for their occupation: Hritik Roshan is tall and fit, because he needs to remain active all the time, especially on the set. A jumper will have thighs that are incredibly strong. A thrower will have a better-developed upper body,” says Giriraj Seth, a 16-year-old athlete. Seth seems to have the right perspective on things, until he says of a friend going to the gym: “He’s already skinny; he doesn’t need to.” So there you have it: skinny is king.

When genes don’t allow for it

Dr Vijay Sagar brings up a rather pertinent point. “There are racial differences to be taken into account,” he says. “Indian adolescents have a different body type compared to Caucasian or African adolescents.” Typically, an Indian teenager will mature physically at a much later stage, but the aspiration to look the way sportsmen and film/television stars from the West look can lead to long-term issues.

These issues show up later in life, says Setalvad, who describes a few middle-aged men she has seen in her practice, who are even bulimic. In order to maintain a certain physique, not always possible with stressful jobs and the paucity of time, they turn to this most drastic measure, she says.

When kids mirror adults

What makes kids especially vulnerable is the fact that their closest role models, their parents, may often talk about “putting on so much weight”, “feeling fat”, “eating empty calories”. Sushanti Sen (name changed to protect identity), realised her conversations with family members were a lot about how she needed to lose weight and about junk food and superfoods. “I knew I needed to watch what I preached, when my perfectly fit son, a soccer player, began looking at himself in the mirror and saying he needed to lose weight.” Having suffered from bouts of anorexia, Sen knew the dangers of a poor relationship with food. She also knew that eating disorders were a consequence of several other psychological factors.

When the mind is what matters

Younger males are not mentally equipped to deal with bullying, peer pressure, parental discord and other emotional traumas, which often lead to low self-esteem. “Males between the ages of 15-25 years, are psychologically less developed, and struggle with self-identity,” explains Dr Reddi. They may feel like a lot of things in life are beyond their control and relate to something they feel will empower them. This manifests in trying to take control over their bodies.

“However, they are not aware of what is required and adopt maladaptive strategies,” says Dr Reddi. “Young adults don’t have long-term goals; they are invariably looking for a quick fix.”

When it’s about masculinity

A major issue with boys is the recognition and acceptance of the fact that they may have an eating disorder, whether it is anorexia, binge eating disorder (BED), bulimia or body dysmorphic disorder. According to Dr Vijay Sagar, “They feel stigmatised and think they will be viewed as effeminate, as these issues are viewed as feminine problems.”

By the time these problems are recognised in India, and the child is brought in for treatment, they have already developed associated problems such as anxiety disorders, panic attacks and depression. “Most of these patients have crossed the threshold of diagnosable problems, but there are many out there with sub-threshold problems, who need help,” he says.