Men may still hesitate to ask for directions or give up the TV remote, but they're apparently crossing the gender line into another area once firmly dominated by women: Obsessing about their body image and developing eating disorders.
In the past two decades, reports the British Medical Journal, the number of men who openly report dissatisfaction with their physical appearance has tripled -- and today, nearly as many men as women say they are unhappy with how they look. Meanwhile, therapists report seeing 50% more men for evaluation and treatment for eating disorders than they did in the 1990s.
And the root of this trend may be a new type of disorder -- an obsession for six-pack abs and bulging biceps that seems especially common in athletes and other fitness enthusiasts.
Though statistics show that about 10% of men suffer from the two best-known eating disorders -- anorexia and bulimia -- a growing body of evidence suggests that men may be especially vulnerable to muscle dysmorphia, a condition in which one obsesses about lacking muscle definition and mass, even with a muscular body. This condition is not unlike that satirized in Saturday Night Live sketches featuring the Schwarzenegger-like, sweatsuit-wearing Hans and Franz, whose mission was to "pump you up."
Laughs aside, the problem is so real that in the March/April issue of ACSM's Health & Fitness Journal, published by the American College of Sports Medicine, Ball State University nutritionist Katherine A. Beals, PhD, RD, highlights the growing trend among fitness buffs and offers advice to athletic trainers on spotting the problem in weight lifters and other fitness center regulars. "Millions of boys and men today harbor a secret obsession about their looks and are endangering their health by engaging in excessive exercise, bingeing and purging rituals, steroid abuse, and overuse of nutritional and dietary [products]," she writes.
Although a relatively new area of medical research, many experts believe this disorder is grossly underreported. But those at particular risk, says Beals: men who constantly seek instant results from workouts and frequently check their progress in mirrors or on scales. Though her findings are geared to athletes -- or those who want to be -- others say that less-athletic men are not immune to muscle dysmorphia and related body image problems.
"As far as we know, all men are prone to these types of issues," says Katharine Phillips, MD, director of the Body Image Program at Brown University's Butler Hospital and author of several books on men's body image problems, including The Adonis Complex: The Secret Crisis of Male Body Obsession. "The reasons why haven't been well studied, but one factor may be the availability of anabolic steroids, which are potentially dangerous but can make men become much more muscular than Mother Nature ever intended."
Another possible reason being explored: Feelings of threatened masculinity. "Perhaps this is the one domain left where men can feel like men, since women can do everything that men can do, except they can't bench-press hundreds of pounds," she tells WebMD. "What has happened over the years is there's an increasing emphasis on men's appearance, and in particular on looking muscular, and it coincides very nicely with the increasing equality women have attained in society."
Whatever the causes, and likely there are many -- including life experiences or even genetics -- there's no denying that some men are feeling the pressure. Even GI Joe dolls have bulked up in recent years.
"In women with eating disorders, the focus is usually on thinness, but men tend to want to be muscular and gain weight," says Catherine Loomis, PhD, psychologist at the Eating Disorders Center at Rogers Memorial Hospital in Oconomowoc, Wis., one of the nation's few treatment centers that specifically treats men with eating disorder and body image problems. "A lot of it has to do with cultural pressures placed on men to look a certain way. As a result, they may develop a fear of certain foods and anxiety over the way they eat."
So when do men cross the line from a healthy workout to an unhealthy and potentially dangerous obsession? One hint: Exercising more than once or twice each day, with no days off from weight lifting.
"I usually note four points that determine whether you've crossed the line or not," says Roberto Olivardia, PhD, another Adonis Complex author and psychologist at McLean Hospital and at Harvard Medical School who specializes in men's body image problems:
- Distortion of body image: "If you see yourself as being fat or puny, but others around you say that you're muscular, that's a red flag," he tells WebMD.
- Exercise interferes with other areas of life. "If your relationships, job, or school suffer because of your exercise routines, that's a warning sign."
- Your harm yourself in pursuit of fitness. "If you're taking steroids, tearing joints or ligaments because of overtraining, or you're fainting because you're not taking in enough liquids, that's a sign of trouble."
- Your self-esteem is based solely on your appearance. "If you feel that the perfect body is the only way you can feel good about yourself, that's another warning sign. You need to get self-esteem from many areas in your life -- and not only from your muscles."