Male Eating Disorder Symptom Patterns and Health Correlates From 13 to 26 Years of Age

Abstract

Objective-Research on the manifestations and health correlates of eating disorder symptoms among males is lacking. This study identified patterns of appearance concerns and eating disorder behaviors from adolescence through young adulthood and their health correlates.Method-Participants were 7,067 males from the prospective Growing Up Today Study. Surveys from 1999-2007 (spanning ages 13-26 years) provided repeated measures data on: muscularity and leanness concerns; eating disorder behaviors (purging, overeating, binge eating, use of muscle-building products); and health correlates (obesity, non-marijuana drug use, binge drinking, and depressive symptoms).Results-Latent class analyses of observations at ages 13-15, 16-18, 19-22, and 23-26 identified one large Asymptomatic class and four symptomatic patterns: Body Image Disturbance Correspondence to: Jerel P. Calzo, PhD, Division of Adolescent/Young Adult Medicine Boston Children's Hospital, 300 Longwood Ave., AU-Box 17, BCH3189, Boston, MA 02115; jerel.calzo@childrens.harvard.edu. Supplemental material cited in this article is available online.The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH.Drs. Horton, Crosby, Swanson, and Calzo served as the statistical experts for this research.Disclosure: Drs. Calzo, Horton, Sonneville, Swanson, Crosby, Micali, Eddy, and Field report no biomedical financial interests or potential conflicts of interest.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. (high appearance concerns, low eating disorder behaviors; 1.0%-6.0% per age period); Binge Eating/Purging (binge eating and purging, use of muscle-building products, low appearance concerns; 0.1%-2.5%); Mostly Asymptomatic (low levels of muscularity concern, product use, and overeating; 3.5%-5.0%); and Muscularity Concerns (high muscularity concerns and use of products; 0.6%-1.0%). The Body Image Disturbance class was associated with high estimated prevalence of depressive symptoms. Males in the Binge Eating/Purging and Muscularity Concerns classes had high prevalence of binge drinking and drug use. Despite exhibiting modestly greater appearance concerns and eating disorder behaviors than the Asymptomatic class, being in the Mostly Asymptomatic class was prospectively associated with adverse health outcomes. HHS Public AccessConclusion-Results underscore the importance of measuring concerns about leanness, muscularity, and use of muscle-building products when assessing eating disorder presentations among males in research and clinical settings.

Predictors of muscularity‐oriented disordered eating behaviors in U.S. young adults: A prospective cohort study

“…Our longitudinal findings confirm previous literature finding associations between muscularity‐oriented disordered eating and substance use (Calzo et al, ) and depression (Grossbard et al, ; Olivardia et al, ). Overall, poor adolescent mental health and well‐being as well as substance use may predict future engagement in muscularity‐oriented disordered eating behaviors in young adulthood.…”

Prospective health associations of drive for muscularity in young adult males

“…Previous studies have similarly showed that body dissatisfaction in males is associated with depression Calzo et al, 2016;Holsen, Kraft, & Roysamb, 2001;Paxton, Eisenberg, & Neumark-Sztainer, 2006). Previous studies have similarly showed that body dissatisfaction in males is associated with depression Calzo et al, 2016;Holsen, Kraft, & Roysamb, 2001;Paxton, Eisenberg, & Neumark-Sztainer, 2006).…”

Eating disorder behaviours amongst adolescents: investigating classification, persistence and prospective associations with adverse outcomes using latent class models

“…Important limitations to highlight, however, relate to attrition, which was relatively high at age 18, and was higher amongst girls who were assigned to symptomatic classes vs. those in the asymptomatic class at 14 years of age; low power to investigate boys, due to low endorsement of ED symptoms under study. This might be due to the questions included as indicators, maybe geared towards female-specific ED behaviours and cognitions[38,39]. Indicators used were based on questions derived from the Youth Risk Behavior Surveillance System questionnaire[22], therefore symptoms were self-reported and fewer behaviours consistent with anorexia nervosa were present in the questionnaire, therefore limiting our ability to investigate anorexia-type behaviours.…”