“There’s still a perception that eating disorders mainly occur among girls and women, which can correlate to deeper feelings of shame among boys and a stronger desire to hide the problem,” explains Maggie Moran, MSW, LCSW, Senior Primary Therapist at Princeton Center for Eating Disorders, which provides treatment for boys as young as age 8.
“At the same time, the media focuses heavily on the latest nutrition fads, some of which exclude important food groups that a growing young person needs,” she adds. “In the midst of these culturally defined ideals, eating disorders in boys may be detected less often.”
Orthorexia, or an obsession with health food, is just one condition that requires vigilance in this population. Restricting disorders like anorexia nervosa are also commonly seen in boys undergoing treatment at Princeton Center for Eating Disorders.
“Trauma is frequently a precipitating factor among boys, as a damaged sense of safety can lead to a maladaptive attempt to regain control through self-imposed eating restrictions,” says Najeeb Riaz, MD, Medical Director of Princeton Center for Eating Disorders. “We’re also seeing young patients with autism spectrum disorder, which often carries with it an obsessive quality that can easily coexist with an eating disorder.”
Signs of an Issue
According to Dr. Riaz, treatment is indicated if a child or teen falls below 85 percent of his ideal body weight, and pediatricians should watch for the following clinical signs of a potential eating disorder among their patients:
- Lack of growth or rapid weight loss
- Electrolyte imbalances, especially lower magnesium or phosphate levels
- Elevated amylase levels
- EKG irregularities
When an eating disorder is suspected, early referral for an evaluation is critical to avoid longer-term impairment to overall growth and health. Treatment goals are to restore prepubescent boys back to 100 percent of their ideal body weight, and postpubescent boys to at least 90 percent.
“Young male patients tend to be more resistant and guarded about sharing concerns or receiving help, so it’s especially important to build a therapeutic relationship from the very first point of contact,” adds Dr. Riaz. “Using a team approach, we work to normalize the treatment experience, assess and treat any coexisting mood problems or medical conditions, engage the family in recovery, and restore weight in a medically secure manner.”