Body Image, Binge Eating, and Bulimia Nervosa in Male Bodybuilders

Article excerpt

Objective: Male bodybuilders (MBB) exhibit more severe body dissatisfaction, bulimic eating behaviour, and negative psychological characteristics, compared with male athletic and nonathletic control subjects, but few studies have directly compared MBB and men with eating disorders. This study compared men with bulimia nervosa (MBN), competitive male bodybuilders (CMBB), and recreational male bodybuilders (RMBB) on a broad range of eating attitudes and behaviours and psychological characteristics to more accurately determine similarities and differences among these groups.

Method: Anonymous questionnaires, designed to assess eating attitudes, body image, weight and shape preoccupation, prevalence of binge eating, weight loss practices, lifetime rates of eating disorders, anabolic androgenic steroid (AAS) use, and general psychological factors, were completed by 22 MBN, 27 CMBB, and 25 RMBB.

Results: High rates of weight and shape preoccupation, extreme body modification practices, binge eating, and bulimia nervosa (BN) were reported among MBB, especially among those who competed. CMBB reported higher rates of binge eating, BN, and AAS use compared with RMBB, but exhibited less eating-related and general psychopathology compared with MBN. Few psychological differences were found between CMBB and RMBB.

Conclusions: MBB, especially competitors, and MBN appear to share many eating-related features but few general psychological ones. Longitudinal research is needed to determine whether men with a history of disordered eating or BN disproportionately gravitate to competitive bodybuilding and (or) whether competitive bodybuilding fosters disordered eating, BN, and AAS use.

(Can J Psychiatry 2006;51:160-168)

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Clinical Implications

* Bodybuilding among men is associated with an increased risk of body dissatisfaction, weight and shape preoccupation, and pathological eating behaviours.

* Compared with RMBB, CMBB are more likely to engage in binge eating and meet criteria for BN during their lifetime

* CMBB are also at higher risk of using AAS, compared with RMBB, but the high prevalence of use in RMBB indicates the use of steroids for cosmetic reasons.

Limitations

* A clinical sample of eating disorder patients and a community-based sample of MBB comprised the overall sample. The differences in recruitment may have biased the results.

* Diagnostic criteria for BN was established by self-report without a confirmatory clinical interview; thus, the prevalence and severity of binge eating and abnormal weight control practices may be overestimated or underestimated.

* The sample of MBB was relatively small; therefore, results may not represent the studied populations.

Key Words: bodybuilding, body image, binge eating, bulimia nervosa, anabolic androgenic steroids

Large-scale surveys reveal that male body dissatisfaction has increased dramatically during the last 3 decades, from 15% to 43%, making current rates almost comparable to those found in women (1). There is converging evidence from cross-sectional and experimental research that exposure to the exceptionally thin beauty standards for women as advertised in the media, as well as exposure to the lean and muscular male ideal, increases body dissatisfaction and negative affect in both women and men (2-6). Female body dissatisfaction typically manifests in feeling too heavy or fat with a concomitant desire to be thinner (7), while most young men seek to be leaner, yet larger and more muscular (4). These expressions of body dissatisfaction are consistent with standards of attractiveness for each sex. The high prevalence of body dissatisfaction is concerning, given that body image issues are often the driving force underlying disordered eating, compensatory bulimic behaviours, full-blown eating disorders (8), and use of AAS (9). …