Jerel P Calzo1, Nicholas J Horton2, Kendrin R Sonneville3, Sonja A Swanson4, Ross D Crosby5, Nadia Micali6, Kamryn T Eddy7, Alison E Field8. 1. Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, and Harvard Medical School, Boston. Electronic address: jerel.calzo@childrens.harvard.edu. 2. Amherst College, Amherst, MA. 3. Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, and Harvard Medical School, Boston; University of Michigan School of Public Health, Ann Arbor. 4. Harvard T. H. Chan School of Public Health, and Erasmus MC, Rotterdam, the Netherlands. 5. Neuropsychiatric Research Institute, Fargo, ND, and University of North Dakota School of Medicine and Health Sciences, Fargo. 6. Behavioural and Brain Sciences Unit, Institute of Child health, University College London and Great Ormond Street Hospital, London; and Icahn School of Medicine at Mount Sinai, New York. 7. Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, and Harvard Medical School. 8. Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, and Harvard Medical School, Boston; Harvard T. H Chan School of Public Health, Boston; Channing Division of Network Medicine, The Brigham and Women's Hospital and Harvard Medical School, Boston; and Brown University, Providence, RI.
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 to 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 to 15, 16 to 18, 19 to 22, and 23 to 26 years identified 1 large Asymptomatic class and 4 symptomatic patterns: Body Image Disturbance (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. CONCLUSION: 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.
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 to 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 to 15, 16 to 18, 19 to 22, and 23 to 26 years identified 1 large Asymptomatic class and 4 symptomatic patterns: Body Image Disturbance (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. CONCLUSION: 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.
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