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To identify patterns of appearance concerns and eating disorder behaviors from adolescence through young adulthood, the authors analyzed survey data from 7,067 males (aged 9 to 14 at the start of the survey) who completed questionnaires annually from 1996 to 2001 and biennially from 2001 to 2007. Those surveyed were asked to report concerns over muscularity and leanness, as well as eating disorder behaviors (purging, overeating, binge eating, and use of muscle-building products) and health correlates (binge drinking, drug use, and depressive symptoms).
Latent class analyses of observations at ages 13 to 15, 16 to 18, 19 to 22, and 23 to 26 identified one large asymptomatic class and four symptomatic patterns: Body Image Disturbance (high appearance concerns, low eating disorder behaviors); Binge Eating/Purging (binge eating and purging, use of muscle-building products, and low appearance concerns); Mostly Asymptomatic (low levels of muscularity concern, product use, and overeating); and Muscularity Concerns (high muscularity concerns and use of products).
By age 22, 6% of participants were classified to the Body Image Disturbance class, which exhibited high risk for depressive symptoms across adolescence. Relative to the Asymptomatic class, the Muscularity Concerns class had over four times the estimated prevalence of drug use at ages 16 to 18 years, over three times as many participants starting to use drugs at ages 19 to 22 years, and twice as many participants engaged in frequent binge drinking at ages 19 to 22 years.
“Although the classes that emerged differ from similar analyses on female samples, the findings are consistent with research in females indicating that subclinical symptomatic patterns of eating disorder symptoms are also associated with concurrent and incident depressive symptoms and substance use,” the authors wrote.
For related news, see the Psychiatric News article “How to Recognize, Treat Body Dysmorphic Disorder,” by Katharine A. Phillips, M.D.
(Image: iStock/Bulent Ince)