Boys and their body image

He’s a heart throb to young girls around the country, but the looks of actor Reid Ewing were never good enough to the person who mattered the most – himself.

Ewing, who plays Dylan on the hit comedy Modern Family, opened up about how he obsessed over his looks in a recent op-ed piece in the Huffington Post. He says that he has faced eating disorders, depression and body dysmorphic disorder, a condition he describes as a “mental illness in which a person obsesses over the way he or she looks.”

Reid said that he would take pictures of himself, analyzing his looks, before deciding he needed plastic surgery. He said he felt ugly and that his looks were unacceptable.

Reid describes in great detail the horrible pain he went through during his initial surgery, cheek implants and yet felt the need to do it again. He says that no one gave him a mental evaluation, except to ask if he suffered from depression (he did), to learn of his history of eating disorders.

Joy Crabtree, PsyD., a psychologist at Cook Children’s, says that the insecurity and body dysmorphia often develops during adolescence, and they become more unhappy as they get older. In some situations, the discontent may develop in childhood, and start with a specific dislike for a certain part of their body or over focus on a perceived flaw.

“I like how the article makes the point that therapy is a great place to start before jumping into big cosmetic surgery decisions,” Crabtree said. “I think standard protocol requires some level of psychological screening for most bariatric surgeries as well.”

Crabtree says people sometimes don't think of boys dealing with these body image issue, but she treats boys struggling with eating disorders and their own looks.

One in 10 of those diagnosed with eating disorders are male. Moreover, nearly a third of adolescent boys participate in unhealthy weight control techniques, like skipping meals, smoking cigarettes, vomiting or taking laxatives (National Association of Anorexia Nervosa and Associated Disorders). The American Psychological Association says males are less likely to seek treatment for an eating disorder due to the perception that it is a disease that only affects women, but the shameful secret isn’t just a girl thing.

Issues with eating and problematic concern over weight usually begin during adolescence or young adulthood. According to Joy Crabtree, PsyD., a psychologist at Cook Children’s, “This is typically a higher time of stress in general, and also a time when bodies are changing quickly or rapidly; this creates more discomfort with their self-image. Additionally, sometimes males are involved in sports where there is a focus on either gaining or losing weight, which can contribute to eating challenges as well.” Crabtree notes that eating disorders tend to occur among those who have perfectionist tendencies. “Increased stress can be a contributor, as well as unreasonable goals or ideals for meeting or maintaining a certain weight in order to participate in certain sports,” she observes.

To tackle the issue, Crabtree says schools should make their staff aware that males can suffer from eating disorders in addition to female students. Coaches and athletic personnel should be careful not to set unrealistic standards for their athletes and reach out to students and their parents if they see unhealthy patterns developing. In the meantime, though, the responsibility to identify problematic concern over weight or an unhealthy relationship with food lies with a boy’s parents.

Parents need to remember that eating disorders can be even more problematic in young men due to their reluctance to come forward. Watch for boys who develop a focus on eating only “healthy” food, counting calories, step on the scale a little too frequently or exercise excessively. Crabtree recommends “ensuring your family has a healthy focus on body image in general without a frequent or specific focus on weight, food intake, calorie counting etc. Try to stress balance in food intake and activity or exercise for overall health.” In addition, get input from your primary care physician regarding whether your child is in the average weight/height range or needs to focus more on eating a more balanced diet.

For boys diagnosed with an eating disorder, the treatment approach would not necessarily be different than it would for a girl. Crabtree stresses, however, that “the clinician must be aware and sensitive to the fact that they may be more avoidant or resistant to treatment in general, as well as less inclined to be open or honest about the issue as it is not as frequently seen as a male issue or concern.” Parents can help their teenaged boys to gain perspective on what is typical or average and what is extreme and unhealthy. Just as with young girls, it is important to stress that the celebrities they see on television or in the media are not typically “average” bodies. Parents can’t change societal pressures, but they can foster healthy behaviors and a realistic outlook on body image within their own households.

About the author

Natalie Raymond is an associate marketing specialist at Cook Children’s. She graduated from Texas Christian University with a Master of Science in journalism and certificate in business in 2014, and has a background in strategic communication and health care communication. Natalie enjoys doing her part to help our patient families stay healthy and spends her spare time with her eight furry friends (also known as pets).