1. Taylor Hartman Hartman
Dr. Barnes
SC 493
8 May, 2015
1
Men’s Perceptions of Body Image, Body Satisfaction, and Eating Disorders:
The Influences of Identity
Introduction
Presently, there is a rise in the amount of new instances of body image dissatisfaction
uncovered throughout literature reviews, monographs, and academic journals conducted by
researchers. Eating disorders and body image troubles were once perceived as “woman’s only”
disorders, dating back to cases of the first publication of eating issues recorded by Richard
Morton, in 1694 (Cohn & Lemberg, 2013). As early as 1960, clinicians at St. George’s Hospital
in London began studies incorporating large samples of men with eating disorders. This research
peaked in the late 1980s, continuing into the 1990s, due to an increased amount of emphasis
placed on men from the media to be more muscular, and conscientious of their appearance.
According to a recent meta-analysis, Strumia, Emilia, Malvina, & Tatiana (2011) assessed the
population of the United States and estimated that between 5% and 10% of all eating disorder
cases occurred in males. Currently, there is an even larger amount of undiagnosed men suffering
from body image troubles and eating disorders, especially since the stigma attached to the illness
itself is very persistent. Furthermore, stereotypes that include body image issues only pertaining
to woman, as well as men being raised to be manly and not worry about their weight, may
decrease and deter these men with body image and eating disorders away from diagnosis and
treatment (Strother, Lemberg, Stanford, & Turberville, 2012). Presently, the primary focus of
research on men with body image distortions and eating disorders is the study of the individual
characteristics surrounding the nature of their illnesses, the prevalence of their mental and

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physical health, weight competitiveness, and ideal body image, which are linked to the culture of
media.
Literature Review
Body Image and Eating Disorders
There is no one “face” of what body image troubles look like. It may manifest itself in
men of all shapes, sizes, colors, and origins. According to recent research, the National Eating
Disorder Association estimates that 10 million men will at one point suffer from disordered
eating in their lives (Wade, Keski-Rahkonen, & Hudson, 2011). Nowadays, not only is there a
growing amount of research that describes the identities of men suffering from eating disorders,
the amount of treatment facilities that treat these illnesses have about doubled since 2000,
resulting in a 34% increase in newly established centers for recovery, stability and wellness
(Cohn, 2013). This increase may demonstrate that professionals, clinicians, and researchers are
adapting and catering to the need for the treatment and research of eating disorders and body
image complications in men. Similarly, rates of recorded body dissatisfaction among men have
increased from 10% to 43% over the past 30 years (Goldfield, Blouin, & Woodside, 2006;
O’Dea & Abraham, 2002), which are relatively similar to the rates of approximately 50% found
among North American women (Garner, 1997). In addition, a research team who studied
samples of college-aged males discovered that 95% of their participants had experienced some
level of body image dissatisfaction (Mishkind, Rodin, Silberstein, and Striegel-Moore, 1986).
This statistic emphasizes the ever-growing number of males who are affected by body image
troubles.
As of 2013, the Diagnostic and Statistical Manual of Mental Disorders describes the new
subtypes of the debilitating feeding and eating disorders, which now consist of anorexia nervosa,

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bulimia nervosa, binge eating disorder, and otherwise specified feeding and eating disorders,
which took over the previous eating disorder, not otherwise specified (American Psychological
Association, 2013). Hudson, Hiripi, Harrison, Pope, & Kessler, (2007) incorporated prevalence
rates of DSM-IV anorexia nervosa, bulimia nervosa, and binge eating disorder in several
American and Canadian studies: 0.9%, 1.5% and 3.5% among women, and 0.3%, 0.5% and 2.0%
among men respectively. According to the previous estimates, rates of females suffering from
each disorder appears to be more common, whereas males are a low, yet growing demographic
that may require further research for more precise data.
Body image dissatisfaction has also made its way into mainstream society for men. More
entrenched with their own perceptions of their bodies, men who have a preoccupation or a drive
to be thin or muscular may develop negative self-images (Barlett, Vowels, & Saucier, 2008).
Due to this preoccupation, Barlett et al. (2008) found that men reported taking pills, going on
diets, abusing muscle-enhancing drugs – like steroids – and engaging in excessive exercise, and
even having cosmetic surgery, because of their negative perceptions of their bodies. These are
some examples of how research and treatment have become more sophisticated through new
research publications and knowledge of the eating disorder illnesses.
Two types of foundational theories have been used in body image and eating disorder
research: social comparison theory (Festinger, 1954) and cultivation theory (Gerbner, 1969).
Social comparison theory utilizes the idea that people make self-appraisals by evaluating
themselves relative to others. Examples of this would generally include any person who admits
to comparing themselves in superior or inferior status to someone else, and thus believes that
they are better or worse depending on their perception of themselves. Another theory that is used
in eating behavior and body image perception studies is cultivation theory. Gerbner (1969)

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hypothesized that people often internalize messages broadcasted by the media. These messages
can have a significant effect on an individuals’ standards and realization of one’s own self in
relation to others. For example, the more an individual is exposed to mass media, he is more
likely to internalize and compare himself to body image ideals and see them as realistic
standards.
There is also one type of body image disorder that includes body dysmorphic disorder
(BDD), which entails dissatisfaction with body image, distinct distress with body type and
feelings of negative sensation associated with a marked preoccupation with weight. (APA,
2013). In addition, body dysmorphic disorder may be the problem when an individual obsesses
over a physical feature, which he or she believes, incorrectly, is deformed or ugly (Smolak &
Murnen, 2002). One specific form of this disorder, muscle dysmorphia, is pertinent to men.
Muscle dysmorphia is characterized by the persistent feeling of being small, despite being above
average weight and/or heavily muscular (Harvey & Robinson, 2003). This disorder has been
described as the opposite of anorexia nervosa; individuals suffering from muscle dysmorphia
exercise compulsively, and often use steroids or other supplements. Another subcategory of body
dissatisfaction includes body surveillance, or body checking. This category of behavior simply
includes checking ones own body, comparing oneself to others, and most importantly, involves a
person’s value of aesthetics over body function (Marino-Carper, Negy, & Tantleff-Dunn, 2010).
In mental health, there may be underlying issues and multiple reasons for a certain
pathology of behavior. For example, eating disorders and body image issues in males are usually
attached to one or more mental disorders, which refers to a term called comorbidity. Several
studies found that upon assessment, anxiety and depression were the most common comorbid
disorders in their sample with eating disorders in their sample of men with eating disorders

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(Cohn & Lemberg, 2014; Carlat, Carmago & Herzog, 1997; Strumia et al. 2011; Woodside et al.
2001). Furthermore, anxiety disorders accounted for 67% of comorbid disorders, followed by
30.7% of patients who were suffering from depression. (Cohn & Lemberg). In addition to this
statistic, a similar study found that 55% of men within the research sample were also depressed,
or in a depressed state (Strumia et al. 2011). Furthermore, 17% had a substance abuse disorder,
24% suffered from a type of personality disorder, and 14% had an alcohol dependence disorder
(Strumia et al. 2011). Moreover, in a study conducted by Woodside, Garfinkel, Lin, Kaplan,
Goldbloom, & Kennedy (2001), the researchers identified an association between psychiatric
diagnoses (major depression, social anxiety, social phobia and simple phobia) and disordered
eating symptomatology. These findings showed an increase in eating pathologies that were
linked to multiple forms of anxiety, sadness and other phobias, and obsessions.
Symptoms of eating disorders and body image dissatisfaction may come with an array of
risk factors, and physical and mental health complications. For example, weight history is the
most important indicator as to whether a child received adequate caloric intake (Andersen,
1999). Explained further, a history of undernourishment and under eating could be a huge risk
factor for the development of an eating disorder. In addition, most men lose weight through
intense fasting, purging behaviors, laxative abuse, and excessive lifting and running (Harvey,
2003). In a similar study conducted by Andersen and Holman (1997), participation in sports
where weight control is needed to improve performance was a risk factor in the development of
eating disorders and/or body image dysmorphia.
Comorbid psychical and mental symptoms result from males who suffer from anorexia.
These symptoms usually include the loss of the hypothalamic-hypopituitarism-hypogonadis,
which decreases the sexual drive in men (Harvey, 2003) More visible signs of anorexia and

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starvation include sebum depletion, as well as lanugo, which is the fine baby hair that is marked
across the epidermis. Bulimia, on the other hand, manifests itself through more observable signs,
such as Russell’s sign, which are scars and or callouses on the hands and fingers due to purging,
caused by the raw acidic fluids eating away at the skin (Harvey, 2003).
Demographics of Body Image and Eating Disorders
Gender
More sociologically oriented factors have also been suggested as possible explanations
for body dissatisfaction. Several authors, for example, have pointed to the effects that increased
exposure to mainstream media (advertising, magazines, newspapers, pornography, and films)
attribute to men’s perception of body image ideals (Duggan & McCreary, 2004; Hartoum &
Belle, 2004; Harvey & Robinson, 2003; Morgan & Arcelus, 2009; Morrison, Morrison, &
Hopkins, 2003). Additionally, the emphasis on sculpted, lean, and muscular bodies can have a
negative effect on men’s desire to change their body perceptions and may change their
perceptions of other men around these mostly unattainable body ideals (Duggan & McCreary,
2004; Hartoum & Belle, 2004; Harvey & Robinson, 2003; Morgan & Arcelus, 2009; Morrison,
Morrison, & Hopkins, 2003). Gender role norms can be generally described as the set of
attitudes, behaviors, and thoughts that society holds as representative of the male or female
gender (Connell, 1995). In addition, these roles can be crucial to understanding the male
experience of eating disorders and body image complications.
The existing crossover of negative eating and negative body image can also manifest
itself into feminine and masculine behavior. Lakkis, Riciardelli, & Williams (1999) found that
men who reported having feminine traits, such as co-dependence and passivity, sought approval
from others. Furthermore, the creation of the femininity hypothesis (Lakkis et al. 1999) was

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proposed to argue that conformity to feminine norms may become a risk factor for eating
pathology and body dissatisfaction among women (Lakkis et al. 1999; Meyer, Blissett, &
Oldfield, 2001). Similarly, it may also been used in relatable cases and studies involving men
who do not identify as masculine, and tend to favor more feminine behavior. In addition,
Thomas, Ricciardelli, & Williams (2000) found that young boys and young men who reported an
endorsement of feminine roles, also reported a greater drive to diet, and were more preoccupied
with food intake. Furthermore, body dissatisfied males who endorsed feminine gender roles may
be likely oriented towards thinner, rather than larger body ideals, suggesting a link between
femininity and thinness-oriented eating disordered symptomatology in males (Meyer, Blissett &
Oldfield, 2001).
In contrast to the study of body image research and males who strive for thinness, body
image researchers have also focused on muscularity concerns. These types of investigations are
usually paired with the theory of threatened masculinity, which states that a pursuit of hyper-
muscularity is attached to a vulnerability of feeling threatened with respect to masculinity
(Mischkind et al., 1986; Pope, Phillips, & Olividari, 2000). Masculinity and muscularity are
therefore seen as important, if not, essential components to certain aspects of male confidence. In
addition, the masculinity hypothesis, created by Blashill (2011) argues that muscularity-oriented
men who are overly fixated with achieving low body fat and high muscle mass may be at risk for
body dysmorphic disorder pathology (Griffiths et al. 2015). Furthermore, men who strive for this
ideal may be perceived as more inclined to communicate more traditional masculine
characteristics more effectively to other males than others (Griffiths et al. 2015).
Some research has highlighted the possibility that there exists a significant amount of
peer and culturally manifested pressure to conform to the concepts of a specific and idealized

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physique that has become normative in mainstream society. These cultural pressures are similar
to the “Act Like a Man Box” created by Paul Kivel (1984). Research conducted by Kivel (1984)
demonstrated the structure of masculine behavior in society as rampant and ongoing.
Furthermore, he theorized that society teaches our boys and men to ignore feelings of love and
sadness, and to embrace a life of aggression, responsibility, and toughness (Kivel, 1984).
Moreover, masculine behavior is reinforced when men adhere to their roles, which
stereotypically includes dominance, confidence, sexual drive, and physical and emotional control
(Griffiths, Murray, & Touyz, 2015). In modern American society, this narrow image of
masculinity pushes men and boys into becoming fearful and hyper vigilant of every emotion and
behavior they exhibit. Eventually, this may cause boys to grow up fearing the possibility of
detachment from social groups and settings if their behavior is not aligned to the behaviors
discussed in Kivel’s (1984) work. In addition, the inability to assert oneself above these fears can
put men at risk for denial of gender conformity.
Sexual Orientation and LGBTQ Community
Past research recognizes that sexual orientation is important in the study of men with
eating disorders because of the link between the LGBTQ community and the “ideal” body
weight (Ousley, Cordero, & White, 2008). Currently, an estimated 3% to 5% of men in the
United States population are homosexual and it typically increases to 40% or 45% in the eating
disorder population of men (Ousley, et al. 2008). In a separate study, researchers studying eating
disorder factors and characteristics found that symptoms related to body dysmorphia and eating
pathologies increased by 10 times with gay and bisexual men than with heterosexual men
(Strong, Williamson, Netemeyer, & Geer, 2000). These rates imply that though the amount of

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men in the eating disorder and/or body image dysmorphia populations remain low, the incidents
of homosexual and bisexual men who suffer from those disorders increase dramatically.
A group of researchers described how men’s sexual orientation may affect the risk for
having an eating disorder and body image issues, which may be due to their social settings and
pressures, while others argue body image dissatisfaction and eating disorders may affect one’s
sexual orientation or sexual preference and drive for sex (Dakanalis, Zanetti, Riva, Colmega,
Volpato, Madeddu, & Clerici, 2013). Dakanalis et al. (2013) article found that in the need to
attract other men, LGBTQ men might fixate or alter their body, which becomes a socio-cultural
factor in the LGBTQ community. Dakanalis et al. (2013) explained that the excessive concerns
of ideal body weight, being slim, or excessive muscularity, is something similarly found in many
traditional issues that women with eating disorders face. Another interesting point of this
literature has focused on the importance within gay communities for men to present a healthy
body as a counterweight to the stigmatizing force of HIV/AIDS (Diaz, 2006; Ramsay, Catalan,
& Gazzard, 1992; Varas Diaz, Toro-Alfonso, & Serrano-Garcia, 2005). This heightened anxiety
about health concerns in the LGBTQ community has also made its way into the mainstream
ideals of healthy body image in the LGBTQ community.
Some research has discussed the connections between homophobia and the stereotypical
feminine behavior in homosexuality. For instance, researchers have studied the evidence of the
overplaying of behavior in males and identifications of gay men, bisexual men, and men who
have sex with men (Meyer, et al. 2001; Pope et al, 2000; Russel & Keel, 2002). Moreover, these
studies found that some men tend to exaggerate typical stereotypical male behavior in order to
compensate for their lack of muscularity, which was self-reported as attached to masculinity and
pertinence in social relationships (Meyer, et al. 2001; Pope et al, 2000; Russel & Keel, 2002).

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Additionally, the theme in their sample of men was geared toward the drive toward masculinity,
or included a combination of their gendered behavior and drive to masculinity, which varied
along the masculine and feminine spectrum (Meyer et al. 2001). Furthermore, a number of men
in their research were found to act as stereotypical heterosexual, masculine males, and relied on
their more toned bodies in order to prove their masculinity, despite the orientations of their
sexual desire (Russel & Keel, 2002). It is evident that the differences between gender and
behavior is distinct and manifests itself in negative stigma (Pope et al. 2000).
Other studies such as research conducted by Yager, Landsuerk, Wiesmeier, & Kurtzman
(1988) examined college men who had eating disorders and found that many homosexual men
had binge eating problems. Furthermore, many reported feeling “fatter” than how others
perceived them. The men also used diuretics and felt shameful of their weight and image (Yager
et al. 1988). Additionally, these results suggested that binge eating disorders were more prevalent
among homosexual men rather than heterosexual men in a given lifetime prevalence (Yager et al.
1988).
A further study examined by Yean, Benau, Dakanalis, Hormes, Perone, & Timko (2013)
assessed disordered eating, body dissatisfaction, and how they compared with the participant’s
sexual orientation. The men within their sample had a greater drive for muscularity than women
had. With regards to homosexual men, gay men had reported more body image dissatisfaction, as
well as an internal drive for thinness (Yean et al. 2013). In a similar study, bisexual men reported
less body shape dissatisfaction then homosexual men (Hunt, Gonsalkorale, & Nosek, 2012).
Additionally, body dysmorphic disorder was a precursor to some who had body image
dissatisfaction. Further, induced stresses also led men into a drive for muscle gain, thus causing
some men to have a physique anxiety. Their findings also noted that self-esteem was a

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determinant on the drive for muscle, and for “ideal”, thin body types. These body type fixations
were also self-reported as factors in their sexual orientation and sexual drives, which ultimately
became a risk factor for their eating disorder (Hunt et al. 2012).
According to a study conducted by Bosley (2011), gay men were more accurate and
frequent in checking their bodies than heterosexual men. Furthermore, gay men were found to
exercise more than the heterosexual men, according to their studies. Additional findings
suggested that gay men felt physical attractiveness was important, and were just as likely to
compare and check their bodies as much as women had (Bosley, 2011). These risk factors were
linked to their idea that those specific behaviors and ideas were correlated to bulimia
symptomology. Overall, the homosexual men were also more likely to discuss their bodies and
appearance more than women and heterosexual men (Bosley, 2011). Overall, the anxiety of
heightened perceptions about one’s body was a major concern in this sample of homosexual
men. In fact, while there is no solid causal relationship currently established, homosexuality in
itself is commonly considered to be a risk factor for body image complications and eating
disorders in men.
Sexual Abuse Victims
Sexual abuse is another related topic that is sensitive and related to sexual orientation,
eating disorders, and body image. According to a study conducted by Schwartz & Cohn (1996)
researchers examined a 1980s statistic in which victims of sexual abuse prevalence was 1 in
every 7 men. Because occurrences in males are already underreported, and because there is an
association between shame and guilt with eating disorders and sexual orientation, their studies
suggested that males who are victims of sexual abuse may develop issues with sexual and/or
gender orientation, along with fear of sex itself (Schwartz & Cohn, 1996). To clarify, there was a

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higher occurrence of homosexual men with eating disorders who happened to have been sexually
abused (Schwartz et al. 1996). Though this was a finding of the study, it does not imply that all
sexually abused men become gay, or develop an eating disorder, but that they are at a higher risk
to develop body image complications due to repressed memories and physical abuse (Schwartz
et al. 1996). Furthermore, researchers had noted that anorexia was the common struggle for their
sample of men with eating disorders who have been traumatized by sexual abuse (Schwartz et al.
1996). Additionally, their research proposed that due to hormonal imbalances in the brain, the
chemical imbalances due to anorexia nervosa and the denial of self-acceptance, caused certain
men to become asexual, avoiding sexual encounters altogether (Schwartz et al. 1996).
Another study conducted by Bosley (2011) was initiated in order to study body image,
LGBTQ identities, eating disorders, and sexual abuse. Her research found that bisexual men
especially were at higher risk for developing bulimia, rather than anorexia, and had also
experienced encounters with sexual abuse as children. Furthermore, the homosexual men were
connected to previous sexual abuse, which was a factor in their development of bulimia nervosa.
Bosley’s (2011) references to Feldman & Meyer (2007) reinforced the relationship between
disordered eating as coping mechanisms for the emotions from childhood abuse. Bosleys’ (2011)
analyses did report, however, that further research is required in order to generalize this small
field of data.
Race, Ethnicity, and Nationality
Western culture in the United States is connected with subjecting people to “ideals” by
familiarizing people with a set of behavioral guidelines. Furthermore, these might include norms,
upbringing, media, schooling, etc. In addition, there may include an assimilation of other
cultures, behavior, norms, and beauty into that of those portrayed by mainstream messages

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within the United States. Cultures of other diverse countries obviously vary in respect to the
standard ideals portrayed by their standards. Additionally, there may be a growing need for
research in cross-cultural and ethnic relations due to the variety of standards of ideal beauty and
body image satisfaction across nationalities, races, and ethnicities. In order to illuminate this
previously explained phenomenon, a study conducted by Agliata & Tanteleff-Dunn (2004) found
exposure to beauty and fashion magazines were consistently linked with body disturbances for
men in western societies. Additionally, they found men exposed to male models possessing the
ideal look of their society reported feeling more depressed and dissatisfied with their muscularity
and body image than those exposed to neutral advertisements (Agliata & Tanteleff-Dunn, 2004).
Warren & Rios (2012) studied young male second-generation Hispanic-American college
students still assimilating into American society. The study was designed to assess perceived
stress, anxiety, and body image awareness. Participants reported higher levels of anxiety and
stress due to the mass media portraying images of the ideal body along with assimilation into the
norms associated with male physique and body image (Warren et al. 2012). In addition, higher
levels of body image dissatisfaction and body dysmorphia were reported. Furthermore, these also
caused some a heightened anxiety to “fit in” through exercising, eating less, and internalizing
nervousness and hyper-vigilance about the opinions of others (Warren et al. 2012). This study
exemplified how media portrayals and body image issues connected internalized thoughts and
pathology in regards to the Hispanic-Latino-American population at the collegiate level (Warren
et al. 2012).
A related study regarding Hispanic men in the United States focused on body image and
eating disorders. De Santis, Layerla, Barroso, Gattamorta, Sanchez, & Prado (2012) reported a
link between eating attitudes, behavior, and body image. Results found sexual behaviors

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decreased when negative eating behaviors increased. As the first descriptive cross-sectional
study of its kind, it branched out and extended to Hispanic individuals with similar eating
disorders. Overall, 13% had a risk for an eating disorder, and since they were homosexual as
well, the study decided not to generalize to the overall community. Due to this finding, it is safe
to say that not all homosexuals are at a risk for an eating disorder; rather, sexual orientation may
be a common trait for those populations who suffer from eating disorders and body image
complications. Additionally, due to the upbringing of many Hispanic men, they are raised to be
more machismo and masculine, and are expected to engage in risk taking behaviors (Meyer &
Champion, 2008).
Ryan & Morrison (2012) conducted a study incorporating the Drive for Leanness Scale to
measure attitudes toward Irish men and women. This study was used to compare the participants’
perceptions of ideal body weight and body type, considering men and women’s motivating
interest was low body fat and muscle mass. Conducted in western Ireland, men and women
strove for both leanness and muscle tone. Additionally, men typically reported muscular body
images as their ideal body image. Their data also suggested men’s drive for muscularity
predicted a variety of muscle dysmorphia symptoms. On the other end of the spectrum, there was
lack of data on men’s drive for thinness in this study, and it has yet to be investigated in further
detail (Ryan et al. 2012). Generally, the Irish men in this study tended to drive for the more
stereotypical male-muscular ideal form of body image, whereas the females strove for more lean,
yet thin ideals. Interestingly, both sexes overall sought a more fit and athletic body type (Ryan et
al. 2012).
Similarly, another study focusing on the behavior of Italian college-aged men examined
participant’s self-reported sexual orientation, eating behaviors, and mood (Dakanalis, Mattei,

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Bagliacca, Prunas, Sarno, Riva, & Zanetti, 2012). Using the Body Surveillance and the Body
Shame Subscale, they attempted to measure the way participants viewed their own appearance.
According to their research, they found no significant pathway from body surveillance to
depression, though body surveillance had a direct effect on body shame and an effect on
disordered eating (Dakanalis et al. 2012). Their research found heterosexual men exposed to
objectifying media led to body checking and body shame, which led to some disordered eating.
Depression was also statistically significant in this case, another comorbid diagnosis generally
seen in patients with disordered eating and body image dysmorphia (Carlat et al. 1997).
More innovative research takes into account an Asian male perspective. A study in
Singapore was conducted to determine differences in the features of eating disorders in males.
Most of the researchers noted that most men in their sample did not have full-blown diagnoses
for an eating disorder or body dysmorphia, but had very debilitating symptoms of eating
symptomatology (Tan Shain, Lin Miao Shan, Kuek Shu Chen, Lee Ee & Boon Swee Kim, 2014).
Researchers also noted that certain participants alluded to punishing themselves by purging, or
excessively exercising after receiving comments about their weight in a negative manner. This
pattern of behaviors is similar to research conducted by Smolak et al. (2002), in which their
study identified self-punishing behaviors such as food restriction and other substance use as
compensatory means to manage their emotional states. Furthermore, these patterns were self-
reported as tools of empowerment in which men were able to exercise self-control and
possession over what goes in and out of their bodies (Smolak et al. 2002). Overall, it is clear that
some Asian males may tend to use guilt and shame as reasons to punish and restrict food intake
due to a fixation on weight management.

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As an illustration, Asian males—including Chinese males in Singapore—are more
vulnerable to idealized images of muscular bodies because their true body sizes are usually not
as muscular as Caucasian males (Barnett, Keel, & Conoscenti, 2001; Cachelin, Rebeck, Chung,
& Pelayo, 2002). As a matter of fact, the majority of the readers in Singapore are Chinese, but
models of muscular body images in men’s magazines are predominantly Caucasian (Khoo &
Karan, 2007). Barnett et al. (2001) findings support the idea that men idealize and standardize
their beauty in men of western cultures. Generally, the comparisons between cultures can be
explained through a combination of social comparison theory (Festinger, 1954), and of
cultivation theory (Gerbner, 1969) because these instances include cases of comparing cultural
media messages from other nations and internalizing them as standard beauty ideals.
Education and Age
There are few studies examining the influence of age, income, or education among men
with eating or body image disorders. However, certain studies such as the one conducted by Keel
et al. (2010) focused on the risk of how middle-aged men developed significant problems with
eating. Additionally, they tried to explain this phenomenon through healthy weight gain as age
progressed, along with what the person at that time considered an ideal body weight.
Furthermore, a study conducted by Kimmel & Mahalik (2005) and Siever (1994) suggested a
desire to hold onto an ideal body physique was coupled with a desire for youthfulness. Their
implications suggested older gay men might compare themselves to younger, fit gay males,
subsequently negatively associating their older age with a negative perception of their body
image.
Still, in regards to education, very little research tackles the social identities of eating
disorders and body image. Another study suggested patterns of bulimia are connected with the

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development of young adults, especially students who are in higher education, due to peer
pressure and exposure to suggestible audiences and influences (Gravener et al. 2008). Other
caveats from these studies included more gender-driven styles of “eating” while attending an
undergraduate institution (Gravener et al. 2008). The researchers realized their sample of men
labeled eating disorders as either feminine or masculine, depending on the severity of illness. For
example, anorexia nervosa was seen as more feminine, because of the ties to a drive for thinness,
whereas binge eating disorder was labeled as masculine, due to the extroverted behavior in
weight gain (Gravener et al. 2008). Students in higher education were also found to be more
susceptible to bulimia nervosa (Kelly-Weeder, 2011). Furthermore, a link was found between
binge drinkers and disordered eating. Their results of the study found binge drinkers and
disordered eaters were not substantiated as typical of college men or for risk in developing an
eating disorder.
Measuring And Responding to Body and Eating Disorders
Measuring Disorders
Due to the fact that eating disorders were only treated as a “female disorder”, the
invention and adaptation of tools to assess eating disorders were never recognized as only meant
for men until recently. One study specifically admitted to the lack of proper test tools to properly
examine, measure, and rate the severities of certain men and their disorders. Darcy & Lin (2012)
explained that males dramatically underscored women in these tests that were meant to assess
their eating disorder. She described males consistently scored lower than females on most
measures even when the severity of the psychopathology was relatively equivalent. Additionally,
it was not valid or reliable to use female-oriented tests for severity assessment until norms have
been established for the men as well (Darcy et al. 2012). Without the correct tools to test people

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and to collect data, articles written without these crucial tools become null and meaningless
simply because they do not accurately assess and detail the experiences of men with eating
disorders. A 2001 Canadian study published in the American Journal of Psychiatry compared
males with full and partial eating disorders and men without eating disorders (Woodside,
Garfinkel, Lin, Kaplan, Goldbloom, & Kennedy, 2001). They found the overall combined
prevalence rate for full and partial eating disorders was 2.0% of the entire Canadian population
of males and females (Woodside, et al. 2001). Furthermore, the research findings are more than
likely to be an underestimate due to the diagnosticians, psychometric evaluators, and clinicians
inability to properly diagnose and treat these eating disorders.
As of now, the Eating Disorder Examination, EDE-Questionnaire, Eating Disorders
Inventory, and the Bulimic Inventory Test are used for both males and females. Conversely, only
the Drive for Muscularity Scale, along with the Male Body Image Concerns Scale, Male Body
Checking Questionnaire, the Body Change Inventory, the Obligatory Exercise Questionnaire and
the Appearance and Performance Enhancing Drug Use Schedule are the top notch tests that have
been established for men only (Woodside, et al. 2001). While most exhibited great reliability,
consistency and validity, the need for more updated test construction is required to evaluate
specific behaviors of men with eating disorders.
Treating Disorders
Traditionally, men have been raised to play the role of the “strong oak”. Normally, they
are taught to be strong, dedicated and hard workers who become self-sustaining and never show
their emotions. These cultural hetero-hyper masculine standards alienate these men from
achieving proper treatment and recovery in their eating disorders. Furthermore, higher levels of

19. Hartman 19
gender role conflicts and traditional masculine ideals may be associated with negative attitudes
toward psychological help.
For those who decide to admit to requiring psychiatric and medical help, the steps to
recovery are possible. More likely than not, an eating disorder patient is stabilized through
weight restoration through decreased restraint and restriction. Additionally, binge eating and
compensatory behaviors (such as exercising, laxative use, and purging) are eliminated as well.
Conventional psychotherapy for men suffering from eating disorders is the typical route for
many patients. CBT and DBT, which stand for Cognitive Behavioral Therapy and Dialectical
Behavioral Therapy, are the usual standard procedure for treatment of these disorders. Both
therapies place a strong emphasis on the mindfulness of emotional control and stability as well as
self-awareness. Moreover, coping strategies are associated through internal experiences of
episodes of the disorder. Sometimes, men may feel shameful and guilty about their position as
the client, which may cause them to become withdrawn, thus disturbing the therapeutic process.
Diener, Hilsenroth, & Weinberger (2007) asserted that therapists who included discussions of the
clients roles as leaders, fathers, sons, brothers, and husbands may help ease the process. This
allows the male to open up with his experiences, as well as be more susceptible to taking the
therapy seriously. Furthermore, without treatment being a long, arduous role for both client and
therapist, there are chances of relapse and discomfort on both sides of the therapeutic
relationship.
Data and Methods
This research uses data drawn from semi-structured in-depth interviews with young
college men who attended John Carroll University and who agreed to discuss their perceptions
on their body image. The research currently being studied is on body image and perception of

20. Hartman 20
body satisfaction; five John Carroll University male students were recruited. Convenience
sampling, specifically, snowball sampling, was the method of choice to gather participants for
this study. Snowball sampling is a sociological sampling technique in which existing study
subjects recruit future subjects from among their acquaintances. This way, data and participant
sizes can grow. The sample size was recruited via email, solicitation of friends, and strangers.
The use of snowball sampling was used because of the nature of the research; the student body
was readily available and easily accessible. Additionally, participants were at least informally
acquainted to the researcher prior to the interview; the participants knew of the researcher. Also,
it was possible due this style of informal research, the participants may have answered questions
more truthfully. Lastly, all students were contacted, and had agreed to help with this study.
Typically, the researcher initiated a follow up via email in order to make sure the participant was
still interested. Throughout the process of interviewing, participants’ names were coded via the
first letter of his name. This measure was done in order to track and differentiate their responses,
as well as to keep their identities confidential for publication purposes.
Sample Characteristics
The range of the participants’ ages was 18–22 years old, with a mean age of 20.8 at the
time of the interview. Four males divulged that they were heterosexual, and the other male said
that he identified as homosexual. Additionally, the students varied in their class year. Three
males reported that it was their senior year, the last semester before graduation. Furthermore, the
remaining males consisted of one junior and one freshman male. All males had self-reported as
middle class, varying from “firm middle class” to “low middle class”. The sample size gathered
consisted of males who all self-reported as White/Caucasian. Lastly, and interestingly enough,
one male had disclosed he currently suffers from obsessive-compulsive personality disorder.

21. Hartman 21
Research Design and Analysis
The nature of the interview varied in length, due to sets of questions asked. Typically, the
interviews ranged between 30 minutes and 60 minutes. The interview topics incorporated
specific status identities that were formed into questions related to body image, body image and
perceptions of healthy behavior and eating habits, as well as questions regarding exercise and
comparing themselves to other males. Some of the topic questions include: “How satisfied would
you say you are with your body?”, “Do you think you have a positive or negative body image?”,
Have you ever suffered from body image problems or serious body dissatisfaction?”, “In what
ways do you think your gender influences your body image and/or satisfaction?”, and “Do you
think your sexual orientation influences what you would like your body to look like?”.
The participants gave the student researcher oral consent before the interview, and
informed the researcher he was over the age of 18. Also, all participants voluntarily participated,
and all information was gathered via an audio recording device. Additionally, all audio-recording
files were kept on a laptop that was password-protected to the researcher and his advisor.
Following the interviews, the student researcher transcribed all responses. Afterwards, the
transcriptions were organized and then coded by themes. The themes were created by including
characteristics and patterns of the responses, in addition to being included for simpler data
analysis. Furthermore, similar replies were organized and grouped together in order to accurately
depict the degree of replies of a particular question.
Findings
Overall, there were three main patterns of results found in the interviews with the
participants. These patterns included: gender and body image, sexual orientation, and influences
of sports and media on body image.

22. Hartman 22
Gender and Body Image
Gender was a major topic under discussion with the current research. Questions probed
the students for their perceptions on their gender conformity, how their body image directly or
indirectly influenced how they should look, and how they felt about those gender statuses. All
participants reported having their body image affected by being male. Furthermore, all of their
experiences were uniquely different from one another. Generally speaking, media, sports, and
family upbringings affected their body images.
All participants agreed that men in general were not supposed to talk about or worry
about their body, because it was not seen as “masculine”. One participant had commented on the
stigma,
I think it's more acceptable, but there’s definitely still a stigma for whatever reason. And,
I think it goes back to the old hyper-masculine paradigm, or stereotype of men where you
know, unemotional, very compartmentalized…Women have their own issues. So, I
think unfortunately, it's the fact that 20th century perception of gender particularly
about males that prevents a better dialogue. [Participant, #1]
This finding supports previous data found by Strother et al. (2012) in which men are to act as
masculine, strong, and not bothered by issues of weight and body image. Another participant had
offered his take on masculine expectations,
…socially acceptable? No, I don’t think so. It’s frowned upon…I think that it is more of a
feminine, considered a feminine thing to try to care about weight, whereas men are not
supposed to care. You get a beer gut and whatever, or something like that because that’s
"manly". Yah, so I think that it just has to do with the fact that men in general are
expected not to talk about, you know, issues that they have with themselves and things
like that. So, this is just another example of one of those issues being in this case, body
image, where I think it wouldn’t be as acceptable to talk about. [Participant #1]
Additionally, one participant sampled in this study felt society asks for men and young
boys to be more manly and tough. This construct is a similar component negating the
acceptability of males openly discussing concerns of body image. Another participant explained,

23. Hartman 23
I think that’s kinda the manhood, the manliness that society, that we ask of ourselves.
We ask of our boys and men, so I, ugh . . . I barely, let alone, I don’t think it’s acceptable
for some boys, for some boys to eat vegetables because that’s seen as girly. [Participant,
#3]
This quote brings up concerns about what males eat. This participant argues what goes into the
bodies of men can dictate how manly or girly they are perceived. Eating foods without second
thought is something this participant explains as commonplace, starting in younger ages,
You know, in the cafeteria, oh, chicken, fries, man. I think that there's that attitude.
So I think to, to be able to actually have the freedom to express yourself in food, to begin
with, in a lot of high schools, and in middle school, that’s a step. [Participant, #3]
Ultimately, the ability to express oneself in food can be channeled into the freedom to express
one’s body.. In addition to expression, men who eat what they want, when they want, however
much they want, allows them to raise their disinterest in worries about body image. Additionally,
this expressive eating behavior allows men to assert their masculinity without displaying anxiety
or worry about body image to others.
Not surprisingly, all five of the participants cited media images affecting the “typical”
male in his idea of body image. Furthermore, they all believed that most men are concerned with
getting bigger, or more muscular, rather than smaller in response to messages portrayed by the
media. One participant had cited a strong media influence to his perceived standard body image,
…well, growing up, I was always a sport fan. So, there was that image of again, the big,
strong, athletic, fast, guys that was always my like, if I had, I’d say from early on
elementary school all through high school. I was always watching sports, you know, on
TV all I watched was ESPN, so that only male, the only image I ever had of masculinity
was these crazy athletic, you know. So, that was I guess, that affected my image, and that
I wanted to be like that. [Participant, #2]
This response mirrors cultivation theory (Gerbner, 1969) in which people internalize media
messages. At a young age, this participant felt his only image of the ideal male was through
sports. A result of this can include how the media skews the male perception of toned, fit,

24. Hartman 24
athletic men as the only type of accepted body image. One participant who was a little different
from some of the others explained his viewpoint when he said,
On the male side, I think that there's two prongs for most men. It’s about you know,
being very athletic, being very muscular, being in shape, etc. And that in itself is a form
of body issue. For me personally, though, I've been more so toward the anorexia, thin,
side of it, which can kind of encompass this weird kind of positioning of my gender.
Because, I think most guys my age are about getting bigger, and getting athletic, I’m just
like, you know, trying to be my thin little self [Participant, #1]
Though this point is important, it does not mean that the men believed their body image was
affected by media messages; it was generally purported others were affected, rather than
themselves. Interestingly, the point made by these men is reminiscent of previous research
conducted by Hargreaves & Tiggemann (2006). This study found that people believe that body
image portrayed in the media has little or no influences on the self but has great influence on
their peers. This phenomenon may help explain how men have a realization of media affecting
others. Therefore, a man’s perception of his body is safe and untouched by media.
The participant quoted above is not alone in being male and wanting to appear or feel
thinner. Though many of the participants reported not worrying about getting bigger, or fatter,
some reported the opposite. Two participants reported they were worried about being
overweight, and one revealed that he intentionally calorie restricts on days when he did not feel
satisfactory. In fact, this participant disclosed he was suffering from obsessive-compulsive
personality disorder, which he blamed as the reason for his anxious and obsessive need to calorie
restrict. He said,
Uhm, I would say just based on the whole idea on the calorie restriction, there are some
days where for whatever reason there’s like an off or fat day, I will potentially calorie
restrict, uhm that was again, maybe the self-destructive pattern of behaviors. [Participant,
#1]

25. Hartman 25
Furthermore, his reaction toward his body image was more aligned to wanting to be thinner and
smaller than the other participants who felt getting bigger, more muscular, and stronger was
important. Another participant reported when he was younger in college, he was more
overweight than he was during his interview. He had admitted to abusing pills and powders that
he would use to flush out the negative body image and excess weight. He clarified,
Yah, I would go to CVS, uhm, I’m trying to remember, this was years ago, but I went to
CVS. I didn’t have a car, so I walked. I was scanning the shelves and thinking, ‘what’s
gonna lose me weight--what’s gonna get rid of fat?’ and I would just try a couple things
and uhm, yah. I would try them and I wouldn’t really tell anybody what they were, ‘cause
when it’s powder, you just stir it into a water and it looks like fruit punch, uhm, and it
didn’t work. [Participant, #3]
In this explanation, it is apparent that this participant did not want others to know he was
preoccupied with his weight or trying to lose weight. As mentioned earlier, he thought it would
appear emasculating if other men knew of these feelings and behaviors.
Sexuality and Body Image
In regards to sexual orientation, most men had referred to questions regarding body
image and sexuality as connected. To these men, sexual orientation influenced how they felt their
body should look. One participant clarified,
Well, straight men wouldn’t really care about his body image as much because a gay man
would. Uhm, they, you know, they’ll eat whatever. They [straight men] care about, you
know, ripping it up in the gym here and there, but besides from that, it’s prevalent, it’s
the idea, it’s, the biggest concern for the average straight guy I hang out with, is getting
some on the weekend. It's not about what they're eating. [Participant, #3]
Here, this participant argued straight men cared about being tougher in order to have a partner,
regardless of the worries of food intake. Additionally, the participant implied gay men may care
about their body image more, which opens up new segments of food intake, exercise, and
internalizing of media messages more than their heterosexual counterparts. Another male shared
the above participant’s viewpoint,

26. Hartman 26
…you know, you have to go get a girl. You have to compete against other people who
you know, might be big, bigger macho with you. Machoer than so, you know you, but for
me, doesn't play that big of a role. [Participant, #4]
This response is similar to the previous above response in that to get a partner in a heterosexual
relationship, he understands there is a competing, macho-masculine aspect of dating.
Additionally, he implied it had not played a big role for him, rather, it affected others. This
implication mirrors the belief mentioned earlier, in which men only believe society affects other
men’s image and perception of their body (Hargreaves & Tiggemann, 2006). Furthermore, all of
the participants argued that straight men would not care so much about their bodies because it
was not masculine to worry about their body image in this way. Also, straight men were
perceived to be preoccupied with other things such as dating, going to the gym, and eating
whatever they wanted. This type of explanation stems from previous research stating gay men
may put body consciousness and awareness first in social settings (Duggan & McCreary, 2004).
This emphasis on body image contrasts with that of straight men, mirroring previous research in
which homosexual men may tend to have greater social physique anxiety (Duggan & McCreary,
2004).
Sports, Media Influences, and Body Image
In addition to gender and sexuality as factors in eating disorder and body image
symptomatology, sports, athletics, and media influence impact men as well. Many of the
participants mentioned sports and athletics were important and influenced how they thought
about their bodies. Specifically, competition was important; athletics drove many participants to
define their body satisfaction around having the most fit, toned, and abled body in order to do
well in sports. One participant argued,

27. Hartman 27
If someone performs better than me, it’s generally because they're in better shape than I
am, right? So, they might be stronger, or lighter, you know, weigh less, and that would be
a chance for me to say that I need to change something about myself. [Participant, #2]
This claim spoke volumes about how some men may be willing to change themselves in the
name of competition, and of body image value. In this example, competition was only important
if the participant was able to compete, succeed, and defeat his athletic opponents. In regards to
overall body satisfaction, he also mentioned in a previous response,
I'm, I mean physically, just, like a healthy weight, I guess just being able to do anything
that I would want to do. Physically, you know, if I want to go for a run, I can do that. If I
want to, you know, play basketball, I can do that, you know. I, I guess I’m not held back
by anything. [Participant, #2]
Therefore, the idea that this participant may be constantly willing to change himself to be bigger
and better may imply that he is open to changing certain aspects of his body in order to be
happier. Furthermore, this participant’s attitude toward his body was a reflection on his sport
performance. This point is the opposite to the data found by Marino-Carper et al. (2010) in which
they defined men who were obsessed with body surveillance as aesthetics over functions. Here,
this participant claims the opposite in which functions comes first, which in turn causes
happiness and confidence in the ability to compete in athletics. Another participant admitted to
anxiety and distress in regards to his body image, with emphasis on comparing himself to
athletes.
In regards to anxiety, some men pointed out comparing their bodies to others caused
them distress. Most had not considered themselves pound watchers however, many of them
mentioned comparing themselves to other athletes and friends sometimes led to a negative mood
and negative sensation about the way they felt about their body image. In order to justify this
claim, one participant stated,

28. Hartman 28
Yah, it’s definitely more so comparative, it’s not necessarily like, ‘oh, I need to drop like
10 pounds’. I’m not much of a weight or pound watcher; I never weigh myself. It’s more
so not even really like, again, obviously we all compare, but not necessarily compare in
like ‘oh do much curls so I can get better’. I’m just more of a comparison, subconsciously
or consciously that leads to [negative] mood, that leads to the [negative] sensation.
[Participant, #1]
Additionally, some men mentioned that the media portrayals of the ideal male body influenced
their perceptions of their bodies. For example, many of the participants acknowledged
professional athletes made them aware of what the media portrays, in regards to body image, and
what that does to young men in society. One participant rationalized,
I see Gaylin—like a fast distance runner—like Gaylin Rupp, or Mo Farah. You think, ‘oh
the fastest man in the world, like wow, like, their calves are so defined and their quads
and their form is perfect’. Like, that's what I want to be. That would make me the best
runner. So, I guess I would strive for that, and definitely, yah, definitely could see that. I
mean, there's so many like, if you go, if you see magazines like, buff guys or like, really
big lifter guys, and I could see that, absolutely. [Participant, #5].
All of the participants also pointed out the fact they would change themselves to perform better
in order to be more competitive, and to assert their dominance over other males. Perhaps this
theme incorporates a denial, inability, or unawareness of one’s confidence. What is not discussed
is changing one’s body implies one is aspiring to a standard or a goal one does not have at the
moment. For example, striving toward what an athlete may look like implies one may also enjoy
the power and control that goes along with high-ranked competing athletes. Furthermore,
changing one’s body can imply men do not openly regard their current body image as inferior,
yet tend to strive for bigger and better as an ever-changing standard of masculinity.
Discussion
The purpose of this study was to examine perceived attitudes and perceptions of body
image satisfaction levels among college-aged male students at John Carroll University.
Furthermore, the study aimed at measuring body image with special interests in unique identities

29. Hartman 29
present in the participants. Overall, the interviewees tended to state being a male was drastically
different than being a female with body image issues. The theme of being a male was to be more
masculine, tougher, stronger, and less preoccupied with weight and body image. Furthermore,
being a male did not allow for them to discuss their views to the general public. Specifically,
they felt it was not accepted to discuss their issues on weight and body image as a problem.
Another aspect of current body image research is how the media has portrayed and
affected men through norms within society. These portrayals give men messages that body image
type varies from time to time. Furthermore, adhering to a specific muscular or incredibly thin
figure may be unrealistic. In addition, body image norms may change over time, causing
inconsistencies and fluctuations in adherence to fads. These mixed signals portrayed by the
media (such as those projected into runways, television shows, movies, and pornography, etc.)
may create discrepancies between idealized and current body image size.
Other results from this study examined the importance of sports in the way in which
masculinity is dictated in mainstream media as the expected role for males. Furthermore,
society’s construction of the ideal male can skew the line between body image based off of
competition and body image based off of happiness in aesthetics.
To conclude, the differences in body image perceptions generally reflected previous
research. Furthermore, most, of the responses suggested there are patterns of behavior, along
with incidences of attitudes toward social conformity concerning male beauty. In this sample,
some males mentioned that their ideal body image was to be larger, stronger, and more muscular.
Those who reported this varied in their attitudes and perception toward gender and sexual
orientation status. This finding demonstrates some straight males who want to be thinner, while
others, such as gay males, may wish to be larger, and more husky. Additionally, a few straight

30. Hartman 30
males also mentioned becoming smaller and thinner was their ideal. These two distinctions in
data are relevant in research as well. Furthermore, all but two participants indicated high levels
of body dissatisfaction at one point or another in their lives, which is reminiscent of previous
research conducted by Mishkind et al. (1986). Perhaps the reasons behind these differences in
perception of body image are due to a blend of upbringing, exposure to media, and overall,
beliefs toward the concept of masculinity. These three areas of body image research may help
explain why there is such a strong emphasis on striving for perceived beauty, strength, and
conformity.
Although body image and eating disorders are recognized troubles in the 21st century, it
is important to incorporate treatment, along with more accepted types of body image that do not
shame or guilt men in society. Future research can focus on identifying more specific
characteristics such as LGBTQ populations and body image, or heterosexual and homosexual
men only, in order to get a more general understanding of a distinct population’s culture and
body image norms. Furthermore, including more participants, as well as including more diverse
and specific questions would also open up the conversation to more dialogue and more unique
experiences!