Medical and scientific understanding of eating disorders is changing and expanding. what happened?
Dr. Smith: Historically, eating disorders have mostly been treated as anorexia, which is defined as a disease of adolescent women who want to lose weight for aesthetic reasons.
Dr. A.S. Nagata: Especially in the past decade, there has been a growing recognition that some people who are dissatisfied with their body image do not try to lose weight. Some men and boys They are trying to be big and muscular. In fact, one-third of teenage boys across the United States say they are trying to bulk up and gain more muscle. And a subset of those may develop eating disorders or muscle dysmorphia, which can cause significant psychological distress and physical health problems.
What is muscle dysmorphia?
Dr. A.S. Nagata: Also known as anorexia nervosa or anorexia nervosa, it is a disorder in which a person feels that their body has little or no muscle, even though they are actually considered fit or athletic by others.
Dr. Smith: Maybe it’s because they want to be fit for hockey, or because they want to be more muscular or “trim” from an appearance standpoint. The motivation driving these behaviors may not be consistent with thinness, but we still see similar behaviors. We see a stressful workout. We see the elimination of certain types of food. We see marked dietary restrictions. Then there are those who choke or spit, fear that, or are always picky and fall off their growth curve. And because children and teens are growing and developing rapidly, those changes can lead to serious medical problems.
These complications can lead to starvation. what does that mean?
Dr. Smith: It is an imbalance between a person’s energy or nutrient needs and what they actually put into their body.
Dr. A.S. Nagata: When your body puts out more energy than it takes in, this can lead to starvation. Your vital organs begin to shut down because they don’t have enough energy to take care of themselves. And I think there’s an under-recognition that starvation can happen to people who exercise a lot without getting enough food.
So, is there an overlap here when it comes to boys and athletics?
Dr. A.S. Nagata: Yes, absolutely. I think that men who are athletes are more likely to have an eating disorder because, to some extent, some of these behaviors are common in competitive sports.
Dr. Smith: When it comes to the physical consequences of over-exercising, under-eating, and eating disorders among athletes, we have a term called the “female athlete triad.”
What are the components of the female triad?
Dr. Smith: Weight loss, changes in bone density, and dementia, which occur when women miss their periods. Another example is our sexism and how we have contracted this disease.
Dr. Smith, you’ve done some of the most cutting-edge research on eating disorders, including the finding that eating disorders take a toll on men.
Dr. Smith: From 2002 to 2019, more than 11,000 hospitalized children and adolescents aged 5 to 17 years in Ontario looked at eating disorders. What I found was that while hospitalization rates increased by 139 percent overall, the largest relative increase was among men: their rate of hospitalizations rose by 416 percent. Common reasons for hospitalization include symptoms such as a very low heart rate, abnormal levels of minerals in the blood, or suicidal thoughts.
To what extent does your research in Canada suggest what is happening in the United States?
Dr. A.S. Nagata: I think our trends are very similar. we have A recent study That focused on boys in the United States who were hospitalized for eating disorders. Compared to girls in the hospital, we found that boys have more serious medical problems. Boys have longer hospital stays, higher rates of cardiac arrhythmias, and anemia than girls. This may partly reflect the fact that men are often identified or identified later.