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Nelson and Hughes (1999) examined the risk factors of developing an eating disorder and also asserted that male athletes display increased susceptibility. This proves especially true in sports where body size and proportion remain under intense scrutiny. Nelson and Hughes discussed the elevated incidents of anorexia and bulimia in their male sample population and also suggested the likelihood of higher prevalence rates than previously suspected. They reported that there is minimal research literature addressing eating disorders in males and discussed the need for future research endeavors in this area.
Patel, Greydanus, et al. (2003) investigated prevalence rates for adolescent athletes and concurred with previous studies that posited the underestimation of incidents in the male athletic population. Patel, Greydanus, et al. specifically emphasized young men in sports that focus on body weight and body image--wrestling, swimming, track, rowing, and gymnastics. The pressure that these athletes put on themselves leads them to engage in maladaptive eating behaviors that prove dangerous to their physical health such as: excessive exercise, caloric and fluid restriction, laxative and diuretic use, self-induced vomiting, and starvation (Patel, Greydanus, et al.).
Diving, bodybuilding, gymnastics, and running represent additional sports that hold increased risk for the development of eating disorders. In these sports, the impact of body image is emphasized, the athletes are judged to some degree by physical appearance, and to be competitive they often demand extremely low percentages of body fat (Murphy & Gutekunst, 1997; Oliosi, Dalle Grave, & Burlini, 1999; Patel, Greydanus, et al., 2003). The belief of some athletes is that competing in a lower weight division or reducing their body fat index will increase their chances of winning. Both coaches and athletes tend to adopt this belief system to succeed. Ironically, the deleterious side effects of anorexia or bulimia often hinder their performance due to the health risks of disordered eating patterns that physically weaken the athletes and lead to decreased performance (Murphy & Gutekunst). Clearly, the demands placed on athletes to achieve and maintain a certain body weight put them at heightened risk for the development of eating disorders.
Manley, Rickson, and Standeven (2000) reported that boys present with anorexia at a significantly higher percentage than adult males, although they point out that the reasons for the growing prevalence in boys remains unclear. They comment on this possibly resulting from burgeoning sexual conflict emerging in the adolescent period. The lack of knowledge regarding the sexual characteristics of boys and men with eating disorders underscores the need for further research (Scheider, 1991; Walcott et al., 2003). Knowledge of the existing research in this area can benefit school counselors by providing them with an awareness of the additional risk that homosexual youth may face for the development of an eating disorder. This knowledge assists the school counselor with identification and represents the first step in the treatment process.
Features of Obsessive Compulsive Disorder are frequently seen in individuals suffering from anorexia and bulimia. The obsessive-compulsive behaviors focus on food, body image, and weight. Also, impulse control issues remain prevalent in males with bulimia; this links with Substance Abuse and Cluster B Personality Disorders such as Borderline, Histrionic, and Narcissistic as individuals with these diagnoses also display poor impulse control (American Psychiatric Association, 2000).
As with Personality Disorders and Mood Disorders, low self-esteem is often reported in eating disordered clients. This has been demonstrated in both subjective and objective accounts (American Psychiatric Association, 2000; Nassar & Hodges, 1992). School counselors aware of the link between eating disorders and the diagnoses enumerated in this section will have relevant information to assist them with accurate identification of students at risk.
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