Corson, along with Arnold E. Andersen, M.D., UI professor of psychiatry, discusses this issue in "Body Image Issues Among Boys and Men," a chapter in the recently published Body Image: A Handbook of Theory, Research and Clinical Practice.

"The formation of the unattainable ideal image for both genders begins in childhood and is reinforced by the media and children’s toys," Corson said.

Emphasizing the ideal image of thinness for women, Barbie dolls have grown thinner over the past 40 years, but GI Joe action figures have grown larger and more muscular, presenting an ideal body image for men. If the proportions of a 1960s GI Joe were applied to a man who is 5 feet 10 inches tall, he would have a 44-inch chest and 12-inch biceps. His 1990s counterpart would have a 55-inch chest and 15-inch biceps, according to Corson and Andersen’s article.

As boys grow older, the muscular ideal is perpetuated through the media, including men’s magazines, which present extremely lean, defined and muscular male models.

"These models are ordinary men made to look like they were carved out of stone, although the photos were probably airbrushed to create that chiseled look. That’s just unrealistic," Corson said. "I don’t think that the editors of men’s magazines have even recognized this as a problem yet."

While women with eating disorders tend to have numerical goals (for example, weighing 100 pounds or fitting into a size two), men’s eating disorders involve a constant competition to stay more defined than other men. This competitiveness may stem from a power shift in recent years, Corson said.

"The power dynamic in society is changing, especially in the workplace, where women are gaining more power," Corson said. "Many men feel that they are facing new competition, and by bulking up, they can regain a sense of control as well as convey a sense of power, as the size of a man’s chest, shoulders and his height all convey physical prowess."

Men may also feel more pressured to be physically attractive now that women—including their wives and girlfriends—are entering the workforce in larger numbers. This was less of an issue when women stayed at home more and were not exposed to other potentially attractive mates, Corson said.

For many men, eating disorders and body image problems begin as a health kick, but end up in an unhealthy cycle. Diet and exercise can be beneficial, however, when these activities become excessive and interfere with a person’s health and ability to function on a day-to-day basis, it may indicate the presence of an eating disorder.

Starvation can have serious short-term and long-term complications. Osteoporosis (the thinning of the bones) has been found in men and women who restrict their caloric intake. Purging through the use of laxatives, diuretic abuse or vomiting can lead to life-threatening electrolyte imbalances. Excessive exercise, especially when coupled with the use of steroids, can lead to physical injury as well as end-organ damage, and the use of diet pills (which usually contain stimulants) may lead to sudden cardiac death. While men can suffer from anorexia nervosa, bulimia nervosa (binging and purging) is more common.

"Men have a propensity to become bulimics because a lot of them are used to eating large quantities of food, and it’s disturbing for them to be without that," Corson said.

Men can also suffer from body dysmorphia, where they obsess over one or more body parts. For example, men may have a phobia that their shoulders are not large enough. This often leads to excessive exercise, coupled with steroid abuse.

The UI Health Care Adult Psychiatry Clinic offers help for men and women battling eating disorders and body image problems. Patients initially are seen at the clinic for a one-to-two hour diagnostic interview, where they are interviewed by a psychiatry resident or a psychiatric social worker who specializes in eating disorders, as well as by Andersen. The interview determines the level of care needed—inpatient, partial hospitalization or outpatient.

Weight is only one factor in determining a patient’s need, Corson said. Other considerations include medical problems such as electrolyte imbalances (brought on by vomiting or laxative abuse) or coexisting psychiatric conditions, such as depression leading to suicidal feelings.

Following the initial diagnostic assessment, Karen Olmstead, UI psychiatric social worker, continues to work with these patients, often on a weekly basis. Olmstead uses cognitive therapy to help them understand their body image distortions and enable them to follow their eating plan, which is set up by Cathy Dostal, UI Hospitals and Clinics eating disorder dietician.

Andersen also leads a weekly support group to help men with eating disorders recognize that they have a disorder and understand how their disorder is both similar to and different from eating disorders in women. The group also supports families and helps them recognize the problem as well.

"The best way to prevent an eating disorder is awareness about the pressures put on both men and women to attain an unreachable ideal image," Corson said. "It’s unfair that both genders have to put up with that pressure. No one should grow up being told that they are not worth very much unless they conform to society’s extreme ideals."

For more information, contact the UI Adult Psychiatry Clinic at 319-353-6314.

0 is published by Guilford Press. The book is edited by Thomas F. Cash, Ph.D., professor of psychology at Old Dominion University, and Thomas Pruzinsky, Ph.D., professor of psychology at Quinnipiac University and adjunct assistant professor of plastic surgery at the New York University School of Medicine.

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