Health Agenda

Mental Health

The worrying rise in men’s body image issues

Almost half of all men have body image issues, which can lead to eating disorders and exercise addiction. Here’s what to do about it.

Every time 39-year-old teacher Niall O’Brien has to buy a new shirt or pair of jeans, he feels distress and anxiety. “I can’t remember the last time I felt good about my body shape,” Niall explains. “As I don’t look like a male model, actor or health influencer, I feel ashamed and embarrassed that I’m not attractive enough. Body shame has really eroded my self-esteem.”

Over the past four years, Niall gained weight after surgery complications, many courses of antibiotics and months unable to exercise. “Trying to improve my body shape and self-image has become a constant battle, but I rarely talk about it for fear I’d just be told to toughen up,” he says.

Men, body shape and mental health

Though we may think of body image insecurity as a ‘woman’s issue’, statistics tell another story. According to the Australian Psychological Society (APS), body dissatisfaction in men tripled from 1984 to 2009.

“That figure is now likely to be much higher,” says Tamara Cavenett, practising clinical psychologist and president of the APS. In one Australian study, 60.4% of men said they were dissatisfied with their body.

Unsurprisingly, those more unhappy with their body shape had higher psychological distress. “Body image issues can lead men to feel worthless, and cause short- and long-term mental ill health, such as anxiety and depression,” Tamara explains.

The domino effects can lead men to withdraw from close relationships, stop dating, avoid applying for work promotions, opt to study online to avoid being seen, and stop socialising – because at events and gatherings, they feel tense and self-conscious about their body.

Dieting and eating disorders in men

Men who are unhappy with their shape often turn to dieting. “I’ve been on one diet after another including keto, low carbs, high protein, protein shakes, intermittent fasting and a soup diet,” says Niall. “Sometimes I lose a little weight or a lot, but I feel ravenous all the time and once I stop the diet, the weight always comes back.”

Yo-yo dieting is common among people with body image issues. Over time, dieting can increase your weight gain risk. “Rigid diets are also not sustainable and cause restriction of entire food groups, which can lead to nutritional deficiencies,” says Joel Feren, accredited practising dietitian (APD) and spokesperson for Dietitians Australia.

For example, cutting out grains and carbs can reduce your fibre intake, causing constipation and depletion of important B-group vitamins. “Dieting is a known risk factor for developing eating disorders such as anorexia or bulimia, which may then increase health issues such as loss of bone density, body dysmorphia, mental health illness and a slower metabolism,” says Joel.

According to the Butterfly Foundation, men account for over one third of Australians experiencing an eating disorder and 40% of Aussies with a binge eating disorder. However, for some men, it’s not just about being thin. While still striving for less body fat, some are focused on building muscle mass too quickly, which can also lead to health problems.

To increase muscle mass, men often tuck into more protein, especially red meat, which may bump up their risk of heart disease, says Joel. “Meanwhile, they may skimp on fruit and vegetables, losing important health-boosting phytonutrients such as antioxidants and polyphenols, which can protect against disease.” To try to change these restrictive and rigid eating patterns, Joel encourages men to eat for energy and health now and into their future. “This means including all food groups and trying new meals to find the joy in food again,” he says.

What causes body image issues in men?

A growing number of men are now spending hours pumping weights at the gym to bulk up their muscles while eating less to burn more body fat. Some are then developing muscle dysmorphia (often called ‘bigorexia’), which is a little like the reverse of anorexia.

“This cultural ideal of men as muscled and strong, with six-packs and glutes of steel, is reinforced in social media, advertising and also by having male sports stars as the main role models for men,” says Tamara. “Unfortunately, some men feel pressured to start using steroids, which can cause increased anger, lower testosterone levels and increase heart attack risk.”

The issue of exercise addiction

Disordered eating often goes hand in hand with exercise addiction, which increases risk of physical injury. “Overuse and excessive load from overexercising can cause tendon injuries, trauma, stiffness, inflammation, joint strain and torn muscle fibres,” says exercise physiologist Lauren Sexton from Exercise and Sports Science Australia. Shoulders, knees, hamstrings, quadriceps and the lower back are often affected.

Lauren says for men to meet Australia’s exercise guidelines, they should be doing 150 to 300 minutes of exercise over five to seven days per week. “To be healthy, men should cross-train over a week, to include aerobics (such as cycling or swimming), resistance training, some exercise with a friend or workout buddy, and exercise for flexibility, such as yoga,” Sexton says. “This approach can help men sustain a healthy weight or lose a little weight if they’ve gained a few kilos and feel too embarrassed to work out in public. But before taking up exercise, men should always consult their GP.”

How do we promote positive body image in men?

Signs of disordered eating or exercise addiction often include obsessive counting of kilojoules, skipping meals, restricting whole specific foods, doing two or three workouts back-to-back, and becoming more withdrawn and exhausted. “If a man you know is clearly struggling with body image issues, offer to talk about it, make a GP appointment for him and go with him for support,” Tamara suggests.

A GP can prescribe wraparound care from a dietitian, psychologist and exercise physiologist who each specialise in body image issues. “These experts can help men reduce ‘safety behaviours’ such as weighing themselves repeatedly and mirror-checking,” Tamara explains. “They can also support men to change self-critical self-talk and start to value their body for its function rather than measuring their self-worth from the size of their waist or biceps. Unfollowing threads on social media and reducing its use can also substantially help.”

Help at hand

We’ve partnered with PSYCH2U to offer HCF members easier access to mental health support through online video consultations with a psychologist. Eligible members* can also access a comprehensive mental health support program that provides customised care through online, telehealth and chronic disease management programs.

For support around body image or an eating disorder, see your GP or contact the Butterfly Foundation’s National Helpline on 1800 334 673 or visit their website.

If you're struggling with depression and/or anxiety, and need to speak to someone now, call Lifeline on 13 11 14.

Words by Stephanie Osfield
First published July 2022 

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IMPORTANT INFORMATION

* Must have HCF gold level hospital cover for 12 months. Eligibility is based on clinical need as assessed by PSYCH2U.

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