Women are pushing back against the unrealistic body ideals that have long dominated American society, speaking out about discriminatory, fatphobic “norms” and sharing stories about related eating disorders. Such conversations still have a long way to go, but they are at least being had. This is not the case among men.
Social psychologist Jaclyn A. Siegel was pursuing her master’s degree at Villanova University in the mid-2010s, researching how workplace environments can support or hinder eating-disorder onset, maintenance, and recovery, when she noticed that little information existed on eating disorders in men. This research gap encouraged Siegel to study the issue as she worked toward her PhD at the University of Western Ontario. Concentrating on the intersection of gender and eating disorders, she published research on topics like self-objectification, body-based social comparisons, body shame, and father-daughter communication about body image. Her current research focuses on the effects eating disorders have on intimate relationships.
At the age of twenty-six, Siegel became a postdoctoral research scholar with the San Diego State Research Foundation. She continues to serve there as project director of the Pride Body Project, an NIH-funded clinical trial of an eating-disorder prevention program for individuals who identify as men and are gay or bisexual, or experience sexual attraction to men. Siegel is also an adjunct professor at San Diego State University, teaching classes on the psychology of human sexual behavior. She sits on the editorial boards for five academic journals — Body Image, Psychology of Women Quarterly, Psychology of Men & Masculinities, Frontiers in Social Psychology (Gender, Sexuality, and Relationships), and Sex Roles — and is the style editor and social-media coordinator for Psychology of Women Quarterly.
Over video calls, Siegel and I discussed how traditional masculinity in the U.S. leads to a certain male body ideal, which has contributed to eating disorders, body-image dissatisfaction, and muscle-dysmorphic disorders in individuals across sexual and gender identities. These issues are compounded by a lack of awareness and research, and in Siegel’s view the field has a lot of room to grow. Ultimately, though, she sees the problem as not with men themselves, but with patriarchal structures that are harmful to society in general. The solution, she says, is to expand our definition of masculinity, and thus expand men’s potential.
Risak: How do you define masculinity?
Siegel: I would describe masculinity as a set of stereotypes about what is “normal” for men. Masculinity is socially constructed, and being seen as a “real man” in the eyes of others is a precarious undertaking. In societies marked by gender inequality, where traditional gender roles are rewarded or socially mandatory, many men feel that they must regularly engage in behaviors consistent with these norms to be perceived as sufficiently masculine and thus avoid stigma, discrimination, and sometimes even violence.
We often talk about “toxic masculinity,” but, in reality, masculinity is multifaceted and contains many beautiful elements. It appears in different ways in different cultures and in different eras.
Risak: How do we typically evaluate masculinity in the United States today?
Siegel: In 2003 James R. Mahalik and colleagues published the Conformity to Masculine Norms Inventory, a psychological inventory we use for evaluating different elements of masculinity, which includes eleven distinct factors: winning (the desire to be high achieving); emotional control (the idea that men shouldn’t cry); risk taking (being unafraid of a challenge, not willing to back down); pursuit of status (the desire to get money or power); primacy of work (choosing your employment over your interpersonal relationships or your personal well-being); violence (not necessarily a desire to engage in physical or verbal violence, but a sense that violence is sometimes warranted); playboy attitude (a desire for multiple sexual partners); self-reliance (don’t ask for help, figure things out on your own, and don’t let anyone see you sweat); power over women (a sense that men are natural leaders and should be in charge of women); dominance (a desire to be in charge of every situation); and homophobia. Obviously this last one does not translate easily to gay or bisexual men, but many experience internalized homophobia, which is strongly positively correlated with body-image dissatisfaction.
Risak: Are these norms specific to the U.S., or would you say they are relatively universal?
Siegel: I mostly study men in the U.S., but I did some work in Canada as well. We see a little less rigidity in masculine norms in Canada. There are certainly other countries in the world where traditional masculinity is highly prized and rewarded, and men there experience more gender-role stress. For example, men in Greece and Japan score higher on measures of gender-role stress than men in countries like Sweden or the Netherlands. But most of the published research on masculinity focuses on countries that are WEIRD — Western, educated, industrialized, rich, and democratic.
Risak: Why do you think that is?
Siegel: The first reason is that most psychological research is conducted on undergraduate students, because they are cheap and available. Participation in research is often a requirement for undergraduate psychology courses. Another reason is that many of the psychological instruments we use to assess masculinity or body image — such as the Conformity to Masculine Norms Inventory — are developed using WEIRD samples and cannot readily be translated into different cultures or languages.
Risak: Have these norms changed throughout history, or have they remained largely static?
Siegel: Social psychologists have been attempting to assess masculinity only for the last few decades, so it’s hard to say with certainty whether changes have occurred. I do think that, as society evolves and gender relations shift, we see changes in what it means to be a man, particularly when it comes to something like attitudes toward the LGBTQ+ community. We are currently seeing the emergence of more-flexible masculinity among celebrities like Harry Styles. But I’m not convinced that, as a society, we are becoming broadly accepting of men who distance themselves from masculine norms, as traditional masculinity is still prized in a variety of domains, such as the workplace. The emergence and popularity of celebrities and influencers who endorse and promote rigid masculinity ideology, such as Andrew Tate and Jordan Peterson, speaks to the broad appeal of these ideologies today.
Risak: How is the “masculine body” defined?
Siegel: It depends on the person and where they live, but in the U.S. we typically see a mesomorphic ideal: lean, muscular, and with a low body-fat percentage. This is persistent across the U.S. and common in LGBTQ+ communities in particular. Sexual-minority men are at elevated risk for eating disorders due in part to the lean ideal being perpetuated in their communities. I do want to note, though, that there are queer subcultures with totally different body ideals. Gay “bears,” for example, idealize larger, hairier men.
Risak: Why is lean and muscular the ideal?
Siegel: There are evolutionary theories: that such a body type suggests the man is probably fertile, capable of getting resources, and would otherwise be a good fit for sexual reproduction. But as a social psychologist, I hesitate to accept biological or purely evolutionary answers to these questions.
The “tripartite influence model” in social psychology focuses not on where these ideals come from but rather on how they are perpetuated. This model was initially proposed to explain why women experience body-image dissatisfaction, but it has since been expanded to capture men’s experiences. How we decide what our body should look like, and why, traditionally comes from our three primary sources of information: peers, parents, and media. Research on men’s body image has also included a fourth source: romantic and sexual partners. When I teach this to my students, I refer to it as the “four Ps”: peers, parents, porn, and partners. Porn is only one subset of media, of course, but there is quite a bit of research suggesting that increased exposure to sexualized media is a predictor of body-image dissatisfaction in men.
The body-related messages communicated from all these sources reinforce the mesomorphic ideal in a variety of ways. People may experience teasing or bullying from peers if their bodies don’t conform to the ideal. This teasing may be about muscularity or about weight. Parents and partners may make disparaging comments about weight or shape, but these are often cast as concerns. Partners may inadvertently reinforce norms through compliments about bodies. And the media certainly perpetuates the mesomorphic ideal.
We learn from these norms and strive to adhere to them, particularly if we’re someone who fears backlash or makes a lot of social comparisons. We know that people who make more social comparisons about their bodies or eating tend to feel worse about themselves, because they believe they’re failing to measure up to their peers.
Risak: What role do these body ideals play in the dynamic between men and women?
Siegel: Body norms work to reinforce unequal gender dynamics, with many men striving to be big and muscular, and many women striving to be dainty and petite. Within the context of most heterosexual relationships, there’s often a consensual reinforcement of these norms: many women, explicitly or not, communicate that they want to be with muscular or tall guys, and many men communicate that they want to be with curvaceously thin women. The bodies we idealize are representing the structural power difference between women and men. For men, actual physical force is a form of social power, and for women, being physically smaller has the potential to make them reliant on men. Feminist scholars have portrayed the cultural obsession with women’s thinness as a feature of patriarchy that keeps women distracted from their lack of power and diminished social status. It can be hard to focus on your civil rights when you are fixated on your appearance or weight.
We often talk about “toxic masculinity,” but, in reality, masculinity is multifaceted and contains many beautiful elements. It appears in different ways in different cultures and in different eras.
Risak: Have these gender dynamics shifted at all in the wake of the #MeToo movement?
Siegel: I don’t know of a study that provides that sort of information. Since #MeToo just happened in 2017, research is unlikely to have been published yet. I am curious, though. I think we did see an initial impact of #MeToo on policies, procedures, and social attitudes. But, as with all social movements, things tend to regress to the status quo. A pretty clear example of this is Black Lives Matter in 2020: There was initial social momentum toward defunding the police. A few years later we’re seeing that people, cities, and organizations are not following through on the promises they made in 2020. I’m not optimistic that the #MeToo movement will maintain its momentum. I hope it will, but the backlash we have seen to it gives me pause.
Risak: How do social norms of gender affect people who don’t conform to the gender binary or who don’t identify as heterosexual?
Siegel: As a person who is cisgender [individuals whose current gender identity is the same as the sex they were assigned at birth — Ed.] and not actively doing transgender research, I can only try my best to summarize this. To get the best information, you should read the original work being done by Jerel Calzo, Claire Cusack, Scout Silverstein, and Allegra Gordon.
Some statistics suggest that transgender individuals have a two- to four-times-greater risk of eating disorders. One reason is that controlling their bodies can help them pass in a transphobic society: Transgender women can pass more easily if they make their bodies smaller. Trans men can pass more easily if hips and curves are bound or hidden. Being thin can reduce gender dysphoria and help transgender individuals avoid the violence and discrimination that are pervasive in our society. It’s a safety strategy.
There is less research on nonbinary individuals. They can be pulled in either direction — toward masculine body presentation or feminine body presentation — or they might fluctuate in between. It’s hard just to be a person who’s not gendered, because we have such strong gender norms and expectations about what bodies are “supposed” to look like.
Risak: Many fitness influencers recommend exercise routines, diets, and nutritional supplements to help followers achieve an ideal physique. At what point does this type of messaging become problematic?
Siegel: Joyful movement is good for you. Getting your heart rate up is healthy. Getting out and being with your friends while moving can provide a positive social experience. But if you are exercising out of a drive for muscularity or thinness, to alter the appearance of your body rather than the functioning of your body, then you might find yourself trapped in a cycle that puts you at risk for an eating disorder.
There are certainly fitness influencers who promote a healthy relationship with the body, regardless of its size. Jessamyn Stanley, the yoga influencer, is a perfect example. But, more often than not, exercise is portrayed as a way to lose weight and become more attractive. Influencers might also encourage certain eating regimens, such as “bulking and shredding,” that have the potential to contribute to dysregulated eating. Not everyone who engages in rigorous exercise or dysregulated eating patterns will develop an eating disorder, but for people who are susceptible to disordered eating, these fitness regimens can potentially cause harm.
Another somewhat insidious way exercise and fitness influencers can have an adverse effect on people’s well-being is through coded language around health. The relationship between health and weight is far more complicated than we might think. Being thin and losing weight are not necessarily signs of good health, and being fat and gaining weight are not necessarily signs that someone is in poor health. Encouraging people to “get healthy” through weight loss is misguided, unscientific, and, frankly, fatphobic.
Exercise is a dicey subject even among eating-disorder researchers. When we look at the definitions of eating disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM), exercise isn’t involved in many of them. Exercise can be listed as a compensatory behavior in diagnosing cases of bulimia nervosa or anorexia nervosa, but some people experience compulsive exercise outside of that.
We are learning more about the complexity of eating disorders, which have long been understood as a female condition associated with the SWAG stereotype — skinny, white, affluent girl — even though eating disorders have been documented in men as far back as the 1600s. These conditions were called “anorexia nervosa” and “bulimia nervosa,” instead of “anorexia hysteria” and “bulimia hysteria,” because men do develop them, and doctors didn’t believe that men could experience hysteria. For long periods in the twentieth century, however, there was a general misconception that eating disorders affected only women, and the diagnostic criteria and treatment options became gendered. Older versions of the DSM, for example, list “amenorrhea” — cessation of a menstrual period for at least three months — as a diagnostic criterion for anorexia nervosa.
In the 1980s more and more men were entering eating-disorder clinics, and they weren’t presenting in the same ways as women were. Although women often develop eating disorders out of a desire for thinness, the masculine norms of dominance, confidence, sexual success, and physical and emotional self-control make men more likely to develop an eating disorder in an attempt to become muscular. So, many men engage in different behaviors to achieve an ideal body, including excessive exercise, regimented eating behaviors, and appearance- and performance-enhancing substance use.
Men now make up 25 to 33 percent of eating-disorder diagnoses. The threatened-masculinity hypothesis of disordered eating posits that one reason why we’re seeing an uptick in muscularity-oriented disordered eating is men’s desire to reestablish dominance in increasingly gender-egalitarian societies.
I suspect that every statistic we have about men with eating disorders is an underrepresentation of the actual number, because it’s not stereotypically masculine to admit to having these conditions.
Risak: What impact does the feminine association with eating disorders have on men?
Siegel: As I mentioned, self-reliance is one characteristic of traditional masculinity. Because of this, men are less likely to seek help for medical and psychological conditions. They’re not expected to have mental-health problems, because that would shatter the ideal of the strong, stoic man. Add a traditionally “feminine” condition like an eating disorder on top of that, and it puts them at risk of being ridiculed as less manly if they acknowledge or seek help for the condition. I’ve heard men express the fear they might be perceived as gay for having these conditions.
I suspect that every statistic we have about men with eating disorders is an underrepresentation of the actual number, because it’s not stereotypically masculine to admit to having these conditions, and it’s definitely not stereotypically masculine to go to a doctor or specialist and get a diagnosis. So it’s difficult to know how many men are really struggling. And since most treatment plans were developed with women in mind, we don’t often see the same level of effectiveness for men who do get into treatment. Traditional elements of masculinity are not addressed in most eating-disorder programs. I think there are some men who might acknowledge they have a problem but who feel they’re not going to get help once they get in the door. More therapists are becoming knowledgeable and sensitive to these issues, however. So if you don’t succeed with the first therapist, don’t give up. Continuing to seek help, even after negative initial experiences, is always recommended.
Risak: Is it possible to recover from an eating disorder, or is it something a person must learn to live with?
Siegel: That’s a debated question. I’m in recovery from an eating disorder: during my early twenties I was in treatment for acute anorexia. And I believe that full recovery is possible. For the last eight years I’ve been researching people living with eating disorders, and there are definitely some who feel the eating disorder is no longer a meaningful or salient part of their life. Many people go on to live very full lives after the initial eating disorder, and symptoms don’t have to be monitored as closely. But there are also people who have chronic eating disorders and experience periods of relapse and remission throughout their lives. I don’t think professionals in the field have taken a definitive stance on whether full recovery is possible for every person with an eating disorder.
Risak: What is “muscle dysmorphia,” and what are its risks?
Siegel: You will often see muscle dysmorphia colloquially referred to as “bigorexia,” but that’s a bit of a misnomer. Muscle dysmorphia is characterized by obsessive thoughts about muscularity, a perception that one is insufficiently muscular, a powerful desire to become more muscular, and repetitive urges and self-surveillance associated with a desire to be muscular. In many instances muscle dysmorphia is associated with excessive exercise; it is important, however, to note that these studies have small sample sizes. One study showed that 90 percent of men who experience muscle dysmorphia have used appearance- or performance-enhancing drugs. That particular study, however, included laxatives as an “appearance- and performance-enhancing drug,” which is a broader categorization than we typically see. Other research has shown that 40 to 50 percent of men diagnosed with muscle dysmorphia have at least experimented with anabolic steroids — to create the appearance of additional muscle mass — and androgenic steroids, to create more traditionally masculine features, like a stronger jawline.
There are various adverse outcomes associated with steroid use, including cardiovascular disease and psychiatric effects such as mood swings, aggression, and violence. Long-term use has also been associated with hypogonadism [when the sex glands produce fewer hormones — Ed.] and neurotoxicity, though this research is still new. Muscle dysmorphia itself can have a host of physical and social consequences, including muscle or joint damage from compulsive exercise, as well as prioritizing exercise over work, social outings, or romantic relationships.
There’s a lot of debate about whether the muscularity-oriented disordered eating associated with muscle dysmorphia should be labeled as a feeding-and-eating disorder, rather than an obsessive-compulsive disorder. Right now, muscle dysmorphia is a specifier for the “body dysmorphic disorder” label in the DSM, which falls under obsessive-compulsive and related disorders. The major diagnostic criteria for muscle dysmorphia focus on compulsive thoughts and “checking” behaviors. People with the disorder may have difficulty being present with others or focusing on the task at hand because they are constantly plagued by thoughts about their body and are consistently monitoring their body. Some research suggests that men with muscle dysmorphia engage in more body-related social comparisons and are more likely to withdraw socially from their peers.
Risak: Research on muscle dysmorphia focuses almost exclusively on white men. Are there studies of the disorder in individuals of other races and gender identities?
Siegel: I don’t have data readily available on the disorder in women, or in nonbinary people. I have seen a few studies that looked at female bodybuilders to determine whether muscle dysmorphia can exist in women. It seems as though it can, but overall more research is needed on women. There is also scant research on the condition in men who are not white. In fact, there is very little research on the body-image experiences of Black men at all.
Risak: What does the absence of research on Black men suggest to you?
Siegel: That the undergraduates who participate in student sample research are mostly white. We’re diversifying our methods in psychology, but convenience sampling is still the most common, even though it is definitely not the most representative of the population. There’s a belief that Black men are shielded from eating disorders and negative body image, but that’s because of flawed methodology. It’s not grounded in reality. One reason why we’re not seeing Black men with eating disorders is because the tools we use to evaluate eating disorders generally aren’t culturally sensitive. Even if Black men are included in research, we’re missing the specific cultural nuances necessary to assess their disordered eating.
The absence of culturally sensitive tools for finding body-image disorders in Black subjects speaks to a larger problem of generally ignoring the experiences of Black people in our research. The field of psychology is only starting to grapple with its structural racism.
Risak: How difficult is it for men suffering from muscle dysmorphia to ask for help?
Siegel: It can be extremely difficult for people with muscle dysmorphia to even recognize they have this condition. There is a normalization of muscularity-oriented disordered eating among men. It’s hard to know where the boundary lies between “gym-bro” culture and a psychological condition. Some men take pride in strictly adhering to specific dietary practices and exercise behaviors that give them a sense of control and enhance their appearance, and they might not recognize this as a problem. Their friends, if they’re also steeped in gym and exercise culture, might be rewarding them socially, and romantic or sexual partners might make positive comments about the size or shape of their body and musculature.
I don’t want to minimize women’s eating disorders — they are very serious; I would know — but one benefit women have is that people, including medical doctors, are more aware of eating disorders and body-image concerns in women. They are more likely to notice behaviors like skipping meals, restricting certain food groups, losing a lot of weight, or bingeing and purging, and they will call them out. A loved one or friend or parent will step in and say, “This isn’t acceptable. We’re going to get you help.” That’s often not the case for men. Because men with big muscles are praised in our society, it can be difficult for people to intervene and say, “Hey, you need to get help for this.”
Risak: What can we do as a society to make treatment a more accessible option for men?
Siegel: We need to take a threefold approach. First, we have to grapple with traditional masculinity and the adverse behaviors associated with it. We have to acknowledge how it hurts men and makes it difficult for them to get the help they need.
Next, we need to figure out how we can create a more expansive, more colorful version of masculinity that allows men to engage in the elements of it that feel right for them — being assertive, being a leader, taking risks — without harming themselves. Author Tony Porter discusses the “man box” of masculinity, suggesting that rigid adherence to traditional masculinity doesn’t allow men to reach their full potential, because there are elements of femininity necessary for them to succeed. Men who are stuck in the man box can’t feel their feelings or be particularly effective communicators. They might not get the help they need for body-image issues, alcohol-use disorder, depression, or anxiety. Men have the potential to be so much more and do so much more good in the world. If we expand our definition of masculinity, we will help society as a whole.
We also need to destigmatize therapy. I recently spoke with Joe Kelly, who has written a series of books about how men can support their children in getting treatment for eating disorders. He uses the language of coaching rather than therapy with men, because they are more receptive to that approach. He helps men understand that getting help doesn’t make them less of a man. We must also address the financial issues, because therapy can be financially out of reach for many.
Ultimately we want men not to need help. We don’t want these problems to exist in the first place. I talked about the tripartite influence model; we have to think about how we as peers, as parents, as partners, and as consumers and producers of media contribute to men’s unrealistic body ideals. We have to stop promoting this mesomorphic ideal as the best a man can be. The best a man can be has nothing to do with what he looks like, but rather with his kindness, his care for others, his passions. We need to stop venerating men who are nice to look at and instead find role models in men who are nice to others.
It’s worth noting that we live in an extremely fatphobic society. Weight stigma is regarded as one of the last socially acceptable forms of prejudice, perpetuated by doctors, peers, nutritionists, fitness influencers, and others. Trying to make your body lean or thin is a natural response to that pressure. If we truly want to change the way people engage with their bodies, we have to fix our weight-stigma problem.
Risak: What are you working on now?
Siegel: I am researching eating disorders in the context of romantic relationships. I have interviewed more than sixty people, including quite a few men and nonbinary people, who are living with and recovering from eating disorders and are also in romantic relationships. So far my research suggests that relationship quality can play a huge role in determining the trajectory of someone’s recovery — or relapse.
There is not much research on how eating disorders affect relationships, and vice versa, and virtually all of it focuses on the experiences of heterosexual couples in which the woman has anorexia. So I sought out a diverse sample regarding diagnosis, gender, sexual orientation, relationship configuration, and age to shed light on elements that were overlooked in past research.
We talk about relationship-related triggers, ways that partners can effectively support those living with eating disorders, and how they fail to do so. We also discuss how eating disorders affect dating, sex, and pregnancy; how partners can create an environment where the person recovering from the eating disorder feels safe, loved, and supported; as well as any fears they may have for the future.
A lot of people I’ve spoken to, including men, feel anxious about discussing their eating disorders or body-image concerns with their partner, but I consistently find that people who have not disclosed their eating disorder to their romantic partner feel ashamed or embarrassed, as if they had something to hide, whereas people who have disclosed these things feel closer to their partner. They can be more honest. They don’t have to pretend that everything is OK. And their partner can then be more sensitive to their concerns.
Risak: We’re two women discussing issues regarding men’s bodies. If the situation were reversed, it would likely be seen as problematic.
Siegel: Problematic is a word that I try to avoid, because it’s nonspecific and gets thrown around a lot. I think there is room for both lived expertise and research expertise. But deliberately choosing to interview a man about women’s experiences of their bodies could be perceived as overlooking the numerous female experts in this field.
In this context, we are two women discussing men’s body image, and you absolutely could have spoken to a man about this. I don’t have the experience of living in a man’s body, but I have interviewed many men about their bodies. I speak to men about their bodies and body image every single day. Anyone who feels I am providing a partial perspective should speak to the men in their lives about their bodies. I would prefer that. This discussion is a great starting point, but the most important thing people can do is normalize conversations about body image.
There’s a moment that comes to mind: Years ago I was doing a study about how men experience eating disorders in the workplace, and how the workplace can serve as either a barrier or a bridge to recovery for them. One man made a point that has stuck with me. He said, “There’s no script for men to talk about their bodies.” And I think that is right on. He struggled for words throughout the interview because, he said, he’d never been asked about this before, even though he was living with a clinically significant eating disorder.
So go talk to the men in your life. Get the full story from them.
Risak: For a researcher who studies the harmful effects of traditional masculinity, you present men in a mostly positive light.
Siegel: I call myself a capital-F Feminist, and a lot of people, when they speak to me, think I’m going to say, “We just have to get rid of the men; then all of our problems will be solved!” But I’ve seen the best of men. I have witnessed them leverage their power to support women and LGBTQ+ colleagues. I recognize that men are under tremendous pressure to perform traditional masculinity, and they could use our support. I also live with my incredible male partner. He’s a man I enjoy quite a lot. He is the best of men.
Patriarchy is the problem, not men. At the end of the day, patriarchal norms and expectations hurt us all. We need to promote authenticity and reduce the need to adhere to traditional masculine or feminine norms. If we do that, everybody wins.