Anorexia nervosa and bulimia in adolescent males.

Anorexia nervosa or bulimia in adolescent males occurs ten times less frequently than in adolescent females. When they occur, however, they can be clearly identified and differentiated from disorders also associated with weight loss such as swallowing phobias. Early diagnosis and treatment leads to improved outcome. While the formal psychopathology of male anorectics is similar to that of females, there is often a different motivation for the initial weight loss in males. They are more often concerned with attaining an idealized male body and avoiding teasing or criticism about their appearance. When males become ill, they tend to develop the full anorectic syndrome or not to become ill at all. Recognition of the special needs of adolescent males for individualized treatment increases the change of optimal outcome. Anorexia nervosa and bulimia in the teenage male should be seen as an ineffective method of dealing with developmental crises by gaining a sense of effectiveness and control through weight reduction and food restriction. Treatment seeks to improve quickly the starvation-related aspects of the illness while attempting to find more appropriate methods of dealing with the life crises prompting the illness. The real goal of treatment is to make the anorectic or bulimic illness unnecessary by encouraging the patient to continue the work of individuation and separation so that challenges in development and problems in living are resolved in a direct rather than an indirect way through an eating disorder.