Abstract
There are various biological, psychological, and social factors that contribute to all conditions or disorders (Fitcher & Krenn, 2003) This literature review discusses biological, psychological, and social factors that influence disordered eating, specifically in males. Additionally, this review emphasizes the effect that social stigmas and media have on feelings of body dissatisfaction which, in turn, can be associated with symptoms of eating disorders. Unfortunately, today’s society continuously exposes, both, men and women to messages that tell them their body is what defines them (Duggan & McCreary, 2004). Such messages can be conveyed through social factors like advertisements, stigmatized gender roles, parents, and media (Ricciardelli & McCabe, 2004).  It has been found that exposure to these factors may lead to internalization of the media’s pre-conceived notions of the “perfect man”, which can be linked to increased body dissatisfaction (Thompson and Stick, 2001). For the majority of males, muscle-oriented body dissatisfaction led to a drive for muscularity (McCreary and Sasse, 2000). Conclusively, uncontrollable biological factors, sociocultural influences, and psychological turmoil are associated with body dissatisfaction and symptomatic disordered-eating in males.

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Analysis
Despite the increased prevalence of eating disorders among women, research has shown that disordered eating behaviors are on the rise in males (Furnham, Badmin, & Sneade, 2002). This literature review divides variables that influence disorders in males into three groups: biological, psychological, and social factors (Ricciardelli & McCabe, 2004). The biopsychosocial model, explains health and illness from a biological, psychological, and social perspective (Suls & Rothman, 2004). Furthermore, this model perceives that it is not just one system involved in the experience and outcomes of an individual’s health or illness, but all three systems, interactively working. (Suls &Rothman, 2004). The effect of social stigmas and media on an individual’s perceived level of body dissatisfaction demonstrates the impact of social influences on psychological functioning (Harrison & Cantor, 1997). Likewise, uncontrollable biological factors such as BMI or pubertal timing, may affect levels of body dissatisfaction (Ricciardelli & McCabe, 2004).
Unfortunately, today’s society continuously exposes both men and women to messages that tell them their body is what defines them (Duggan & McCreary, 2004). Messages, such as these, can be conveyed through parents, stigmatized gender roles, and media.  It has been found that some individuals may begin to internalize, or truly believe society’s pre-conceived notions of attractiveness, and begin engaging in eating disorder symptomatology to try to reach these, somewhat unattainable, goals (Thompson and Stice, 2001).  So how do these biological, psychological, and social factors specifically influence disordered eating in males?
Biological Factors of Disordered Eating in Males
Physiological factors consist of the individual’s genetic makeup, a component that one does not necessarily have control over (Suls & Rothman, 2004). Research has shown that two of the most significant biological factors linked to eating disorders among males are body mass index (BMI) and pubertal timing (Ricciardelli & McCabe, 2004). Adolescent males who were overweight, with a higher BMI, reported increased levels of body dissatisfaction and societal pressures to decrease fat and increase muscle mass (Ricciardelli & McCabe, 2004). An individual with a higher BMI may experience teasing among peers which could affect the social aspect of his life. Social isolation can lead to feelings of negative affect (depression and anxiety), dieting, and an increased likelihood of engaging in eating disorder behaviors (Ricciardelli & McCabe, 2004).
Compared to women, males hit puberty approximately two years later (Fichter & Kreen, 2003). Pubertal timing, is a biological risk factor of eating disorders in males because depression, social isolation, and body dissatisfaction may increase depending on when puberty is experienced (Ricciardelli & McCabe, 2004). Males who were late to mature experienced increased levels of body dissatisfaction and were more likely to turn to be exercise dependent than those who experienced late maturation (Ricciardelli & McCabe, 2004). Late maturation also increased symptoms of depression, parental conflict, and were perceived as less popular among their peers (Ricciardelli & McCabe, 2004). It is shown that both of these biological factors negatively affected the individual’s psychological and social aspects of their life, increasing the likelihood of disordered eating.
Social Factors of Disordered Eating in Males
Messages concerning society’s ideal body are being disseminated to adolescents by their parents. Research pertaining to parents’ role in body image disturbances among girls is known, but what about the role of parents in the development of the body image among boys? McCabe and Ricciardelli (2001) conducted research which exhibited mothers were perceived to have a greater influence for attitudes about body image on their sons’. Furthermore, it was seen that through positive comments, mothers were more influential on their son’s body image in regards to accepting dieting as a means to lose weight (Wertheim, Martin, Prior, Sanson, and Smart, 2002).. On the other hand, through criticism, fathers were more accepting of exercise as a strategy for weight loss (McCabe and Ricciardelli., 2001)
Studies suggest that media trends may be linked to the development of eating disorders in media consumers. In today’s Western society male’s physical insecurities are targeted by emphasizing the need for special diets, enhancing supplements, or fitness programs. Regardless of the product being sold, the message that men continuously need to improve themselves is being advertised in magazines, such as Men’s Health. (Duggan and McCreary, 2004). It is common that images in the media contribute to body dissatisfaction in women but, Pope et al. (2000) has brought a new perspective to the table concerning males. Research suggests that men may have it worse than women in terms of self-ideal discrepancy (Duggan and McCreary, 2004). Duggan and McCreary (2014) believe that after decades of advertisements regarding appearance, women have learned to ignore or face the media (Duggan and McCreary, 2004). However, men are perceived to be conditioned to socially abstain from discussing such issues and find it uncomfortable to express their physical insecurities (Duggan and McCreary, 2004). This finding is an implication that men are more susceptible to medial influences than women in terms of body dissatisfaction and as a result, they tend to buy advertised products to enhance their physical appearance (Pope et al, 2000).
Stigmas associated with gender roles are a major contributor to body image disturbances in males. The masculinity hypothesis proposes that men are at risk for muscularity- oriented body dissatisfaction and disordered eating due to gender roles including dominance, confidence, sexual success, and physical and emotional self-control (Griffiths et al., 2014). Results from this study showed that greater muscle dissatisfaction and muscularity-oriented disordered eating, but not body fat dissatisfaction or thinness-oriented disordered eating, was associated with increased conformity to masculine norms. A possible explanation for this is that some males feel as if they lack these masculine qualities or are more reserved, therefore they feel as if a larger, more muscular body could compensate for those feelings leading to body dissatisfaction and disordered eating. (Griffiths et al., 2014) So how social factors and messages from the media impact interact with psychological functioning of an individual?
Psychological Factors of Disordered Eating in Males
As seen in the previous sections, biological and social factors are linked to negative affectivity, body image internalization, and body dissatisfaction. Body image is how one perceives and evaluates their appearance and physical capability (Taylor, 2015). Research has shown that different associations of body image are different in men than women. Males are more likely to associate attractiveness with increased, lean, muscle definition, leading them to a drive for muscularity (McCreary and Sasse, 2000). On the other hand, females with body dissatisfaction typically associate attractiveness with being thin. (Duggan and McCreary, 2004).
Media trends may be linked to internalization which, in turn, can lead to the development of eating disorders (Harrison and Cantor, 1997). Individuals internalize the ideal body image that the media portrays due to stigmatized gender-roles. This concept, body image internalization, refers to the degree to which an individual really believes society’s definition of attractiveness and engages in behaviors, such as disordered eating, to try to reach these somewhat unattainable ideas. Therefore, it is the dissatisfaction of the body that theoretically promotes dieting and negative affect, which can increase the risk for onset of eating disordered-symptoms. (Thompson and Stice, 2001).
Eating Disorders in Males
There are multiple types of eating disorders, however, the most common are anorexia nervosa, obsessively dieting and/or exercising until one reaches a body weight extremely under optimum level, and bulimia, which involves alternating cycles of binging and purging using techniques such as vomiting, laxatives, extreme dieting, and drug or alcohol abuse (Taylor, 2015).  Research has shown that there are substantially higher percentages of eating disorders such as anorexia nervosa and bulimia found in females (McLean, Paxton, and Wertheim, 2016). This may be due to the fact that females are more likely to adopt strategies to lose weight (i.e. anorexia and bulimia), whereas males were more likely to adopt strategies to increase weight and muscle tone. (McCabe and Ricciardelli, 2001).
Men with eating disorders are a topic of interest that continues to grow in the public and scientific world. Disordered eating has been underestimated in males most likely due to conformity of the masculinity hypothesis. Males tend not to engage in dieting behaviors because those actions usually take them further away from their ideal, muscular body, but binge eating, excessive exercise, and steroid use are more common (McCabe and Ricciardelli, 2001). Contrary to females, the most common eating disorder diagnosis for males, accounting for 90% of all cases, is muscle dysmorphia. As mentioned before, a very muscular body is the ideal body type for males. Therefore, researchers have proposed that muscularity-oriented eating attitudes and behavior be classified an eating disorder, rather than a subtype of body dysmorphia (Griffiths et al, 2014). Not only do disordered eating and exercise patterns lead to significant health problems such as low levels of essential minerals and electrolytes, and a higher risk of developing osteoporosis or osteopenia. Likewise, eating disorders may have psychological outcomes such as depression, low-self esteem, and anxiety disorders (McCabe and Ricciardelli, 2001). These, in turn can lead to social isolation, and relationship tensions (Taylor, 2015).   within the males such as depression, low-self esteem, and anxiety disorders
Conclusion
Body image dissatisfaction and eating disorders are a significant physical and mental health problem in Western countries. Males, although it is less common, develop eating disorders due to the fact that they feel pressured to conform to their gender roles of dominance, confidence, sexual success, and physical and emotional self-control (Griffiths et al, 2004). In contrast to females, men perceived leanness and muscularity to being healthy and fit, whereas being fat was related to weakness of will and lack of control. Therefore, men associated attractiveness with increased, lean, muscle definition. This can be tied back to the biopsychosocial model. Recent studies have shown that eating disorders in males are linked to biological, psychological, and social factors. Biological factors such as BMI and pubertal timing, have a significant influence on eating disorders. These uncontrollable variables can lead to increased levels of body dissatisfaction and social isolation, psychological problems due to stigmatized gender roles (i.e. masculinity hypothesis) and the media.  All three components of the biopsychosocial model accurately show how social stigmas and the media affect disordered eating in males. (McCabe and Ricciardelli, 2001).
References

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