The association between problematic pornography use and eating disorder symptoms among heterosexual and sexual minority men

In this study, we investigated the link between problematic pornography use and eating disorder symptoms in men, with body comparison and body image as mediators, and perceived realism and anxiety and depression as moderators. We also analyzed the model for both heterosexual and sexual minority men to detect any differences. The current study included 705 Israeli men, 479 of whom identified as heterosexual and 226 as sexual minority. The majority of the sample (90.6%) identified as Jewish with a mean age of 32.5. Results showed that problematic pornography use was linked to more upward body comparison, which in turn was related to negative body image, and ultimately, increased severity of eating disorder symptoms. Anxiety and depression moderated the association between male body image and eating disorder symptoms. However, perceived realism did not moderate the link between problematic pornography use and upward body comparison. Whereas there were significant differences in the mean rank values between heterosexual and sexual minority men in all measures, the processes linking these measures were virtually the same. To reduce the risk of developing or worsening eating disorder symptoms, clinicians working with male clients should assess for problematic pornography use and body image concerns during therapy.

Cultural consonance, body image, and disordered eating among young South Korean men

Eating disorders are serious mental illnesses, but little research explores non-Western men's cultural experiences of body image and what affects their risks of disordered eating. Drawing on data collected over 17 months (August 2019 to January 2021) of fieldwork in Seoul, South Korea, the lens of intersectionality is employed alongside multiple regression and moderation analysis to understand how two axes of identity which emerged as important from the ethnography-sexual identity and university prestige-shape the ways in which young Korean men's cultural consonance with their local model of the ideal male body, influenced heavily by the kkonminam (flower boy), relates to risk for developing an eating disorder. Among young Korean men, intersections of university prestige and sexual identity frame embodiment of cultural models of male body image as a strategy for the making and maintenance of social relations and the advancement of social status in a precarious neoliberal economy.

Establishing the optimal male cut-off point: confirmatory factor analysis of the eating disorder examination-questionnaire (EDE-Q) in a representative sample of Spanish university students

PURPOSE

Although the EDE-Q is derived from the "gold standard" for the assessment of eating disorders (ED), its factor structure is controversial, particularly in male samples. The aim of the study was to examine the psychometric properties and factor structure of the EDE-Q, as well as to establish a sensitive and specific cut-off point validated by EDE clinical interview.

METHODS

A series of Confirmatory Factor Analyses were performed among a representative sample of 796 male university students, of whom 139 were interviewed. Sensitivity and specificity were calculated by receiver-operating characteristic (ROC) analysis to determinate the most appropriate cut-off value.

RESULTS

The original factor structure was not confirmed, showing a better fit with a 2-factor solution. For the Spanish male sample, a cut-off ≥ 1.09 for at-risk of ED cases and ≥ 2.41 for clinical cases presents an optimal balance between sensitivity and specificity.

CONCLUSIONS

The establishment of specific cut-off points for males may help to reduce the under-diagnosis of ED in this population.

LEVEL OF EVIDENCE

III: evidence obtained from well-designed case-control study.

"Guys with Big Muscles Have Misplaced Priorities": Masculinities and Muscularities in Young South Korean Men's Body Image

Men's body image is an issue of increasing importance as related illnesses continue to grow in prevalence around the world. However, cross-cultural attention to men's body image experiences has been relatively understudied. Based on data derived from cognitive anthropological methods of cultural domain analysis, I develop the concept of "muscularities" to more effectively examine the expectations inherent in multifarious models of body image men continuously navigate. Related to but distinct from "masculinities"-the recognition of culture-bound hierarchies of ways of doing-being a man-"muscularities" attends to the culturally particular ways in which muscles are conceived and evaluated as indices of socioeconomic status, intelligence, social skills, and professionalism, to name a few. Young South Korean men's experiences of chan'gŭnyuk ("small muscle") and manŭn kŭnyuk ("large muscle") challenge universalist assumptions about the kinds of muscles people value in global perspective, demonstrate the necessity of recognizing multiple muscularities in research, and encourage new directions of inquiry that attend to the consequences of variable embodiments of muscularities.

3D visualisation of psychometric estimates for the ideal male body

Psychological concerns are frequently indexed by psychometric questionnaires but the mental representations that they seek to quantify are difficult to visualise. We used a set of questionnaires designed to measure men's concept of their bodies including: the Drive for Muscularity Scale (DMS; McCreary & Sasse, 2000), the Perceived Sociocultural Pressures Scale (PSPS; Stice, Nemeroff, & Shaw, 1996a), the Body Appreciation Scale (BAS-2; Tylka & Wood-Barcalow, 2015), and the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3; Thompson, van den Berg, Roehrig, Guarda, & Heinberg, 2004). We combined their use with an interactive 3D modelling programme to allow men to create computer-generated representations of their ideal bodies. We used a principal component analysis to extract those shape components of our participants' CGI ideal bodies that were predicted by the questionnaires and reconstructed the body shapes that these questionnaires were capturing. Moving from the lowest to the highest score on both the DMS and SATAQ corresponded with changes in muscularity, particularly muscle mass and definition. This approach allows us to demonstrate the actual body features that are being captured by a particular questionnaire.

Attentional engagement, appearance comparisons, and rumination as predictors of body dissatisfaction: Evaluation of a serial mediation model in men

Elevated body dissatisfaction is underpinned by an attentional bias towards images portraying appearance ideals. However, very little is known about the specific attentional mechanisms and mediating factors involved in this relationship in the context of male body dissatisfaction. The present study sought to replicate and extend on previous research among women showing that the relationship between attentional engagement bias and body dissatisfaction is sequentially mediated by appearance comparisons and rumination. Seventy undergraduate males completed an attentional task capable of independently assessing biased attentional engagement with images of muscular and non-muscular bodies followed by self-report measures of appearance comparisons, eating disorder-specific rumination, and body dissatisfaction. Results revealed that a heightened tendency to engage in appearance comparisons was associated with increased attentional engagement with muscular bodies, relative to non-muscular bodies. Moreover, a serial mediation analysis revealed that increased attentional engagement with muscular bodies was associated with appearance comparisons, which in turn were associated with eating disorder-specific rumination and, consequently, body dissatisfaction. The current findings replicate among men the serial mediation model of body dissatisfaction previously described among women and implicate heightened attentional engagement with idealized images as a potential pathway to body dissatisfaction in men.

Differences in weight stigma between gay, bisexual, and heterosexual men

Gay and bisexual men may experience more weight stigma than heterosexual men; however, research is limited. We examined differences in experienced weight discrimination, weight bias, and internalized weight bias in two studies: the first comprising gay (n = 351), bisexual (n = 357), and heterosexual (n = 408) men, and the second comprising gay (n = 614) and bisexual (n = 123) men. In Study 1, bisexual men reported experiencing more weight discrimination than gay (r = .07) and heterosexual (r = .08) men. Bisexual (Glass' Δ = 0.41) and gay (Δ = 0.37) men reported greater internalized weight bias than heterosexual men. Heterosexual men reported more weight bias than gay (Cohen's d = 0.35) and bisexual (d = 0.46) men. In Study 2, gay men reported more internalized weight bias than bisexual men (d = 0.26). Sexual orientation did not moderate the relationships of weight stigma with either body dissatisfaction or psychological quality of life. Among gay and bisexual men, experiencing weight discrimination predicted diminished psychological quality of life through internalized weight bias and body dissatisfaction. Our research emphasizes the importance of assessing weight stigma among sexual minorities and suggests bisexual men might be particularly vulnerable to weight stigma.

'Big boys don't cry': Examining the indirect pathway of masculinity discrepancy stress and muscle dysmorphia symptomatology through dimensions of emotion dysregulation

Prevailing conceptualizations of muscle dysmorphia (MD) have highlighted the role of adherence to stereotypical ideals of masculinity. In addition, the endorsement of masculine norms has been associated with dysfunctional emotional regulation, itself a correlate of body image psychopathology. Building on this, the present study sought to investigate the indirect relationship between masculinity discrepancy stress (i.e., distress related to one's perceived discrepancy in masculinity) and MD symptomatology via different facets of emotion dysregulation among adult men. A sample of 391 university and community men aged 18-50 years completed an online survey measuring the aforementioned constructs. A test of parallel indirect pathways revealed that emotion dysregulation, as a unitary construct, accounted for a substantial proportion (29.3 %) of the total association between masculinity discrepancy stress and MD symptomatology. Further, a significant unique indirect pathway was found through the specific emotion dysregulation facet of lack of access to adaptive emotion regulation strategies. Together, these findings suggest that emotion dysregulation is a particularly important construct to consider in understanding the relationship between perceived discrepancies in masculinity and MD symptomatology.

Who's the 'bigger' man? Parsing the relationships between masculinity and men's muscularity dissatisfaction

Muscularity dissatisfaction is documented to be a pervasive phenomenon among men. While previous studies have examined theoretically relevant predictors of muscularity dissatisfaction, such as adherence to traditional masculine norms, to the best of our knowledge we are not aware of empirical research that has assessed how perceived discrepancies in one's level of masculinity may also be associated with these concerns. Therefore, the objective of this study was to determine whether perceived deficits in masculinity bear predictive utility over and above adherence to traditional masculine norms in the context of muscularity dissatisfaction. An online survey that included measures assessing the aforementioned constructs was completed by 390 university and community adult men. A hierarchical regression analysis showed that while adherence to masculine norms was associated with increased muscularity dissatisfaction, masculine role discrepancy (and attendant stress) were particularly strong predictors of muscularity dissatisfaction. Our findings make a novel contribution to the male body image literature by demonstrating the relative importance of perceived discrepancies in masculinity, and related stress, in the context of muscularity dissatisfaction. Pending replication in relevant clinical samples using prospective designs, this study provides preliminary evidence that masculine role discrepancies may be promising targets to help allay muscularity concerns among men.

Does masculinity moderate the relationship of height with height dissatisfaction? Findings from an Internet forum for short statured men

Research suggests that height is fundamental to Western conceptualisations of masculinity. However, researchers are yet to examine whether individual differences in conformity to Western masculine norms can help to explain why men experience height dissatisfaction. Thus, we investigated conformity to Western masculine norms as a moderator of the relationship between men's height and height dissatisfaction. Men experiencing height dissatisfaction (N = 249) were recruited from an Internet forum that functions as a discussion space for short-statured individuals. Results indicated that shorter men and more masculine men reported greater height dissatisfaction. As hypothesised, we observed a significant interaction between height and masculinity, such that the strength of the relationship of short stature with height dissatisfaction was stronger for more masculine men. Crucially, results from a Johnson-Neyman analysis indicated that it was only for men extremely low in their endorsement of masculine norms (i.e., the 2^nd percentile or lower) that the relationship of height with height dissatisfaction was nonsignificant, suggesting that, in the near-absence of masculine norm conformity, height no longer contributes to male body dissatisfaction. Whilst acknowledging that our findings require further exploration, we propose that conformity to masculine norms may be an influential factor in males' experience of height dissatisfaction.

Assessment and validation of a Spanish version of the Muscle Dysmorphia Disorder Inventory in Argentinian men who exercise: Inventario de Dismorfia Muscular

Despite an increase in body dissatisfaction and muscularity concerns among Latin American men, there is a paucity of research relating to muscle dysmorphia in this population. In this study we aimed to evaluate, for the first time in Latin America, the factor structure of the Muscle Dysmorphic Disorder Inventory (MDDI; Hildebrandt, Langenbucher, & Schlundt, 2004). A sample of 551 men who exercise completed measures of body dissatisfaction, disordered eating, and the MDDI. Exploratory factor analysis in a first split-half sample revealed a 3-factor solution similar to the original version, which was then tested through confirmatory factor analysis (CFA) in a second split-half sample. A re-specified model (allowing for error correlations between Items 10-13 and 11-13) presented adequate fit. Omega coefficients revealed adequate internal consistency (> .80) for the Drive for Size and Functional Impairment subscales. The internal consistency for the Appearance Intolerance subscale was .74 and .72 across subset samples. Associations with body dissatisfaction, disordered eating, body mass index, and frequency of training and rest days are presented as evidence of construct validity. Finally, multi-group CFA indicated that the model was invariant across type of exercise. Overall, these data suggest that the MDDI is suitable for use in Spanish-speaking Latin American male populations.

Men, Muscles, and Eating Disorders: an Overview of Traditional and Muscularity-Oriented Disordered Eating

PURPOSE OF REVIEW

There is growing recognition that eating disorder (ED) symptoms, particularly those of a muscularity-oriented nature, are more common in men than previously understood. The purpose of the current review is to describe contemporary directions and implications of research on traditional and muscularity-oriented ED symptoms among males.

RECENT FINDINGS

Evidence indicates that ED symptoms occur in a substantial minority of men. Importantly, recent research has focused on muscularity-oriented body image and disordered eating in males, demonstrating the prevalence, correlates, and consequences of maladaptive muscularity-oriented attitudes and behaviors. A growing number of assessments are available to measure these constructs in males, and preliminary treatment considerations have begun to be addressed in the literature. Research on male EDs and body image is increasingly focusing on muscularity-oriented manifestations. Continued empirical work will be critical to improve our understanding of the onset, maintenance, and treatment of muscularity-oriented disordered eating in males.

Effects of the exposure to self- and other-referential bodies on state body image and negative affect in resistance-trained men

Previous body image research suggests that first, exposure to body stimuli can negatively affect men's body satisfaction and second, body concerns are associated with dysfunctional gaze behavior. To date, however, the effects of self- vs. other-referential body stimuli and of gaze behavior on body image in men under exposure conditions have not been investigated. Therefore, 49 weight-trained men were presented with pictures of their own and other bodies of different builds (i.e., normal, muscular, hyper-muscular) while being eye-tracked. Participants completed pre- and post-exposure measures of body image and affect. Results indicated that one's own and the muscular body negatively affected men's body image to a comparable degree. Exposure to one's own body also led to increased negative affect. Increased attention toward disliked own body parts was associated with a more negative post-exposure body image and affect. These results suggest a crucial role of critical self-examination in maintaining body dissatisfaction.

Predicting muscularity-related behavior, emotions, and cognitions in men: The role of psychological need thwarting, drive for muscularity, and mesomorphic internalization

We examine the relationships that internalization, need thwarting (NT), and drive for muscularity (DFM), along with their interactions, had with weightlifting, muscle dissatisfaction (MD), and muscle-related-worry (MRW). A sample of 552 men (MAge=20.5 years, SD=3.1) completed the Psychological Need Thwarting Scale, the Internalization subscale of the male version of the Sociocultural Attitudes Towards Appearance Questionnaire, the Drive for Muscularity Scale-Attitudes subscale, the Male Body Attitudes Scale-Muscularity subscale, the Body Change Inventory-Worry subscale, and an inventory assessing weightlifting behavior. DFM significantly predicted weightlifting, MRW, and MD. Internalization significantly predicted weightlifting and MRW. NT significantly predicted weightlifting and MD, and its relationship with MRW approached significance. The interaction terms did not predict weightlifting or MRW. The NT/DFM and NT/Internalization interaction terms predicted MD. These results highlight the role of NT in predicting appearance variables in men.

Validation of the Spanish version of the Drive for Muscularity Scale (DMS) among males: Confirmatory factor analysis

Drive for Muscularity (DM) has been shown to be a relevant construct for measuring and understanding male body image. For this reason, it is important to have reliable and valid instruments with which to measure DM, and to date no such instruments exist in Spain. This study analyzes the psychometric and structural properties of the Drive for Muscularity Scale (DMS) in a sample of Spanish adolescent males (N=212), with the aim of studying the structural validity of the scale by using a confirmatory factor analysis (CFA), as well as analyzing the internal consistency and construct (convergent and discriminant) and concurrent validity of the instrument. After testing three models, results indicated that the best structure was a two-dimensional model, with the factors of muscularity-oriented body image (MBI) and muscularity behavior (MB). The scale showed good internal consistency (α=.90) and adequate construct validity. Furthermore, significant associations were found between DM and increased difficulties in emotional regulation (rho=.37) and low self-esteem (rho=-.19). Findings suggest that the two-factor structure may be used when assessing drive for muscularity among adolescent males in Spain.

The association between sexual orientation, susceptibility to social messages and disordered eating in men

OBJECTIVE

Much research points to higher levels of disordered eating and more negative body image in gay and bisexual men than in heterosexual men. The reasons for this difference, however, remain unclear. We hypothesized that disturbed body image and eating attitudes in gay and bisexual men would be partially explained by susceptibility to social messages.

METHODS

Two hundred and sixty-two men (203 heterosexual, 46 gay and 13 bisexual) between 18 and 35 years of age participated in the study. They completed measures of disordered eating, body image, internalization of attitudes toward appearance, and concern for appropriateness. In addition, they were asked to what extent they were influenced by ten advertisements, four that emphasized physical appearance, and six that did not.

RESULTS

As shown in previous research, gay and bisexual men reported higher levels of disordered eating and dissatisfaction with their bodies than heterosexual men. In addition, the gay and bisexual men were more susceptible than the heterosexual men to social messages, and reported being significantly more influenced than heterosexual men by advertisements focusing on physical appearance, but not by other advertisements. Susceptibility to social messages fully mediated the association between sexual orientation and disordered eating.

DISCUSSION

Results provide support for the hypothesis that sensitivity to social messages about appearance explains, at least partially, the link between sexual orientation and disordered eating in men.

Don't stop till you get enough: Factors driving men towards muscularity

This study tested a modified Tripartite Influence Model with 307 men (age M=27.05; SD=6.25). Sociocultural influences (media and male peers) were predicted to be associated with both internalisation of the muscular ideal and body comparisons, which in turn were predicted to be associated with muscle dissatisfaction and then drive for muscularity behaviours. The model was only partially supported. The results suggested that, contrary to what was predicted, muscle dissatisfaction was not related to drive for muscularity behaviours. Instead, internalisation of the muscular ideal was found to lead to body comparisons, which in turn were found to lead to drive for muscularity behaviours. In addition, internalisation and male peer influence were found to lead to muscle dissatisfaction; male peer influence and internalisation were found to lead to body comparisons; and both media and male peer influences were found to lead to internalisation.

Unique associations between young adult men's emotional functioning and their body dissatisfaction and disordered eating

Research on emotional functioning, body dissatisfaction, and disordered eating in males is predominated by studies of negative affect and emotion regulation. Other aspects of emotional functioning, namely emotion recognition and attentional biases toward emotional stimuli, have received little empirical attention. The present study investigated the unique associations between different aspects of men's emotional functioning and their disordered eating attitudes, muscularity dissatisfaction, and body fat dissatisfaction. Results from 132 male undergraduates showed that muscularity dissatisfaction was uniquely associated with both emotion regulation difficulties and an attentional bias toward rejecting faces. Body fat dissatisfaction was not uniquely associated with any aspect of emotional functioning. Disordered eating was uniquely associated with emotion regulation difficulties. Collectively, the results indicate differences in the patterns of associations between men's emotional functioning and their body dissatisfaction and disordered eating.

The effects of exposure to slender and muscular images on male body dissatisfaction

This research examined the effects of appearance-based comparisons to muscular and slender idealized male bodies and the contribution of internalization and social comparison to change in body dissatisfaction. Participants were 111 male undergraduates who completed measures of body dissatisfaction, internalization, and social comparison and viewed images of either muscular or slender men in advertisements or product-only advertisements. Results indicated that exposure to both muscular and slender images was associated with an increase in body dissatisfaction, with no significant differences in the change in body dissatisfaction between the two image conditions. Internalization and trait social comparison were each associated with an increase in body dissatisfaction; however, upward social comparison was only a significant predictor of a change in body dissatisfaction for the males who viewed muscular images. These results highlight the impact of slender models on young men's body dissatisfaction and support the examination of media literacy interventions with this population.

Social dominance orientation predicts drive for muscularity among British men

The present study tested the hypothesis that men's drive for muscularity would be associated with their valuation of domination, power, status, and aggression over others. A community sample of 359 men from London, UK, completed measures of drive for muscularity, social dominance orientation, right-wing authoritarianism, trait aggression, and need for power, as well as their demographic details. Bivariate correlations showed that greater drive for muscularity was significantly correlated with most of the measures and their subscales. However, in a multiple regression analysis, the only significant predictor of drive for muscularity was support for group-based dominance hierarchies (Adj. R(2)=.17). These results suggest that men's drive for muscularity is associated with a socio-political ideology that favours social dominance.