Recent models which have been designed to explain the development of bulimia nervosa and bulimic behavior have been primarily tested and validated with young adult women and adolescent girls (Shepherd & Ricciardelli, 1998Stice, Nemeroff & Shaw, 1996Stice, Shaw & Nemeroff, 1998Thompson, Coovert, Richards, Johnson & Cattarin, 1995Varnado, Williamson & Netemeyer, 1995). This is despite the fact that approximately 10% of individuals who are treated for bulimia nervosa and binge eating disorder are males (Carlat et al., 1997 and Garfinkel et al., 1995Tanofsky, Wilfley, Spurrell, Welch & Brownell, 1997Wilson, Nonas & Rosenblum, 1993). In addition, community samples of adolescent and adult males have demonstrated high levels of binge eating behavior that are often comparable to that of females (Franco et al., 1988 and Hay, 1998Maude et al., 1993, Snow & Harris, 1989 and Vincent & McCabe, 2000).
Among young women, body dissatisfaction has been consistently found to be one of the main risk factors predictive of bulimia nervosa and bulimic eating patterns (Gleaves et al., 1993 and Killen et al., 1994Ricciardelli et al., 1997, Thompson et al., 1995 and Van Strien, 1996). Stice (1994) proposed a model that identifies two pathways in which body dissatisfaction may lead to the development of bulimic behavior for young women and adolescent girls. The first pathway involves dietary restraint. Within this pathway, body dissatisfaction is closely associated with dietary restraint, and in turn, dietary restraint leads to an increase in the likelihood of binge eating and bulimia nervosa (Brody et al., 1994, Gleaves et al., 1993, Guertin, 1999, Polivy & Herman, 1985, Stice, 1994, Stice et al., 1998 and Thompson et al., 1995). The second pathway is via negative affect. Body dissatisfaction is closely associated with negative affect, and women experiencing negative affect demonstrate higher levels of bulimic behavior (Beebe, 1994, Shepherd & Ricciardelli, 1998, Stice, 1994 and Stice et al., 1998). Bingeing and purging, in turn, are thought to reduce negative affect by providing temporary relief and distraction from one's negative emotional state (Beebe, 1994 and Stice, 1994). Therefore, the two pathways which were developed by Stice (1994) to explain the development of bulimic behavior, have both received empirical support for young adult women and adolescent girls.
In contrast, several studies conducted with non-clinical samples of males, have not always found significant relationships between body dissatisfaction, dietary restraint, negative affect and bulimic behavior (Keel, Fulkerson & Leon, 1997Leon, Fulkerson, Perry & Early-Zald, 1995Richards et al., 1990, Tiggemann, 1994 and Wertheim et al., 1992). It has been suggested that whereas women use dietary restraint to moderate body dissatisfaction, men may not use dietary restraint in the same way (Carlat & Camargo, 1991). Men who are dissatisfied with their body are less likely to want to lose weight, as dieting would take men away for the “mesomorphic” ideal (Carlat & Camargo, 1991 and Raudenbush & Zellner, 1997). In addition, although similar levels of binge eating have been found between men and women, some studies have shown that boys and men are less likely to feel depressed after bingeing, and they report less guilt about binge eating (Carlat & Camargo, 1991, Leon et al., 1995, LaPorte, 1997 and Snow & Harris, 1989). In fact, binge eating in men is not seen as abnormal or as inappropriate as it is in women, and it may even be socially sanctioned for men (Carlat & Camargo, 1991). Thus, the meaning, function and outcome of binge eating may be quite different for males and females. It is also not surprising that men require that a larger amount of food be consumed before they label it a “binge”, and men associate mostly gastrointestinal outcomes rather than negative emotional responses with their labeled binges (LaPorte, 1997).
Whilst the above discussion would suggest that negative affect may not play an important role in determining binge eating and other bulimic behavior among males, some studies have found evidence which links emotional distress to bulimic behavior among males (Fox et al., 1994 and Koenig & Wasserman, 1995Leal, Weise & Dodd, 1995Leon et al., 1999 and Mueller et al., 1995Ricciardelli, Williams & Kiernan, 1999; Vincent & McCabe, 2000). The inconsistent findings with males may be due to the fact that body dissatisfaction among males is fairly equally split between those wanting a larger body size and those wanting to be thinner than their current body size (Davis & Cowles, 1991, Drewnowski & Yee, 1987, Furnham & Calnan, 1998, McCabe & Ricciardelli, 2000 and Raudenbush & Zellner, 1997). This may lead to different associations between bulimic behavior and negative affect in these two groups of males.
The present study was designed to examine Stice's (1994) model among adolescent males and females. Stice's model identifies dietary restraint and negative affect as two pathways which mediate the relationship between body dissatisfaction and bulimic behavior. A separate examination of boys who wanted to be thinner versus those who wanted to be bigger than their current body size was conducted, as this may explain some of the conflicting findings in previous research. Whilst Stice's model has been evaluated for adolescent girls and adult women, the model has yet to be examined for males.
