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‘Bulk and cut’ dieting linked to eating disorders – Canadian study

Investigating the link between “bulking and cutting” diets and mental health in adolescents and young adults, researchers recently found this was associated with a higher incidence of eating disorders and muscle dysmorphia.

Muscularity-oriented eating and weight-control behaviour is common among adolescents and young adults and varies according to gender: bulking and cutting is a dietary technique where people alternate between periods of high caloric surplus – “bulking”, and periods of caloric restriction – “cutting”, to increase muscle definition.

However, until now, few studies have explored the link between bulk and cut cycles and psychological factors, such as the drive for muscularity, eating disorders, and muscle dysmorphia.

The scientists’ study was an effort to understand the prevalence of bulk and cut cycles across genders and to recognise any links with mental health conditions. They found that almost half of young men and one in five women, transgender, and gender non-conforming (TGNC) individuals had engaged in bulk and cut cycles in the past 12 months.

They also found that this habit was linked to an increased incidence of muscle dysmorphia and eating disorders among all genders.

The study was published in Eating and Weight Disorders- Studies on Anorexia, Bulimia, and Obesity.

For the study, the researchers used survey data from 2 762 people from the Canadian Study of Adolescent Health Behaviours. Participants were between 16 and 30-years- old and were recruited between November and December 2021 via adverts on Instagram and Snapchat.

Survey topics included:
• Engagement in bulking and cutting cycles over the past 30 days and 12 months
• Drive for muscularity
• Eating disorder evaluation
• Muscle dysmorphia
• Demographic factors, including race/ethnicity, education level, gender identity

After analysing the results, the researchers found that men were almost twice as likely as women and TGNC individuals to engage in bulk and cut cycles in the past 12 months and in the past 30 days. Conversely, though, they found that women and TGNC participants tended to complete more bulk and cut cycles than men.

Additionally, the result showed that in men, women and TGNC participants, bulking and cutting were associated with a higher drive for muscularity, eating disorders, and muscle dysmorphia.

However, eating and cut cycles correlated only with muscle dysmorphia among TGNC participants in the past 12 months.

“Muscle dysmorphia is also known as bigorexia or reverse anorexia,” Dr Jason Nagata, assistant professor of paediatrics at the University of California, San Francisco, and senior author of this study, told Medical News Today.

“Muscle dysmorphia occurs when someone becomes obsessed with becoming muscular. They may view themselves as puny even if they are objectively muscular.”

Dieting among men vs women

To explain their results, the researchers noted that men’s engagement in bulking and cutting — with an average of three cycles per year — generally aligns with regimes promoted by the fitness industry to achieve body ideals.

They added that women might be more compelled to engage in shorter bulk and cut cycles, leading to a greater number of completed cycles, to ensure a more consistent body image without excessive muscle gain or body fat.

They also noted that the greater number of completed bulk and cut cycles among TGNC individuals might be evidence of a greater level of disordered eating to align with gender-specific body ideals.

Study limitations

Regarding the study’s limitations, Dr Rebecca Pearl, assistant professor at the Department of Clinical and Health Psychology at the University of Florida, told MNT:

“Since bulk and cut cycling has received little attention in eating disorder research and treatment, there is not yet a standardised way to screen for this in young people. It’s possible that the questions used in the current study to assess bulk and cut behaviours may not have measured exactly what the authors intended to measure across all participants.

“As the authors highlighted in their paper, it’s possible that some participants, particularly women and transgender and gender non-conforming individuals, may have been thinking about times when they cycled between binge eating and subsequent caloric restriction (symptoms of bulimia nervosa) when they endorsed the questions about cycling between ‘overconsumption’ and ‘underconsumption’,” she said.

“(P)articipants in this study were recruited via social media. Individuals who are active on social media may have greater exposure to and/or greater interest in messages related to fitness ideals and muscularity-oriented disordered eating and weight control practices (than those less active on social media). Thus, the prevalence of bulk and cut behaviours in the study sample could potentially be higher than in the general population.”

What this means for the future

The researchers concluded that their findings have important implications for future research and clinical and public health efforts.

When asked what these implications might be, Dr Kyle Ganson, assistant professor at the Factor-Inwentash Faculty of Social Work at the University of Toronto and the study’s lead author, said:

“Given the popularity of this dietary practice, and the fact that it is supported and emphasised in many communities (i.e., online, social media, fitness), we need to be thinking of it as potentially overlapping with serious mental and behavioural health conditions that can have significant adverse effects.

“Healthcare professionals need to be aware of this unique behaviour and not just screening for ‘typical’ eating disorder behaviours, like food restriction and binge-eating, or ‘typical’ body-focused attitudes and behaviours, such as [a] drive for thinness.

“Overall, we need to bring bulking and cutting, which is within the larger umbrella of muscularity-oriented eating and weight control behaviours, and the potential problems associated with these behaviours, into focus within our society, and among health and mental healthcare systems.”

Recognising symptoms of eating disorders

Ganson said eating disorders are characterised by intense fears of gaining weight, significant body dissatisfaction, and problematic eating behaviours such as food restriction, binging, and purging.

“If people sense that their psychological, social, and/or occupational functioning is being impeded by their focus on body and food, this may be an indicator of a potential eating disorder,” he said.

“It is important to note here that eating disorders can impact anyone, including all genders and sexual identities, races and ethnicities, people of all body sizes, and across the income spectrum. People shouldn’t assume that they don’t have an eating disorder because they do not fit the mould society has prescribed as having an eating disorder: white, young, skinny, affluent, female.”

He said muscle dysmorphia has similar psychological, behavioural, and functional symptoms to eating disorders. However, it differs as it is primarily driven by significant muscle dissatisfaction and an intense desire to gain muscle.

“This may manifest in excessive and compulsive exercise and weight training, dietary practices aimed at increasing muscularity (i.e., bulking and cutting), and use of appearance- and performance-enhancing drugs and substances, like anabolic steroids,” he pointed out.

Study details

“Bulking and cutting” among a national sample of Canadian adolescents and young adults

Kyle Ganson, Mitchell Cunningham, Eva Pila, Rachel Rodgers, Stuart Murray & Jason Nagata.

Published in Eating and Weight Disorders – Studies on Anorexia, Bulimia, and Obesity on 9 September 2022.

Abstract

Purpose
First, to characterise the prevalence and incidence of “bulk” and “cut” cycles among Canadian adolescents and young adults. Second, to determine the associations between bulk and cut cycle engagement and drive for muscularity and eating disorder and muscle dysmorphia psychopathology.

Methods
Data were from the Canadian Study of Adolescent Health Behaviors (2021; N = 2762), a national study of Canadian adolescents and young adults aged 16–30 years (M = 22.9, SD = 3.9). Prevalence and mean incidence of bulk and cut cycles in both the past 12 months and 30 days were estimated. Modified Poisson regressions were estimated to determine the associations between bulk and cut cycle engagement and levels of drive for muscularity and eating disorder and muscle dysmorphia psychopathology.

Results
The sample comprised of 53.5% women, 38.4% men, and 8.1% transgender/gender non-conforming (TGNC) individuals. Nearly half (48.9%) of men and one in five women (21.2%) and TGNC (21.9%) participants reported bulk and cut cycles in the past 12 months. TGNC participants and women reported a greater mean number of bulk and cut cycles completed compared to men. Engagement in bulk and cut cycles was associated with stronger drive for muscularity across the sample, and more severe eating disorder and muscle dysmorphia psychopathology among men and women.

Conclusion
Findings underscore the common incidence and accompanying psychopathology of bulk and cut cycles among a community sample of adolescents and young adults in Canada, indicating the need for future research, as well as clinical and public health efforts.

 

Eating and Weight Disorders article – “Bulking and cutting” among a national sample of Canadian adolescents and young adults (Open access)

 

MedicalNewsToday article – 'Bulk and cut' dieting linked to eating disorders, muscle dysmorphia in youth (Open access)

 

See more from MedicalBrief archives:

 

Male body image and the potentially deadly pursuit of muscle mass

 

Eating disorders linked to exercise addiction

 

Are eating disorders an addiction?

 

Increase in liver injury linked to herbal and dietary supplements — Australian study

 

 

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