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"They don't really know why they're refusing to eat enough to be healthy, but they have difficulty completing meals." According to the medical experts, many young boys who develop eating disorders are perfectionists, harm-avoidant and intolerant of uncertainty.

They may not be bullied about their bodies, but they're fearful of the possibility.

He's so self-conscious about the small size he wears that Heather puts labels over the tags on his clothes.

She also lets him wear clothes that are too big for him, just to make him feel better. "What is going on inside his head that he's so obsessed with his body? "You can tell that there's something deep inside of him that he's anxious about." Despite public perception, body image issues and eating disorders are not exclusively female problems.

Other research has found a relationship between the increase in idealized male bodies in media and the rise in body dissatisfaction and weight disorders in boys and young men: a 2005 study, for instance, found that media influence had the largest effect on whether middle-school boys were dissatisfied with their bodies.

The increase in eating disorders in male adults is well-established.

Plus, he has started to focus on clothing size as a body metric.

There doesn't seem to be anything medically wrong with Jack's growth pattern, his mom said -- she's taken him to the doctor to be checked out. And his insecurity doesn't seem to stem from any of the usual suspects, like bullying. " It was hard to gauge whether this was a problem, she said, until Jack broke down a couple of weeks ago, telling her that if his body is small, then his brain must be small. The oft-cited figure is that about 1 in 10 eating disorders occur in males, but according to Raymond Lemberg, an Arizona clinical psychologist and expert in the area, newer research suggests that the real ratio is probably closer to 1 in 4.

Jack has frequent play dates, participates in soccer and baseball on school teams, and does well in class. It wasn't until Harrison Pope, a professor of psychiatry at Harvard Medical School, published his seminal work around muscle dysmorphia, an obsession with bulking up also known as "reverse anorexia," in the late 1990s that researchers in the field began to pay attention to boys.

Often, they show signs of anxiety, like a choking or vomiting phobia.

While they may lack the language skills to talk about their bodies in terms of appearance, they express vague abdominal complaints.

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