Research on eating disorders (ED) in men is still insufficient, and the stigma that this pathology is specific for women remains [1, 2]. Both men and women may present disordered eating behaviors (DEB), such as binge eating, restraint eating, emotional eating, disinhibition or body weight and shape control through inappropriate compensatory behaviors, none of which meet the full criteria for eating disorder. DEB are considered risk factors for ED [3, 4] and they are more frequent than clinically defined disorders, especially in adolescents and young adults . However, men face neglect tendency in both the diagnosis and treatment of ED and DEB. Research on both ED and DEB in men is proportionally less than in women, and men continue to be excluded from many clinical or screening studies [1, 2, 6–8].
Worldwide, the global prevalence of ED increased from 3.4–7.8% between 2000 and 2018 . Evidence for different countries shows that the prevalence of DEB in male college students ranges from 5.5–18.3% [10–14]. Meanwhile, data for Mexico show that the prevalence of DEB among first-year male college students varies from 1.9–13.0% [5, 15, 16]. Research in Mexico report no significant differences in the prevalence of DEB between male and female undergraduate students, while other studies have found that Mexican undergraduate male students of human nutrition have a higher frequency of DEB compared to male students from other undergraduate courses [17, 18].
Recent studies indicate that body weight and body image concerns are different between men and women [1, 2, 19, 20]. Research on predisposing conditions for DEB suggest that the internalization of the aesthetic ideal of thinness has been identified as the only common predisposing factor for both men and women; however, drive for muscularity, as a risk factor for DEB, has been identified exclusively for men [5, 15, 20, 21].
According to the specialized literature, body image, muscle dysmorphia and exercise should be considered for the study of ED in men , as well as the practice of dieting with the purpose to achieving fat-free muscles bodies or improving their appearance.
Results from two meta-analyses have demonstrated that, in men, pressure from mass media has a negative impact on body satisfaction, body esteem, self-esteem, psychological problems (e.g., depression, anxiety), and health risks behaviors (e.g., excessive exercising, steroid abuse) . The male ideal figure has become increasingly muscular in the mass media . This could explain dissatisfaction with body image among men and an emerging trend in bodybuilding or drive for muscularity [24, 25].
The promotion of a male body ideal focused on strength, endurance, and superiority causes men to pay more attention to their body and appearance, rather than on their health. This explains why health risks are increasingly related to muscle dysmorphia, steroid abuse and eating disorders .
Muscle dissatisfaction is an increasingly important issue among young men. Evidence suggests that media’s pressure toward muscularity correlates with low body image in men [27–29]. Across cultures, young men accept that muscularity is not only socially desirable, but it is also associated with social status or being more sexually attractive [30–32].
Assessment tools for eating disorders symptoms among males include the Eating Disorder Examination-Questionnaire (EDE-Q; 28-item, 7 item and other versions) and the Eating Disorder Assessment for Men (EDAM, 50-item questionnaire, consisting of 5 subscales) that assess both traditional and muscularity-oriented ED symptoms [33–37]. The self-reported Dutch Restrained Eating Scale (RS) consists of 10 questions on the frequency of restrictive diets; this instrument assesses calorie consumption and predictive validity for the onset of bulimic symptoms . The Eating and Appraisal Due to Emotions and Stress Questionnaire (EADES) assesses eating behavior in relation to emotions, stress and loss-of-control eating [39, 40].
The Negative Affect Scale of PANAS-X questionnaire (Positive and Negative Affect Scale, PANAS-X) has been used to measure negative affect, considered as a predisposing factor for DEB in men [41, 42], a mediator of bulimic behavior  and a perpetuating factor for ED .
In Mexico, different self-administered questionnaires have been widely used in research on ED and DEB, of which the most common is the Brief Questionnaire to measure Risky Eating Behaviors (BQREB), consisting of 10 questions. This tool evaluates concerns on weight gain, binge eating, restrictive and purgative behaviors , BQREB was validated in males aged 15 to 23 years, although it was initially developed for female populations . Other instruments used to explore DEB in Mexican men were the Bulimic Investigatory Test, Edinburgh (BITE), Bulimia Test (BULIT), Eating Attitude Test-40 (EAT-40) and Eating Disorder Inventory (EDI) questionnaires [47, 48].
We hypothesized that the aesthetic body ideal among college males, which include fat mass-rejection and drive for muscularity, is associated with disordered eating behaviors.
Bearing in mind that changes in adolescent and young men behavior attributable to the desire for a more muscular body can have negative consequences on health, and that early diagnosis of risk factors could prevent the development of clinical eating disorders or muscle dysmorphia, the purpose of this study was to develop an instrument to identify men at risk of ED based on both their concerns with body image and weight, and their own eating behaviors.