A quarter of eating disorders are diagnosed in men. So why aren’t we talking about it more?
What we talk about when we talk about eating disorders, by and large, is women. Eating disorders are mental health conditions
Although eating disorders are often considered a “woman’s issue,” men represent a quarter of anorexia nervosa and bulimia nervosa cases, according to a 2007
Eating disorders are
Overall, male eating disorders are more likely to go undiagnosed. The NIMH in 2008 estimated the number of men with eating disorders to be about one million, but that number is likely higher, according to a
Common differences between male and female disordered eating
One difference in the presentation of disordered eating in men versus women is often the
This is an eating disorder pathology
Men, for this reason, are
LGBTQ+ men are more vulnerable to eating disorders than cisgender men. Transgender men, in particular, are about
Men are more likely to mask their eating disorder symptoms than women, along with depression and anxiety that may coexist with those symptoms. When men do not report their symptoms, they do not receive
Another problem with underreported symptoms is that it contributes to the lack of research on eating disorders in men. Because
For example, the current criteria for diagnosing an eating disorder centers on failure to gain weight; many men with eating disorders say they want a larger body or to gain weight.
- a sense of loss of control over eating
- eating alone or in secret
- shame about eating or what you consume
- frequent dieting, perhaps without losing weight.
- substance misuse
- high cholesterol
Bulimia nervosa has a prevalence of
- excessive exercise
- laxative use that may cause intestinal distress
- binge eating
- eroded tooth enamel
- chronic sore throat
- electrolyte imbalance (In one
study, 25% of adolescent boys with eating disorders had low potassium, 5% low calcium, and 10% low phosphorus.)
Anorexia nervosa has a prevalence of
- body dissatisfaction and body dysmorphia, particularly
- fear of gaining weight
- infatuation with a muscular body ideal
low bone mineral density
- vital sign instability
- suicidal ideation (Dying by suicide is the second most common cause of death among people diagnosed with anorexia nervosa, after complications of starvation.)
If you’re experiencing suicidal thoughts, help is available
You can access free support right away with these resources:
- 988 Suicide and Crisis Lifeline.Call the Lifeline at 988 for English or Spanish, 24 hours a day, 7 days a week.
- The Crisis Text Line.Text HOME to the Crisis Text Line at 741741.
- The Trevor Project. LGBTQIA+ and under 25 years old? Call 866-488-7386, text “START” to 678678, or chat online 24/7.
- Veterans Crisis Line.Call 988 and press 1, text 838255, or chat online 24/7.
- Deaf Crisis Line.Call 321-800-3323, text “HAND” to 839863, or visit their website.
- Befrienders Worldwide.This international crisis helpline network can help you find a local helpline.
Some of the most common risk factors for a an eating disorder in men include:
- Use of anabolic steroids.
- Substance misuse: particularly of
stimulants, which may be used to control weight.
- Family history of eating disorders: There may be a
genetic linkto eating disorders. Social and cultural factors in familiescan also play a role; for example, a strong focus on food or dieting or appearance.
- A history of anxiety, mood, or impulse control disorders: These disorders tend to be
comorbidwith eating disorders, and are particularly linked to bulimia nervosa and binge-eating disorder, the latter of which is the most common eating disorder in men.
- Frequent use of
- Being a member of a sexual or gender minority: One
studyshows that members of sexual or gender minorities – being gay, bisexual, or transgender, for example – are between two and four times more likely to develop an eating disorder than cisgender men. Another study showed that gay adolescent boys were more than six timesmore likely to fast, vomit, or take diet pills than heterosexual boys. Up to a thirdof gay or bisexual young adult men reported binge-eating.
There are several treatment options for men experiencing eating disorders. Speaking with a mental health professional is a great first step for determining the best treatment plan for you.
Group therapy with other men may mitigate the risk of being vulnerable about difficulties with food, body image, and weight. It can create a safe space where the stigma of eating disorders as something that are “women’s diseases” may be lessened.
Group therapy can help men discuss potential shame they have around their eating disorder. When therapy centers on these feelings of depression and shame, instead of just on the behaviors around food and eating, intervention may be more successful, according to one
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) can be useful in treating eating disorders in men because this type of therapy helps change negative thinking patterns. CBT can help clients retrain their brains and learn how to manage triggers that set off certain types of harmful behavior, such as binging, purging, or starving.
For adolescent boys with eating disorders, engaging caretakers in treatment through family therapy and having them oversee what their child eats and regulate how often and when he exercises, can be very helpful. Caretakers are trained by therapists to patrol behavior instead of weight gain or loss.
Because control over what is eaten and the amount of exercise is often a key component of eating disorder behavior, removing that responsibility from the person with the disorder and placing it in the hands of caretakers can be an
Eating disorders in men are underreported and underresearched and, subsequently, are often underdiagnosed. The presentation of eating disorders in men is often different than in women, and doctors may miss the cues.
Men are more likely to be focused on weight gain and building muscle than on losing weight or appearing thin. In LGBTQ+ men, body dysmorphia is more common than among straight men and can result in the development of an eating disorder.
Men are also more likely to mask symptoms of eating disorders and to feel ashamed by them, making them harder to diagnose and treat.
Acknowledging that men are also subject to concern over food, diet, weight, and body image, and that in some men, that concern may manifest in an eating disorder, is the first step in raising the curtain that too often hides the reality of male eating disorders.