Though eating disorders are more commonly associated with women, anorexia in men and boys does exist and can be severe.

Though the pressures of unrealistic body expectations affect women worldwide, many men are concerned about this subject as well.

Perfect hair, nails, figure, and skin are all marketing points that can cause hyperfocus on appearance. Male celebrities and models can portray a similar version of unattainable or unrealistic “ideals.”

Men can experience many of the same body-image challenges women do, but they’re often pressured to act as though such things don’t affect them.

Anorexia is a severe condition that can cause health issues and become life threatening. But recovery is possible with the right treatment plan and support.

Anyone can develop an eating disorder, regardless of age or gender.

Men living with eating disorders may be less likely to seek treatment due to the stigma of being viewed as unmasculine or conveying weakness.

Eating disorders, like male anorexia nervosa, may be associated with different personal factors when they occur in men. While most focus is on women when it comes to anorexia, most people are unaware of what symptoms to look for when men live with disordered eating.

Even medical questionnaires designed to assess disordered eating patterns may use language geared more for women than men, contributing to underdiagnosis.

What is anorexia?

Anorexia nervosa is a mental health condition characterized by adopting disordered eating habits — particularly food restriction — as a means of achieving perceived thinness.

Signs of this eating disorder may present as:

  • intense fear and fixation about weight gain
  • distorted body image
  • preoccupation with feeling constantly overweight
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While anorexia is still more prevalent among women, as many as 0.3% of men may experience anorexia during their lifetime.

Living with male anorexia or disordered eating does not mean you have feminine traits. Having an eating disorder does not indicate your sexual orientation.

Anorexia nervosa is a mental health condition that can be spurred by unrealistic body expectations set by media and social circles regardless of:

  • gender
  • race
  • personality
  • sexual orientation

Even particular sports with a heavy focus on weight can encourage unhealthy weight loss habits, such as:

  • wrestling
  • running
  • swimming
  • bodybuilding
  • mixed martial arts
  • rowing
  • gymnastics
  • dancing

Many men and boys experience disordered eating due to trying to be lean and muscular — something often portrayed as the ideal body type for men.

Why is male anorexia associated with being a gay man?

Part of the stigma surrounding male anorexia is its association with the gay community.

Research has found that between 10% to 42% of men with eating disorders identify as gay, though some experts believe gay men may be overrepresented in eating disorder studies. However, gay men might also be more likely to seek treatment than men of other sexual orientations.

Alternative body standards may be why male anorexia is often associated with being a gay male.

Before the AIDS crisis of the 1980s and 1990s, the the ideal gay male body was thinner and leaner, compared to body types in other groups and communities. However, some experts have suggested that the impact of the AIDS epidemic on gay and queer people may have changed the gay male aesthetic, and extreme thinness became associated with being sick or unwell.

The ideal gay male body may be expected to be more muscular and lean in many circles.

This may encourage disordered eating habits as men strive to feel attractive to potential partners.

Specific disordered eating habits, such as binge eating and purging, may be more prevalent among gay men. Gay and bisexual men may be more likely to try to control weight by:

  • fasting
  • vomiting
  • using laxatives
  • using diet pills

Despite these ties between male anorexia and the gay community, most men living with an eating disorder are typically heterosexual.

Anorexia tends to manifest in early adulthood. People of all genders seem to be driven by the same motive to meet their perception of being thin.

For girls living with anorexia, “thin” often means exceptionally skinny — a low body weight. They may just want to fit into the smallest size possible and may not be concerned about strength or the appearance of toned, defined muscles.

Male anorexia can often be about being lean rather than skinny, though not all men living with anorexia care about muscle mass appearance.

In men and boys, this eating disorder often means being thin while also appearing strong.

Unlike some women who are fixated on weight loss, many men living with anorexia may not only restrict their diet but may also:

  • exercise excessively
  • take an abundance of supplements
  • use steroids
  • try diet fads designed to enhance muscle and cut fat

Many people think low body weight is the most obvious warning sign of anorexia. But the shape of the male body may hide excessive weight loss more easily than a woman’s body.

This may mean that “looking thin” is one of the last warning signs of male anorexia to be noticed.

Warning signs

Warning signs of male anorexia can include:

  • frequent bathroom visits after or during a meal
  • hyper-focus on working out, even when injured or during bad weather
  • binge eating
  • dressing in layers
  • denying being hungry
  • food avoidance
  • strict dietary rules or habits
  • fixating on nutritional information or calorie count
  • constant weighing
  • avoiding social gatherings where food is served
  • stress or anxiety when a workout gets missed
  • excessive preoccupation with bodybuilding or physique development
  • statements about being unhappy with weight or body image
  • the appearance of food rituals, such as arranging food in a certain way

Signs and symptoms

Signs of male anorexia may include:

  • decreased sex drive
  • feeling weak or lethargic
  • cold intolerance
  • digestive issues
  • abnormal laboratory levels, such as anemia or low hormone levels
  • dizziness or fainting
  • sleep disturbance
  • slow or poor wound healing
  • impaired immunity
  • yellow skin
  • dental changes
  • thinning or loss of hair
  • hand and finger cuts or swelling
  • difficulty concentrating

The 5 warning signs of anorexia

Anorexia can have many subtle warning signs. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) recognizes some classic diagnostic features, regardless of gender, including:

  • restriction of energy intake that leads to a significantly low body weight
  • intense fear about weight gain
  • persistent behavior that interferes with weight gain
  • feeling low self-worth or disturbance related to body weight or shape
  • lack of awareness or recognition regarding the seriousness of low body weight

Like other eating disorders, no singular cause behind anorexia nervosa in any gender has been pinpointed.

Some 2021 research suggests environmental and biological factors may influence the development of an eating disorder.

Risk factors

Many factors may increase your chances of experiencing anorexia or disordered eating, such as:

  • living through a traumatic experience
  • limited social networks and isolation
  • loneliness
  • acculturation
  • perfectionism
  • low body image satisfaction
  • history of an anxiety disorder
  • cultural weight stigma
  • experiencing bullying
  • history of dieting
  • regular energy deficits from illness, athletics, or dieting
  • having a close relative living with an eating disorder or mental health condition
  • a natural inclination toward inflexible thinking or behaviors
  • intergenerational trauma

Anorexia nervosa can cause severe health complications and be life threatening. But with treatment and support, you can manage the condition.

Medical care

If you or a loved one is living with anorexia, seeing a doctor is essential. Your healthcare team may recommend supervised recovery in a care facility, depending on the severity of:

  • weight loss
  • malnourishment status
  • any physical challenges you may be noticing

A treatment facility’s doctors can help stabilize your:

  • hydration
  • nutrition
  • physiological function

Therapy

Seeing a therapist can also be helpful. Anorexia can cause many physical effects, but understanding what drives your behaviors can make a major difference in your recovery outcome.

Some common types of therapy used for anorexia and eating disorders include:

Medication

Though not usually a first-line treatment for eating disorders like anorexia, medication may also be a part of your recovery process.

Medication can help alleviate symptoms related to depression or anxiety, which may co-occur with anorexia.

Some medications can also help counteract any physical changes you may have experienced, such as digestive issues or hormone imbalances.

Medications can be prescribed only by a doctor. Following guidelines on taking medications as prescribed is vital if they are a part of your anorexia treatment plan.

If you’re living with male anorexia, it’s natural to be concerned about the stigma created by unfair expectations and myths.

Anyone can develop anorexia nervosa, regardless of their identity. Millions of men have experienced living with an eating disorder.

Fear of being labeled “weak” or having your sexual orientation questioned may keep you from seeking professional guidance. But anorexia can be severe and life threatening.

Recovery is possible, and it’s important to seek help from a doctor and therapist. Typically, treatment options for anorexia include:

  • medical treatment, sometimes in a facility
  • therapy
  • medications, in some cases

If you want to learn more about male anorexia, you can visit the National Association of Anorexia Nervosa and Associated Disorders.

If you feel overwhelmed or don’t know where to start, you can speak with a trained mental health representative by calling the SAMHSA National Helpline at 1-800-662-4357. You can also check out Psych Central’s guide to finding a therapist.