Men and Eating Disorders

Before and after the onset of bulimia nervosa photos of a male sufferer.

Did you know that…

  • Males often begin an eating disorder at older ages than females do, and they more often have a history of obesity or overweight.

  • Because eating disorders have been described as female problems, males are often exceedingly reluctant to admit they are in trouble and need help. In addition, most treatment programs and support groups have been designed for females and are populated exclusively by females. Males report feeling uncomfortable and out of place in discussions of lost menstrual periods, women’s socio-cultural issues, female-oriented advertising, and similar topics.

  • The numbers seem to be increasing. Twenty years ago it was thought that for every 10-15 women with anorexia or bulimia, there was one man. Today researchers find that for every four females with anorexia, there is one male, and for every 8-11 females with bulimia, there is one male. (American Journal of Psychiatry 2001. 158: 570-574)Binge eating disorder seems to occur almost equally in males and females, although males are not as likely to feel guilty or anxious after a binge as women are sure to do.

    Clinics and counselors see many more females than males, but that may be because males are reluctant to confess having what has become known as a “women’s problem.” Also, health professionals do not expect to see eating disorders in males and may therefore underdiagnosed them. -According to the ANRED Anorexia Nervosa & Related eating Disorders website 

Now according to The Center for Eating Disorders  Males with eating disorders exhibit similar signs and symptoms as females and suffer comparable physical complications such as osteopenia, reduced sex drive and damage to the heart and other vital organs. Most research shows that there are no significant gender differences in characteristics of the eating disorders or in co-occurring disorders.

As is the case with females, body image concerns appear to be one the strongest variables in predicting eating disorders in males. Studies have demonstrated that the drive for thinness was a more important predictor of weight loss behaviors than psychological and/or family variables, and this desire was true of both adolescent males and females   Studies also demonstrate that cultural and media pressures on men for the “ideal body” are on the rise.  While social and media pressures for female bodies often focus on being skinnier and thinner, the messages aimed at males often promote hyper-masculine bodies that are toned, muscular and perfectly groomed. Men are increasingly the target of diet and weight-loss advertisements, grooming/beauty products, cosmetic surgeries and the fashion industry which may be contributing to rising rates of body dissatisfaction among males. 

Eating disorders affect individuals of all sexual orientations.  However, homosexual men seem to be at higher risk for eating disorders than their heterosexual counterparts.  Researchers speculate this may be due to two factors.  First, the eating disorder may be a way of coping with difficulty or internal conflict related to a sexual identity crisis.  Secondly, the gay culture often places a high value on the thin, muscular physique and so pressure to conform to this ideal may be heightened.

Prevalence in Men

Prevalence figures for males with eating disorders (ED) are somewhat elusive. Many assessment tests have a gender bias, because they were created for females and underscore males (Darcy, 2014). In the past, ED have been characterized as “women’s problems” and men have been stigmatized from coming forward or have been unaware that they could have an ED. Studies have shown an increase in the numbers, although it is uncertain whether more males actually have eating disorders now or are becoming more aware of the gender-neutral nature of ED. Additional research is needed, but several studies provide insight into the male experience of eating disorders:

Well research from the NEDA National Eating Disorders Feeding Hope website states that:

  • The most widely-quoted study estimates that males have a lifetime prevalence of .3% for anorexia nervosa (AN), .5% for bulimia nervosa (BN) and 2% for binge eating disorder (BED). These figures correspond to males representing 25% of individuals with AN and BN and 36% of those with BED. They are based on DSM-IV criteria (Hudson, 2007).

  • In the United States, 20 million women and 10 million men will suffer from a clinically significant eating disorder at some time in their life, including anorexia nervosa, bulimia nervosa, binge eating disorder, or EDNOS [EDNOS is now recognized as OSFED, other specified feeding or eating disorder, per the DSM-5] (Wade, Keski-Rahkonen, & Hudson, 2011).

  • In a study of 1,383 adolescents, the prevalence of any DSM-5 ED in males was reported to be 1.2% at 14 years, 2.6% at 17 years, and 2.9% at 20 years (Allen, 2013).

  • A study of 2,822 students on a large university campus found that 3.6% of males had positive screens for ED. The female-to-male ratio was 3-to-1 (Eisenburg, 2011).

  • In looking at male sexuality and eating disorders, higher percentage of gay (15%) than heterosexual males (5%) had diagnoses of ED (Feldman, 2007), but when these percentages are applied to population figures, the majority of males with ED are heterosexual.

  • Subclinical eating disordered behaviors (including binge eating, purging, laxative abuse and fasting for weight loss) are nearly as common among males as they are among females (Mond, 2014).

  • Various studies suggest that risk of mortality for males with ED is higher than it is for females (Raevuoni, 2014)

  • Men with eating disorders often suffer from comorbid conditions such as depression, excessive exercise, substance disorders, and anxiety (Weltzin, 2014).

There is hope for men who maybe ashamed to ask for help or seek treatment.  Search the links provided in this blog to learn more concerning treatment centers and or support groups. Just don’t  give up!