Is There A Difference Between Eating Disorders In Men And Women?
Eating disorders can affect people of all genders. While women may be more likely to develop an eating disorder, research suggests that more than 6.6 million men in the US will experience an eating disorder at some point in their lifetime. Despite this, men tend to be less likely to be diagnosed and receive appropriate treatment.
While there can be differences in the reasons why men and women develop eating disorders and how their symptoms manifest, early recognition and intervention can be crucial regardless of a person’s gender. Effective treatment for eating disorders usually involves working with a doctor, therapist, and registered dietician.
Common eating disorders
There are multiple types of eating disorders that can affect both men and women. Here are three of the most common.
Anorexia nervosa
Anorexia is an eating disorder typically characterized by highly restricted food consumption and weight loss driven by an intense fear of gaining weight. It is said to have the highest mortality rate of any mental health condition, other than opioid use.
People with anorexia typically eat only small amounts of low-calorie food and exercise excessively, though some may also binge eat and purge by vomiting or misusing laxatives. While many individuals with anorexia are underweight, those who are not may be given the diagnosis of atypical anorexia nervosa.
Bulimia nervosa
People who have bulimia typically binge and purge. Binging generally involves eating a large amount of high-calorie foods in a short amount of time. When people with bulimia binge, they often sense they have no control over how much they are eating. Binging is typically done secretly and may elicit feelings of embarrassment or shame.
After binging, people with bulimia may purge by vomiting or abusing laxatives. They may also engage in other compensatory behaviors to lose weight, like excessive exercise or fasting. Between binges, people with bulimia may eat normally, or they may restrict calories.
Binge eating disorder
People with binge eating disorder usually have episodes of binging during which they consume large amounts of food in a short time. During binges, they may sense they are out of control, and they are usually embarrassed or distressed by their behavior.
The difference between binge eating disorder and bulimia is that people with binge eating disorder normally do not engage in any compensatory behaviors to lose body weight, like self-induced vomiting, laxative misuse, fasting, or compulsive exercise.
Eating disorders in women
Research suggests that women are roughly twice as likely to develop an eating disorder as men. There may be many reasons for this.
For example, studies have found that women generally experience more pressure to be attractive, with factors like social media contributing to unrealistic beauty standards that may lead to disturbed body image or body dysmorphic disorder.
Eating disorders in men
While a desire to be thin often contributes to women developing eating disorders, men tend to be more likely to worry about having a strong, muscular physique.
Eating disorders in men may come with a social stigma. People usually associate eating disorders with a desire to be thin, which may be seen as unmasculine. Studies have found that men may be more embarrassed or hesitant to admit that they have an eating disorder than women, and men generally do not consider eating disorders to be significant health problems. In fact, research shows that some men believe bulimia stems from a lack of willpower. Because men may believe that it is not acceptable to struggle with eating disorders, they may be less likely to seek the help they deserve.
Eating disorder prevalence in men and women
Here are some statistics to illustrate the prevalence of eating disorders in men and women:
- Between 1% and 2% of women and 0.1% to 0.3% of men will have anorexia at some point in their lives.
- Around 25% of people with anorexia are men, but men typically have a higher chance of dying from the condition, likely due to delays in seeking treatment.
- Bulimia affects about 1.5% of women and 0.5% of men in the US.
- About 3.5% of women and 2% of men have binge eating disorders, but there are often differences in how they report symptoms. Women tend to be more likely to report a loss of control while binging, whereas men tend to be more likely to report that overeating was accidental.
Differences in eating disorders in men and women
About 39% of women and 59% of men with anorexia recover to full health. Men tend to be more likely to experience complications like alcoholism, while women may be more likely to develop major depression.
Considerations for men with eating disorders
Many factors should be taken into consideration when creating a treatment plan for someone with an eating disorder. Studies show that rates of eating disorders in males appear to be increasing at a faster rate than in females. Early intervention can be critical, but men may be less likely to seek help.
When treating men with anorexia, bulimia, and other eating disorders, there are a few important considerations. Men who seek treatment may sense they are out of place in facilities that are primarily staffed with and treat women. Recognizing that men may have different needs and presenting gender-specialized interventions may lead to better outcomes.
Males can have some gender-specific clinical features and eating disorder symptoms to consider when developing individualized treatment plans. For example, men with anorexia may be at a higher risk for osteoporosis due to lower levels of vitamin D and testosterone. In addition, men tend to be more likely to misuse growth- or performance-enhancing medications like steroids. It can be important to take these factors into account when creating individual treatment plans.
Treatment for eating disorders
Although there can be differences between why men and women develop eating disorders and the types of co-occurring conditions they experience, men and women do not usually vary significantly in how they respond to treatment.
In general, treatment for eating disorders is very individualized and varies depending on the specific type of eating disorder, its severity, any health complications, and co-occurring mental health conditions. The following approaches may be used.
Hospitalization and inpatient treatment
Hospitalization or other inpatient treatment is usually necessary for people who are severely underweight or who have electrolyte or other nutritional imbalances that must be corrected. These conditions usually require close monitoring. Some people may require refeeding via a feeding tube or IV if they are unable to consume enough by mouth for appropriate weight gain.
Nutritional therapy
Nutritional therapy is often an important part of treatment for all eating disorders. This type of therapy usually involves education about how metabolism works, what amounts and types of foods are required for someone’s age, gender, body type, and medical status, and how to understand natural hunger cues and develop meal plans to ensure proper nutrition.
Psychotherapy
Psychotherapy can be a crucial part of recovering from an eating disorder. Talk therapy typically focuses on a variety of areas, including learning problem-solving skills, understanding how thoughts and emotions affect behavior, and developing strategies to cope with stress.
Eating disorders commonly occur alongside other mental health conditions, like anxiety, depression, and obsessive-compulsive disorder. Therapy can also help individuals manage the symptoms of co-occurring conditions.
If you’re looking for long-term recovery support, or if you want to improve your relationship with food, exercise, and your body, working with an online therapist can help. With an online therapy platform like BetterHelp, you can meet with a qualified mental health professional from the comfort of your home at a time that fits your schedule. There are more than 30,000 providers on the platform, and you can switch providers at any time until you find the right fit for you.
Research has found that online therapy can be an effective treatment option for eating disorders. A 2022 study that focused on people with bulimia and binge eating disorder determined that online enhanced cognitive behavioral therapy had many advantages, including bridging barriers to treatment, like shame, fear of stigma, long waiting times, and financial barriers. The study also suggested that online therapy could provide treatment at an early stage, which could promote better client outcomes.
Takeaway
Is there a difference between male and female eating disorders?
Eating disorders (ED) affect both individuals assigned male at birth (AMAB) and female at birth (AMAF). There are, however, sometimes differences in symptom expression, recovery rates, and prevalence (community samples studies reveal male cases of ED are likely significantly underreported compared to females).
For example, a retrospective cohort study from Danish researchers found better long-term treatment outcomes for males than females, with men returning to a higher BMI and experiencing fewer episodes of purging behavior more quickly than their female counterparts. In another study, The International Journal of Eating Disorders found that out of a sample of 3,714 women and 1,808 men responders, “men were more likely to report overeating whereas women were more likely to endorse loss of control while eating.”
How are men affected by eating disorders?
Eating disorders impact men both similarly and differently than their female counterparts, but the issue is often underrecognized and underreported among the male population. Here are some key findings on the clinical significance of how eating disorders impact men:
Prevalence and diagnosis
While eating disorders are often perceived as a women’s health issue, The National Eating Disorders Association (NEDA) reports they are more common in males than initially thought—affecting roughly 6.6 million males in the US at some point in their lives. Men are less likely to be diagnosed or to seek help, partly due to societal stigma and the belief that eating disorders are "female issues." This can lead to treatment delays and poorer outcomes.
Types of eating disorders and symptoms
Muscle dysmorphia (bigorexia), a subtype of body dysmorphic disorder, tends to be more common in men than women. The condition is characterized by an obsession with body shape, building muscle, and physical appearance. It’s often seen in bodybuilding culture, and while it is a form of body dysmorphic disorder, it does share characteristics with other eating disorders like strict dietary control and compulsive exercise. Recent estimates show anorexia and bulimia rates are growing among men. However, experts are still skeptical that the findings reflect accurate rates, considering the widespread underdiagnosis and reporting of such disorders in men.
Mental health impacts
Men with eating disorders experience similar psychological effects, including depression, anxiety, and low self-esteem. However, societal norms may pressure them to hide these emotions, leading to isolation and shame. Eating disorders in men are often associated with a strong desire to control body image, with a focus on muscularity rather than thinness. This can lead to extreme dieting, supplement misuse, and steroid and laxative abuse to avoid gaining weight, which also have psychological consequences.
The American Journal of Psychiatry reports that men with eating disorders also experience high levels of comorbid psychiatric disorders. Roughly 54% are diagnosed with major depressive disorder and 26% with personality disorder. 37% of men with eating disorders also reported substance abuse. Psychiatry research suggests the combination of major depression and ED can be particularly serious, as both conditions present an increased risk of suicide attempts.
Health risks and outcomes
Men with eating disorders face significant health risks, including muscle loss, cardiovascular issues, and hormonal imbalances (like low testosterone). They often experience higher mortality rates than women with eating disorders due to delayed diagnosis and treatment, as well as physical impacts of extreme behaviors, like excessive exercise or fasting.
Which eating disorder is more common among males than females?
While findings on eating disorder commonalities between males and females are mixed, research does reveal that more men have a specific type of body dysmorphia called muscle dysmorphia (bigorexia) than females, with previous studies indicating that 87.5% of men diagnosed with eating disorders are diagnosed with muscle dysmorphia.
Who has a higher rate of eating disorders?
According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), women are diagnosed and treated for eating disorders more than any other group. However, these statistics may be skewed largely due to underreporting in different groups who may not receive treatment or diagnosis or are frequently underdiagnosed.
Why does anorexia affect females more than males?
While prevalence rates are ever-changing, research indicates that anorexia is more common among young girls and women than boys and men. Potential risk factors include, but aren’t limited to:
- Higher rates of body dissatisfaction
- Societal pressures
- Diet culture
- Comorbidity with other mental health conditions, including anxiety disorders
- Hormonal differences
- Gender roles and expectations
What percent of persons with an eating disorder are female?
Research from The National Institute of Mental Health reports that eating disorders are twice as prevalent among adolescent females than males (3.8% and 1.5%, respectively). Lifetime prevalence increases with age.
Who typically has eating disorders?
Eating disorders affect people of every race, gender identity, sexual orientation, culture, and socioeconomic background, but they are more commonly seen in certain groups. For example:
- Eating disorder risk is prevalent in all ages. Still, systematic reviews have found high levels of emerging ED-related symptoms in childhood, early adolescence, and college students, suggesting age can be a contributing risk factor for some people.
- Women are typically more frequently diagnosed with eating disorders than men.
- Both male athletes and female athletes often participate in sports or activities that emphasize weight or body appearance. Such individuals might feel a unique pressure to maintain a certain weight, body fat level, or appearance to succeed in their field.
- People with mental health conditions might be more prone to developing eating disorders.
- Older studies reveal that individuals with a family history of eating disorders may have a 50%-80% higher risk of developing one.
Why do men not seek help for eating disorders?
Men are less likely to seek help for eating disorders due to a combination of many possible factors, including:
Stigma and Gender Stereotypes
Eating disorders are widely perceived as "women's issues," which can make men feel isolated or ashamed for experiencing them and discourage them from acknowledging symptoms or asking for support. Societal expectations around masculinity also have an influence.
Misdiagnosis and lack of awareness
Because eating disorders are more commonly associated with women, healthcare providers sometimes overlook or misdiagnose symptoms in men. Men may also face challenges in identifying their own symptoms. Additionally, men’s eating disorders often revolve around a desire for muscularity or fitness rather than thinness, which can be misinterpreted as a "healthy" commitment to exercise or dieting rather than an indication of disordered eating.
Fear of judgment and misunderstanding
Men with eating disorders might feel as if they won’t be understood by others, including health professionals, family, or friends. Therapeutic barriers might also contribute to these fears, as many support groups, resources, and treatment programs are tailored to women. Men may feel out of place in these spaces, further reinforcing a sense of isolation and reducing the likelihood of seeking help.
Is bulimia more common in males or females?
Bulimia typically affects females more often than males, with an average onset in the teen years.
How do you tell if a man has an eating disorder?
Identifying whether a man has an eating disorder can be challenging, especially since symptoms may be less recognized or attributed to other factors. However, several behavioral, emotional, and physical signs may indicate an eating disorder. Here are some key indicators to look for:
- Changes in eating habits such as restrictive eating, avoidance of certain food groups, or sudden changes in meal patterns. Also, consuming large quantities of food in a short period, often accompanied by feelings of loss of control or distress afterward.
- An obsession with physical fitness, exercising excessively to the point of injury, neglecting other responsibilities, or using exercise as a way to compensate for eating.
- They may avoid social situations involving food, such as family dinners, parties, or outings where eating is involved. They may also develop more strained relationships with friends or family due to eating habits or behaviors such as secrecy around eating or a reluctance to discuss food choices.
- Significant weight fluctuations might be an indicator, as are signs of malnutrition, such as fatigue, dizziness, gastrointestinal problems, or dental issues (in the case of bulimia, for example).
- Preoccupation with body appearance, including an excessive focus on muscularity or leanness leading to eating disorder behaviors like substance use or extreme dieting to maintain a particular body shape.
- Constantly thinking about food, dieting, body weight, and shape can be a significant red flag.
- Mood changes, increased irritability, anxiety, or depression may accompany eating disorders.
- His levels of body satisfaction might decrease significantly as feelings of inadequacy, worthlessness, or shame related to body image emerge.
- A persistent belief that he is overweight or not muscular enough despite being of average weight or even underweight. He might also minimize the seriousness of the situation or downplay the impact of their eating behaviors on their health and well-being.
If you or someone you know is displaying symptoms of an eating disorder, reach out to an organization such as the National Eating Disorders Association, National Association of Anorexia Nervosa and Associated Disorders, or the Eating Disorders Resource Center for guidance. These organizations offer a wide variety of resources for individuals and their families, including directories of healthcare providers, psychoeducational materials, and eating disorder examination questionnaires.
- Previous Article
- Next Article