The Challenges Of Eating Disorders In Male Athletes: A Closer Look

Medically reviewed by April Justice, LICSW
Updated November 9, 2024by BetterHelp Editorial Team

While many people may assume that eating disorders affect only women, they can also have an impact on men, and male athletes may be at higher risk than non-athletes. It's not uncommon for athletes, whether they are professionals, amateurs, or hobbyists, to experience eating disorders. These conditions, such as anorexia, bulimia, and binge eating disorder, can harm nearly every part of an athlete’s life and career. The pressure to maintain a specific body image or weight and to improve performance can be overwhelming, pushing individuals toward harmful eating habits.

Support is available, and overcoming an eating disorder is possible. Treatment options may include therapy, nutritional counseling, and medical care. With the right support, athletes and others can often find a path to recovery and lead more balanced lives.

Two male athletes in workout clothes go for a run on a bridge on a sunny day.
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Is an eating disorder affecting your mental health?

How can an eating disorder occur in an athlete?

Eating disorders in athletes can develop due to various factors. Intense training regimens and the pressure to keep a specific body weight or shape may cause many to restrict their food intake. Restricting food intake may be particularly common in sports like gymnastics, diving, and distance running, where leanness is often linked to better performance.

Elite athletes often experience even higher levels of pressure. They may get scrutinized by coaches, teammates, and even supporters, which might normalize or encourage disordered eating behaviors. As a result, it may be harder for athletes to recognize the problem.

According to the National Eating Disorders Association, risk factors for developing an eating disorder may include perfectionism and body image dissatisfaction. Elite athletes and those in the general population who have a history of dieting or a family history of eating disorders may also be at high risk. For more on elite athletes and eating disorders, see the following article, which was published in Med Sci Sports Exerc: https://pubmed.ncbi.nlm.nih.gov/23274604/. You might also read the following article on young French male cyclists and eating disorders: https://pubmed.ncbi.nlm.nih.gov/15648494/

Eating disorders in a sports medicine clinic population

Patients in sports medicine clinics often face various challenges, including the risk of eating disorders. One study found that 17% of patients at a sports medicine clinic were at risk for disordered eating. This group had higher average ages and body mass indices (BMI).

The study assessed risk using the 28-item Eating Disorder Examination Questionnaire (EDE-Q). Patients with EDE-Q scores of 2.3 or higher were considered at risk. Women were three times more likely than men to be at risk.

Are disordered eating habits common in male athletes?

While eating disorders are more commonly discussed in women, men may also face pressure, especially in athletics. One study from 2020 found that male athletes were at a higher risk of disordered eating behaviors than non-athletes. 

Sports that emphasize muscle mass and low body fat may put men at high risk. An emphasis on muscle mass may be especially found in sports involving weight and appearance, such as wrestling and bodybuilding.

Male athletes may also encounter societal expectations to perform well and maintain a certain body image. Expectations may lead them to engage in harmful eating behaviors. The competitive nature of sports can worsen these problems, as the need to meet performance goals often overrides mental and physical health concerns.

The most  in male athletes is EDNOS (eating disorders not otherwise specified, which is now called “other specified feeding or eating disorders” (OSFED). This condition includes various harmful eating behaviors that don’t match the strict criteria of other disorders.

The effects of eating disorders on health and performance

Eating disorders can affect not only mental well-being but also physical health and athletic performance. These effects may spill into various aspects of life, from nutritional balance to social interactions.

Nutritional deficiencies

Eating disorders often lead to severe nutritional deficiencies. Individuals with conditions like anorexia nervosa or bulimia nervosa may restrict their food intake to lose weight or maintain a low body fat percentage. Vitamins and minerals like iron, calcium, and vitamin D may be lacking, which may cause an increased risk of anemia, weakened bones, and compromised immune systems.

Muscle dysmorphia

Although classified as a type of body dysmorphia in the DSM-5, muscle dysmorphia is a condition closely related to eating disorders and is common among those excessively focused on body image. Individuals might have a distorted view of their own body, believing they are too small or lack muscle mass, even if they are well-built. This condition may push some athletes to overexercise or use steroids. Overworked muscles and ligaments can become prone to tears and other injuries.

Impaired recovery time

Recovery time is typically key for anyone in sports. Eating disorders can seriously impair recovery time. When the body is deprived of necessary nutrients, it may lack the resources to repair tissues and muscles effectively, which can lead to prolonged soreness and delayed healing from injuries. Poor nutrition can also weaken the immune system, making it harder to fight off infections and other illnesses. Athletes and active individuals may find themselves more frequently sidelined by minor illnesses that could otherwise be quickly overcome. 

Dehydration from excessive supplementation

Some individuals with eating disorders may turn to supplements as a quick fix to appear healthier or fuel extreme workouts. Supplements like protein powders, fat burners, and other dietary aids often require increased water intake, which many people do not adequately maintain. Dehydration may cause various problems, including dizziness and decreased physical performance.  

A group of adults in workout clothes lift weights during a workout class.
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Social isolation and anxiety related to body image

Eating disorders often cause individuals to become socially isolated. Concerns about body image may make people anxious and cause them to avoid social situations. They may withdraw from friends and family, fearing judgment or criticism about their appearance or eating habits. This social isolation can worsen mental health, creating a cycle of anxiety and loneliness. 

The effects of eating disorders can differ from person to person but can be especially difficult for athletes who feel pressure to look a certain way. This can create a cycle that harms their performance and overall health.

Myths about eating disorders in male athletes

Many people have misconceptions about eating disorders, especially when it comes to male athletes. Busting these myths may help others understand the realities faced by this group.

Myth 1: An eating disorder is always visible or obvious.

It's a common belief that you can easily spot someone with an eating disorder. This is not true. Many male athletes with eating disorders look healthy and may even excel in their sports. For example, an athlete might look muscular and fit but still experience bulimia or binge eating disorder. They may have secretive behaviors that aren't immediately noticeable.

Myth 2: Male athletes who are muscular cannot have eating disorders.

Many people think that being muscular means an athlete cannot have an eating disorder. This is false. Male athletes who focus on building muscle can often fall into patterns of muscle dysmorphia. This condition can lead to an obsession with becoming more muscular, often to a harmful extent. Even those in sports emphasizing strength, like football or bodybuilding, may be at risk. They might take extreme measures, such as using steroids or excessively counting calories.

Myth 3: Eating disorders are solely about food and weight.

Eating disorders can go beyond just food and weight. They often involve complex emotional and mental challenges. Many male athletes develop disorders because of low self-esteem or pressure to perform. For some athletes, strict dieting and exercise can seem like the only way to maintain control. 

Myth 4: Eating disorders only affect elite athletes.

There is a notion that only elite athletes face eating disorders, but that's not the case. Students, amateur athletes, and recreational participants can experience them as well. High school athletes, for instance, often face intense pressure to perform, which sometimes leads to disordered eating. They might strive for scholarships or recognition, which can increase risk. Even weekend sports enthusiasts can experience these disorders, possibly driven by social media and societal standards.

Sports medicine and mental health support for male athletes

Sports medicine often combines therapy and medication to support athletes who may be living with eating disorders. Cognitive behavioral therapy (CBT) is commonly used to manage distorted thoughts and behaviors related to eating and body image. CBT may help athletes develop more positive ways of thinking, which may lead to improvement in eating disorder symptoms.

Antidepressants and anti-anxiety medications may help manage symptoms of depression and anxiety that can accompany eating disorders. The FDA has also approved medications for the treatment of certain eating disorders like bulimia and binge-eating disorder. Combining therapy and medication may help improve outcomes. Also, regular check-ups can help monitor physical health and ensure athletes receive timely treatment. Never start, stop, or change any medications without first consulting your doctor. 

Where to find support for eating disorders

Many resources are available for athletes with eating disorders, both online and in person. For example, the National Eating Disorders Association offers helplines and support groups. The organization can also connect individuals with professionals who specialize in eating disorders. The National Institute of Mental Health and the National Alliance on Mental Illness also provide information on treatment options.

You can also look into local mental health organizations or clinics to find nearby support groups or therapists. Reaching out is often the first step to getting the help you need.

Online therapy for disordered eating habits

Online therapy may be a potentially effective way for people with disordered eating habits and mental disorders to seek help. Online therapy platforms typically offer a variety of treatment options, such as videoconferencing, phone calls, and live chat. This may be especially helpful for male and female athletes with busy schedules, as they can save time by not having to commute to a therapist’s office. 

A man in a green sweater sits at a wooden table while typing on the laptop open infront of him with a serious expression.
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Is an eating disorder affecting your mental health?

Can online mental health services be effective for disordered eating?

Online therapy for eating disorders can be just as effective as in-person therapy. One study looked at 150 people with bulimia, who were divided into three groups: two types of online therapy and a traditional 16-week day program. 

Although the in-person therapy group had a higher remission rate, at follow-up a year later, those who used online therapy continued to show improvements. Also, the authors stated that the “treatments were comparable in effect at follow-up, suggesting that internet treatment is a conceivable alternative to standard treatment.”

Takeaway

Eating disorders in male athletes can appear at all competition levels, often driven by the pressure to maintain a specific body image or weight. These disorders can harm mental health, physical health, and performance. However, with appropriate support, including therapy and nutritional counseling, athletes can often recover and find balance in their lives. Regardless of whether you’re a male athlete, know there is help available for eating disorders, whether you have a diagnosis or not. Take the first step toward healing and reach out to BetterHelp today.
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