How Common Are Eating Disorders In Men?

Despite the millions of men managing eating disorders, men are much less likely to be diagnosed due to various factors, including social stigma, expectations of masculinity, and gender bias. 

This article will provide an overview of the most common types of eating disorders among men before diving into the factors that put men at increased risk of these conditions. With this knowledge in mind, you can develop a better understanding of one of the most pressing issues affecting men and spread awareness to encourage those in need to seek support.

Eating disorders: An overview

Disordered eating affects millions of people and is much more than a simple issue with food. These complex mental health concerns require clinicians and psychologists to provide a diagnosis and come up with an evidence-based treatment plan. For some people, this may take place in an outpatient setting. Others may receive treatment at adult or adolescent psychiatric clinics. 

While an eating disorder can manifest in various ways, they all involve, to some degree, unhealthy eating patterns and other harmful behaviors, such as compulsive exercise—in both women and men. Eating disorders often begin with a fixation on body weight, physique, or food. People of all sizes and weights may experience eating disorders. In the most severe cases, eating disorders cause health problems and can even result in death if they are not treated.

Numerous factors can lead to the development of eating disorders, including:

• Genetics – Studies involving twins show that if one twin has developed an eating disorder, the other has a 1-in-2 chance of developing one as well.

• Brain Chemistry – Research has recently investigated the role that brain chemistry may play in developing eating disorders, especially in terms of serotonin and dopamine levels. Those with brain anomalies may be at a higher risk of having an eating disorder. 

• Personality Traits – Individuals managing personality disorders or traits such as perfectionism and neuroticism are more likely to develop disordered eating habits.

• Societal Pressures – Some cultures that do not idealize thinness have far fewer cases of eating disorders. This suggests that Western society emphasizes weight loss, which may promote high rates of certain types of disordered eating. "One size fits all" clothing, movies, social media, and toys like action figures or dolls may promote unhealthy body image expectations. 

According to the DSM-5-TR, eating disorders are referred to as other specified feeding or eating disorders and are delineated as follows:

• Anorexia Nervosa – People with anorexia may limit their food intake and use unhealthy methods to lose weight or maintain a low weight, including excessive exercise habits, vomiting, or laxative use (formerly called laxative abuse).

• Bulimia Nervosa – People with bulimia cycle between binging and purging, eating excessively and then vomiting, or using other methods to lose the calories taken in during the binging period.

• Binge Eating Disorder – People with binge eating disorder tend to eat significantly past the point of feeling full and often feel unable to stop eating. Binge eating disorder differs from bulimia in that binge eating is not “compensated” for by purging or other unhealthy methods.

What types of eating disorders affect men?

The lack of attention and understanding of eating disorders in men may be attributed to the following factors, among others:

• Men are frequently left out of eating disorder research.

• People often do not realize that men can have disordered eating habits.

• Some professionals are biased and thus fail to recognize disordered eating in men.

• Men absorb social stigma that perpetuates the idea that men cannot have an eating disorder.

• Men are sometimes excluded from eating disorder treatment centers.

• Eating disorders may present different symptoms in men than in women.

• The criteria for eating disorder diagnoses are often gender-biased.

Medicine and society have both (incorrectly) largely viewed eating disorders as a strictly feminine issue. In fact, until the most recent version of the DSM-5-TR, loss of one’s period was a requirement to meet all criteria for anorexia. Despite the stereotype that it is primarily women who experience body image issues and disordered eating, many men manage or have managed an eating disorder. These eating disorders may develop for unique reasons and manifest in different ways than in women, but this isn’t always the case.

To examine this further, let’s look at a few of the more common eating disorders, like anorexia, bulimia, and binge eating, diagnosed in men.

Anorexia nervosa

Recent studies show that men make up roughly 25% of cases of eating disorders, including anorexia nervosa. Men with anorexia, however, are more likely than women to face harsh stigmatization or go undiagnosed.

Gender plays a role in that boys and men managing anorexia may not be properly treated even when getting help. Parents of adolescent boys report that local hospitals have failed to refer them to specialists or psychologists for assessment and treatment.

While some men with an eating disorder develop anorexia, it is less common in men than other eating disorders, such as those involving binge eating.

Binge eating disorder or bulimia

Studies show that men who experience disordered eating are more likely to eat excessively rather than starve themselves. It is estimated that roughly forty percent of individuals diagnosed with binge eating disorders are men and boys.

The greater prevalence of binge eating among men with disordered eating habits may connect to societal pressures that encourage men to eat freely while encouraging women to restrict themselves. For many boys and men, binge eating may occur from a desire to be strong and bulked up, leading to a condition known as bigorexia, or muscle dysmorphia.

Muscle dysmorphia, a type of body dysmorphic disorder

Also known as bigorexia, muscle dysmorphia causes individuals to obsess about continual muscle toning. Muscle dysmorphia is categorized by an obsession with being lean and muscular to the point of causing harm to the health of the body and mind. This disorder can be caused by outside influences like the media (especially fitness-related ones) or competitive sports and performance. 

Boys and men with muscle dysmorphia fixate on their bodies and their perceived weakness or lack of body size, muscle, etc., leading to unhealthy behaviors and traits such as excessive weightlifting, muscularity-oriented disordered eating, and self-loathing. At its worst, it can lead to unhealthy use of steroids, depression, and even suicidal thoughts.

One prospective cohort study attempted to further explore the presence of disordered eating behaviors related to increasing muscularity among young adults. The study found that over 20% of young men engage in disordered eating behavior to become more muscular. Several factors that put young people at high risk for these kinds of harmful patterns include perceiving themselves as underweight and engaging in physical activity with the goal of weight gain.

If you think you may hurt yourself or attempt suicide, call a suicide hotline. In the U.S., you can dial 1-800-273-TALK (1-800-273-8255) to reach the National Suicide Prevention Lifeline. Or use the web chat at suicidepreventionlifeline.org/chat.

Male populations at greater risk for eating disorders

As you might gather from the section above, certain boys and men may be particularly at risk for the development of disordered eating habits, including:

• Athletes – Involvement in sports may increase the risk of eating disorders, as athletes face internal and external pressures regarding their weight and physique in order to perform. These disorders may affect male bodybuilders, swimmers, gymnasts, dancers, wrestlers, or runners. 

• Actors – Actors, particularly well-known ones, must sometimes engage in disordered eating to play a particular film role. Moreover, actors may feel intense pressure to look a certain way due to their position in the spotlight.

• College Students – College is a major transition period, and research suggests that young men in college are more likely to develop an eating disorder than men of other ages. After all, they are away from home and may also feel pressure to conform to a certain idealized body type to attract potential sexual partners.

• Men Who Have Survived Abuse – Men who are abused, particularly when young, may be more susceptible to developing eating disorder behaviors than other men. This can be especially true if they were taunted or otherwise ridiculed about their weight or body type.

• Men With Substance Use Disorder – Compared to women with eating disorders, men managing disordered eating have a much higher likelihood of substance use disorder.

Although these individuals may be more susceptible, it can be important to note that anyone can develop an eating disorder at any given time for a wide variety of reasons.

Managing eating disorders

Seeking help for an eating disorder can be a formidable challenge for boys and men in particular due to societal stigma and little information regarding mental health topics related to men and boys. Furthermore, many men do not seek treatment for eating disorders because they may not realize they have an issue requiring professional support. Therefore, the first step can be recognizing the eating disorder itself. Sometimes a family, close friend, or coach might recognize the problem and approach the person to offer guidance in taking that first step.

Next, an individual may decide to participate in therapy sessions where they can openly discuss their feelings regarding body image, self-esteem, and how it impacts their life. They may visit a psychotherapist or healthcare provider for a diagnosis, who can, in turn, offer a treatment protocol. 

One form of psychotherapy, known as cognitive-behavioral therapy (CBT) has been found to be effective in treating eating disorders by cognitive restructuring and ritual prevention exercises that help a person focus holistically on their entire self as opposed to a hyperfocus on details or minor flaws. CBT is one of the most well-known forms of treatment that is also offered in a virtual format known as internet-based cognitive behavioral therapy, or iCBT.

In some cases, medications may be prescribed along with therapy. For example, SSRI (selective-serotonin reuptake inhibitor) antidepressants have been found useful in the treatment of some eating disorders, especially muscle dysmorphia. It can be crucial to always consult a medical provider before starting a new medication.

Online therapy for eating disorders

Eating disorders can be challenging to overcome without professional support. However, life can be busy, and you may also be worried about opening up to a therapist about your personal challenges. If you are too busy to make an appointment or prefer to participate in therapy from the comfort of your own home, you might consider seeking iCBT or other forms of therapy online through a platform like BetterHelp. 

With online therapy, you can speak with a therapist through phone calls, video chats, or an in-app messaging tool. Instead of worrying about seeing someone you know while attending therapy at an office, you can relax comfortably in your own home while receiving the support you need. Online therapy may lead to not only a reduction in symptoms but also greater body acceptance. 

The efficacy of online therapy for eating disorders

Online therapy is supported by research to be highly beneficial, cost-effective, and convenient for the millions of people who choose this format of care. One review published in the International Journal of Eating Disorders revealed that virtual treatment was more effective than in-person therapy in reducing symptoms of moderate eating disorders. Those who participated in online therapy were also more likely to adhere to the study guidelines.

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