For many years, eating disorders were mainly recognised – and studied – in women. Even today, fewer than 1% of published research papers that explore eating disorders focus on how they affect men.
We now know, however, that men can get eating disorders too. The lifetime prevalences of anorexia nervosa, bulimia nervosa, and binge eating disorder among men are 0.3%, 0.5%, and 2%, respectively. This means that almost 3% of men currently develop one of these disorders at some point in their lives.
Given that about one in four eating disorders occur among men, it’s important that we research and understand the symptoms and patterns specific to male eating disorders. While the development and course of the condition are in many ways similar to female eating disorders, there are some clear and important differences. Learning to recognise and address these differences helps to both identify and treat the conditions.
If you think your young person may be living with an eating disorder, it’s important to seek help as soon as possible. Without effective support, eating disorders can seriously damage a person’s health and quality of life, and may even be fatal. However, there are plenty of treatment methods available proven to support young men with eating disorders, helping them to overcome their condition and reclaim a healthy future.
What Is An Eating Problem?
It’s normal for young people to experience changes in their relationship with food. There may be times when they want to eat a lot or don’t like certain foods or meals.
Eating problems happen when a young person’s eating habits or concerns about shape and weight start to negatively affect their daily life. This can take several different forms, including:
- Using food as a coping mechanism for difficult emotions
- Limiting the amount of food they eat
- Feeling afraid of gaining weight
- Experiencing a loss of control when eating
How Are Eating Disorders Diagnosed?
A young person may receive a diagnosis of an eating disorder if their eating problem meets a certain set of criteria. It’s important to recognise that disordered eating problems can be very serious even when they don’t fit into the requirements of a medical diagnosis, and always require care and support.
The Diagnostic and Statistical Manual of Mental Disorders (DSM V) lists several different types of eating disorders, including:
- Anorexia nervosa – characterised by a very low body weight
- Bulimia nervosa – characterised by episodes of binge eating followed by “purges”
- Binge eating disorder – where someone eats a lot of food in a small amount of time, often feeling a loss of control
Each of these disorders can affect young men as well as women and other gender identities. If you think your child may have an eating problem or disorder, it’s important to seek mental health support as soon as possible.
How Do Eating Disorders Affect Men Differently?
If a young person is living with an eating disorder, recognising the problem early can help to prevent their condition from developing and allow the healing process to begin. It’s useful to understand the specific ways that eating disorders tend to affect young men, so you know what to look out for.
Male Body Image
Social norms surrounding ideal body image play a role in the development and course of eating disorders. As a result, differences in these ideals affect the way eating disorders manifest across the gender spectrum.
The ideal male body image is often presented as being adequately muscular, rather than having the low body weight promoted by certain female body image norms. This means that men with eating disorders may be more concerned with being muscular than simply losing weight and engaging in behaviours directed to this end.
One behaviour that is more common among young men and boys with bulimia is the so-called “cheat meal”. A cheat meal is when someone eats a meal with a large number of calories, as a break from a normally strict, controlled diet. Cheat meals often include foods that a young person usually restricts from their diet.
While cheat meals may resemble episodes of binge eating usually associated with bulimia, young people consuming cheat meals often believe that they help them to build muscle and achieve their ideal body image. As a result, while they can still be accompanied by a feeling of loss of control, they may not be accompanied by the same sense of guilt or emotional distress as typical binge eating episodes.
Bulking and Cutting
Young men with eating disorders often engage in cycles of “bulking and cutting”. In the “bulking” phase, young people typically aim to consume a certain amount of protein each day and follow strict (and often arbitrary) dietary rules. They may feel distressed if they deviate from these rules. During this phase, some people begin to experience body-image distress that grows from a perceived lack of muscle leanness.
The subsequent “cutting” phase usually involves a very low-calorie intake intended to quickly decrease body weight and increase muscle “leanness”. The cutting phase may limit muscle development and lead to further distress surrounding their body image, which compels them to build more muscle, thus perpetuating a dysfunctional cycle.
Fewer Eating Concerns
One study found that among female patients and male patients in the same age group, men with bulimia nervosa were less likely to report eating concerns and loss of control while eating than females. On the other hand, a large-scale sample among adolescent boys found that 8.3% experienced regular episodes of loss of control eating, and 6% experienced regular episodes of binge eating.
Understanding Muscle Dysmorphia
Some men with eating disorders also experience muscle dysmorphia (MD), a sub-type of body dysmorphic disorder characterised by a preoccupation that their bodies are not lean or muscular enough. Young people with muscle dysmorphia often see their bodies as much smaller and thinner than others perceive them.
Muscle dysmorphia can be a driving factor of eating disorders in men, who may restrict their diets, excessively exercise, or engage in “bulking and cutting” to try and achieve their desired body image. At the same time, disordered eating behaviours, along with factors such as perfectionism and low-self esteem, can play a big role in the development and maintenance of MD.
What Are the Signs and Symptoms of Eating Disorders in Men?
If you’re worried that your child may have an eating disorder, it might help to look through the following signs. Remember that any eating problem can quickly become very serious, and it’s best to seek professional support if you have any concerns about a young person’s eating.
Some common signs of eating disorders in men include:
- Body dissatisfaction
- Preoccupation with body image, such as a desire to look lean and muscular
- Fear of losing muscle
- Excessive exercise with the aim of “bulking up”
- Engagement in cycles of “bulking and cutting”
- Use of anabolic steroids to gain muscle
- Following strict diets
- Tiredness or exhaustion
- Loss of interest in previously enjoyed activities
- Symptoms of other mental health conditions, like anxiety or depression
What Are the Risk Factors for Eating Disorders in Men?
There is no single reason that young people develop eating disorders. The causes of eating disorders are often complex and rooted in a combination of factors. That said, some things make developing an eating disorder more likely.
Difficult Life Experiences
Men who have had difficult life experiences are more likely to have eating disorders than those who have not. Studies have found that eating disorders are associated with a history of teasing and physical abuse, as well as alcohol addiction and obesity. Difficult life experiences often lead to underlying emotional issues that can drive eating disorders, such as low self-esteem or perfectionism.
Research shows that men with eating disorders are more likely to be diagnosed with a mood disorder, such as anxiety or depression. Eating disorders in men often co-occur alongside other psychiatric issues, including a personality disorder, compulsive exercise disorder, or substance use disorder. While these disorders may both contribute to and result from eating disorders, treating co-occurring disorders alongside disordered eating behaviours is often crucial to lasting recovery.
Social Norms and Media Influence
Social norms and media portrayals of an “ideal male body” may contribute to the development of eating disorders in men. Social media images and online magazines often portray male bodies as muscular and lean, harming a young person’s body image. At the same time, they encourage social norms that push young people to place unnecessary value and importance on ideas of shape and weight, leading to a preoccupation with body image that can underlie eating disorders.
Research has found that homosexual men are more likely than others to be diagnosed with an eating disorder. They also tend to score higher on ratings of eating pathology and body image concerns. A study among 14 to 16-year-old boys living in the UK found that gay and bisexual boys were more likely to engage in binge eating and experience body dissatisfaction.
Treating Eating Disorders in Men
Eating disorders are serious conditions that significantly affect a young person’s life. They affect their relationships with others, their ability to pursue hobbies and interests, and their capacity to enjoy everyday life. They can also cause serious damage to a person’s health and emotional well-being.
The good news is that there is help available. With effective support, young people can overcome eating disorders and reclaim a healthy, fulfilling future.
Effective treatment for eating disorders should be tailored to the individual, reflecting the underlying causes of their condition and any co-occurring disorders. Young people may benefit from several different types of treatment, often in combination. Some of the most common treatment approaches for eating disorders include:
- Cognitive-behavioural therapy
- Interpersonal therapy
- Family therapy
While recovering from an eating disorder isn’t easy, it is possible – and the sooner you can seek help for a young person, the better.
Specialist Eating Disorder Treatment at the Wave Clinic
The Wave Clinic offers specialist mental health treatment programmes tailored to the unique needs of young people. Our individualised treatment experiences guide young people through a transformative journey of personal growth, supporting them to reconnect with their inner-self, develop new skills, and rediscover their love of life. Our expert team draws on specialists from all over the world with expert knowledge of the needs of teenagers and adolescents.
If your child is living with an eating disorder, addiction, or another mental health issue, contact us today. We’re here to help.