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Males & Eating Disorders: Breaking Through Stigma and Stereotypes


Many people still assume that eating disorders only affect females, but at the Center for Eating Disorders we have been treating males with eating disorders for over 20 years. Most research on the subject finds that males represent approximately 10% of all individuals who receive treatment for an eating disorder. However, many professionals agree that the ratio of males to females with eating disorders is actually higher than 1:10 given that eating disorders in males are less likely to be identified and/or correctly diagnosed (Anderson, 1992). Additionally, cultural stigma regarding males and eating disorders can make it more difficult for men to come forward and seek treatment on their own. The good news is that education, support and awareness about eating disorders among males are all improving so that more boys and men are seeking and receiving the treatment they need and deserve.

Males and Eating Disorders

Eating Disorders in Males are Clinically Similar to Eating Disorders

in Females

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.  (Braun et al, 1999)

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 (Wertheim et al, 1992).  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.

Characteristics Among Males with Eating Disorders

  • Lifetime prevalence rates for eating disorders in males are .3% for anorexia, .5% for bulimia and 2.0% for binge eating disorder. (Swanson, et al., 2011).  
  • Among the eating disorder diagnoses, binge eating disorder (BED) has the highest ratio of males to females.  Males make up about 40% of individuals with BED.
  • In general, males with eating disorders historically have an average age of onset that is later than females. However, eating disorders can affect males during childhood, adolescence and all stages of adulthood and more recent trends suggest earlier average age of onset in both genders.
  • Certain athletic activities appear to put males and females at risk for developing eating disorders. Gymnasts, runners, body builders, rowers, wrestlers, jockeys, dancers, and swimmers are particularly vulnerable to eating disorders because their sports often demand weight restriction (Andersen, et al., 1995). While this risk factor affects both genders, males with eating disorders are more likely to be involved in an occupation or sport in which weight control influences performance.
  • 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 (Schneider & Agras, 1987).  
  • Females with anorexia and bulimia have long been noted to have a high prevalence of co-occurring depression, anxiety disorders, substance abuse, and personality disorders.  A similar profile of psychiatric comorbidity has been reported among males with eating disorders.

Treatment & Support

At the Center for Eating Disorders, our staff has extensive experience providing treatment for males of all ages who have been affected by an eating disorder.  We work hard to provide education to local schools, health professionals and community members to try to increase early identification of eating disorders among males.  It’s important to remember that every individual with an eating disorder is unique and may experience the eating disorder in a very personal way – this is true among males and females.  Regardless of gender, it is important to understand the individual’s thoughts and feelings and to develop personalized treatment goals to help them move towards health and healing.    

There are increasing numbers of supportive resources available online for males with eating disorders:

You may also be interested in:

References

Anderson, A. E. (1992). Eating disorders in males: Critical questions. In R. Lemberg (Ed.), Controlling eating disorders with facts, advice and resources (pp. 20-28). Phoenix, AZ: Oryx Press.

Braun, D. L., Sunday, S. R., Huang, A., & Halmi, K. A. (1999). More males seek treatment for eating disorders. The International Journal of Eating Disorders, 25(4), 415-424.

Wertheim, E.G., et al. (1992). Psychosocial predictors of weight loss behaviors and binge eating in adolescent girls and boys. The International Journal of Eating Disorders, 12 (2), 151-160.

Swanson, S. A., et al. (2011). Prevalence and correlates of eating disorders in adolescents: Results from the national comorbidity survey replication adolescent supplement. Archives of General Psychiatry, 68(7), 714-723.

Andersen, R.E., et al. (1995). Weight loss, psychological and nutritional patterns in competitive male body builders. International Journal of Eating Disorders, 18, 49-57.
Schneider, J.A., & Agras, W.S. (1987). Bulimia in males: A matched comparison with females. International Journal of Eating Disorders, 6, 235-242.

Other resources:

Braun, D. L. (1997).  Eating Disorders in Males. Medscape Psychiatry & Mental Health eJournal. 1997;2(2) © 1997 Medscape. Posted: 04/05/2002.

Andersen, A. E., & Holman, J. E. (1997). Males with eating disorders: Challenges for treatment and research. Psychopharmacology Bulletin, 33(3), 391-397.

Andersen, A. E., Watson, T., & Schlechte, J. (2000). Osteoporosis and osteopenia in men with eating disorders. Lancet, 355(9219), 1967-1968. doi:10.1016/S0140-6736(00)02330-8

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