They’re among the deadliest of all mental illnesses, but eating disorders like anorexia and bulimia are often still poorly understood. And although misconceptions about sufferers’ ages and ethnicities abound, one of the biggest fallacies about eating disorders is that they only affect females.
According to the National Eating Disorders Association (NEDA), about 10 million men in the US will suffer from a clinically significant eating disorder at some time in their lives, including anorexia, bulimia, binge eating, or an eating disorder not otherwise specified (EDNOS). In a review of 24 studies, researchers estimated that about 10 percent of anorexia patients are male, but noted that the numbers might be even higher. According to lead author Dominique Meilleur, an associate professor of psychology at the University of Montreal, “The problem is that the subject hasn’t been studied enough among men, so we don’t even know if the symptoms we use to measure for anorexia are appropriate for men, because they are mainly developed for women.” Other research supports the notion that the incidence of eating disorders in males appears to be increasing, estimating that that there’s 1 male for every 2 to 4 females with anorexia, and 1 male for every 3 to 11 females with bulimia.
Why is the number of men who develop eating disorders growing?
Although eating disorders carry the same potential health risks—ranging from irregular heartbeat to osteoporosis to even death—regardless of gender, the reasons for developing an illness may be different in men versus women. Genetics and family history influence the risk in both genders, but mainstream media and social media may play a part as well. These images and societal stereotypes equating thinness with beauty have traditionally only targeted females, but increasingly, there is a proliferation of images elevating the bodies of chiseled male action stars and models.
“I believe the explosion of media-generated, unattainable, ‘perfect body’ images and the desire to emulate them has lowered the societal set point of ‘normative discontent,'” says lawyer, speaker, and eating disorder advocate Brian Cuban, author of Shattered Image: My Triumph over Body Dysmorphic Disorder. “This has resulted in more young men than ever before being triggered into disordered eating, obsessive exercise, and steroid and supplement abuse.”
“Body consciousness seems to be increasing, especially in a more social media-focused society,” says One Medical’s Christine Celio, PhD. “It’s crucial to do full evaluations to assess the degree of binge eating and potential compensatory behavior or restricting.”
What are other risk factors for eating disorders in men?
Other environmental risk factors include participating in specific sports that exalt lean body types, like wrestling, running, or horse racing. And because many people still erroneously assume that food restriction and extreme weight loss are the only signifiers of an eating disorder, few know that compulsive exercise or an obsessive drive toward bodybuilding are potential signs of a problem.
Additionally, research suggests that eating disorders disproportionately impact certain segments of the LGBT community. One small study found that homosexual men were more likely to idealize an underweight body and scored higher on a “Drive for Thinness” scale of the Eating Disorders Inventory. Additionally, a population study from Columbia University found that 15 percent of gay or bisexual men had at some time suffered from an eating disorder or exhibited symptoms of a disorder, compared with just 5 percent of heterosexual men. And according to NEDA, gay males comprise five percent of the general population, but comprise 42 percent of the population of men with eating disorders.
Why aren’t men getting help?
According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), men are less likely to be diagnosed early with an eating disorder, which can delay treatment and recovery. Because of social stereotypes regarding eating disorders solely affecting females, some medical professionals may miss the signs of an eating disorder in male patients. Furthermore, a study of 135 males hospitalized with an eating disorder found that the participants generally felt ashamed of having a stereotypically “female” disorder.
“It’s hard to be a male with an eating disorder,” says Lynn Grefe, NEDA’s President and CEO. “We have to do a better job in the field and be more mindful of not always saying ‘she, she, she.’ We need to talk about ‘the patient,’ or ‘the client,’ or ‘the person affected.’ We need to stop just focusing on women.”
“In many positive ways, our culture has worked toward gender equality, but in other ways we are seeing more gender parity happen in mental health issues, Celio says. “Whether it is eating disorders in males, or anger issues in females, it is important for health care professionals to not jump to conclusions based on sex.”
How can men get help?
Research shows that men who commit to an effective treatment program have positive outcomes, and being male has no adverse effect on recovery.
NEDA offers the following strategies for prevention and early intervention:
- Talk with boys and men about how the media shapes cultural attitudes about male bodies and help them expand their idea of “masculinity” to include non-physical characteristics like being caring and cooperative.
- Encourage young men to participate in activities that are not traditionally “masculine,” like cooking, to expand their concept of “masculinity.”
- Demonstrate respect for gay men and men who display personality traits or are involved in professions that are not traditionally “masculine.”
- Do not emphasize body size or shape as an indication of a man’s worth, identity, or value.
- Learn about eating disorders and consider implementing a support group in your community.
- Encourage young men to seek professional help if you suspect they have an eating disorder or may be at risk.
If you suspect you may be suffering from an eating disorder or any behaviors related to a disorder, be sure to:
- Make an appointment with your health care provider to evaluate your physical health.
- Find a trustworthy mental health provider who specializes in eating disorders. A specific training in male disorders isn’t necessary, but specialized, evidence-based training in treating eating disorders is essential.
The One Medical blog is published by One Medical, an innovative primary care practice with offices in Boston, Chicago, Los Angeles, New York, Phoenix, the San Francisco Bay Area, Seattle, and Washington, DC.
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