Studies suggest that up to a quarter of people suffering from anorexia nervosa and bulimia nervosa are men and an equal number of men and woman have binge eating disorder. Unfortunately, many men go undiagnosed as having an eating disorder, either due to their own reluctance to seek help, stigma and a lack of awareness in the community, or because of a lack of understanding from health practitioners.
Can men get eating disorders?
Research indicates that over one third of people experiencing an eating disorder are men (Paxton et.al.,2021). Many experts believe that this number could be even higher, as the stigma surrounding eating disorders in men prevent many from seeking help.
What are the warning signs of an eating disorder in men?
Eating disorders and disordered eating behaviours in boys and men may present differently than in girls and women, particularly with muscularity-oriented disordered eating (Nagata, Gansen & Murray, 2020). For men, body dissatisfaction is more commonly manifested as the pursuit of a muscular, lean physique rather than a lower body weight (NEDC, 2018). While eating disorders in females often starts in adolescent years, men tend to develop eating disorders at an older age. The average age of onset in men is 17–26 compared to 15–18 in women (Columbia University).
Some of the warning signs of an eating disorder in men include:
- Excessive or compulsive exercise patterns (e.g. Exercising when injured/unwell, exhibiting distress if unable to exercise.
- Preoccupation with fitness and/or muscle toning, body shape, weight and appearance.
- Constant or repetitive dieting
- Restrictive eating behaviour (e.g. Avoidance of certain food groups, counting calories/macros, fasting, replacing meals with fluids).
- Behaviours focussed around food preparation and planning (e.g. Obsessive meal planning and preparing, reading nutritional guides).
- Bingeing and/or purging.
- Fear of gaining weight.
- Social withdrawal or isolation.
- Heightened sensitively to comments or criticism about body shape or weight, eating or exercise habits.
- Muscle enhancing drug use.
What are the risk factors for men and boys?
The general risk factors for eating disorders are the same for men and women. Low self-esteem, perfectionism, weight or body-related teasing or bullying are all known risk factors.
However, there are certain factors that present more or less of a risk to men and boys when it comes to eating disorders:
- Weight-loss dieting is a less common risk factor for men than it is for women.
- Men whose job requires a particular body ‘look’ such as models, actors or entertainers may have a higher risk of developing an eating disorder than the general population.
- Male athletes are at a higher risk of developing an eating disorder with estimates that up to 19% of male athletes experience disordered eating and/or an eating disorder (Reardon et.al., 2019). At a higher risk are those in sports that require a particular physique, such as gymnasts, swimmers, jockeys, weightlifters, wrestlers and body builders.
- Studies suggest that 15% of gay or bisexual men have struggled with eating disorders, and around 42% of men with an eating disorder identify as gay or bisexual (Columbia University. 2007).
Body image issues in men and body / muscle dysmorphia
Cultural messaging around the ‘ideal’ masculine body shape often leads to the desire to pursue a muscular and lean physique. This can heighten body image concerns in males and may be a contributing factor to the development of an eating disorder.
Nearly one third of Australian men are dissatisfied with their body (NEDC, 2017). Research has shown that the number of men experiencing body image dissatisfaction has tripled from 15% to 45% in the last 25 years (Australian Psychological Society, 2014) . Body dissatisfaction or negative body image can often result in overwhelming feelings of disappointment, shame and guilt. It can also lead to unhealthy behaviours such as fad dieting, disordered eating, eating disorders, exercise addiction and steroid abuse. A recent study in Australian secondary schools found that more than half of boys aged 14-16 were using muscle-building protein supplements (Yager & McLean, 2020).
Body Dysmorphic Disorder (BDD) is a mental health disorder where someone obsesses over one or more aspect of their appearance which they perceive to be out of proportion or unbearably unattractive. BDD goes beyond having body image issues to the point where repetitive negative behaviours such as repeatedly checking the mirror, grooming or seeking reassurance for hours on end can cause significant distress and even impact your ability to function in your daily life. Muscle dysmorphia is a type of BDD that causes a person to become obsessed with achieving desired levels of muscularity and leanness. It’s important to note that muscle/body dysmorphia are NOT eating disorders. They fall under the category of anxiety disorders however can exist alongside eating disorders.