Eating Disorder Awareness in the Male Population

Contributor: Carrie A. Decker, Naturopathic physician

Although the topic of eating disorders is often focused on the female population, a growing awareness of the need to discuss the topic of eating disorders in males is also coming to light. Because of the lower incidence of eating disorders in the male population, eating disorders in males are less likely to be recognized, and because of this, are not appropriately treated.

For many the concept of eating disorder brings up the thoughts of anorexia and bulimia nervosa, however other eating patterns such as binge eating and an overly obsessed focus on eating the right thing (known as orthorexia) are also eating disorders.

A greater understanding of what an eating disorder can look like helps us to understand how to recognize when a family member or friend may be struggling with something more than just what to eat. Not everyone who occasionally overeats or tries to follow a healthier diet has an eating disorder however.

How People Become Vulnerable to Eating Disorders

An eating pattern becomes a problem when it disrupts the activities and relationships of everyday life.

In both men and women there are a variety of things which can make a person more vulnerable to developing an eating disorder. Things which can make one more vulnerable to an eating disorder is:

• A personal or family history of mood disorders
• Growing up among in an environment of dysfunctional patterns
• Living in a culture where emphasis is placed on thinness
• Engaging in dieting in adolescence or early adult years
• Being a victim of abuse

Genetics even play a role, as there are also some genetic variants more commonly seen in individuals with eating disorders.

How Many of The Male Population Are Developing Eating Disorders?

The eating disorders of anorexia and bulimia tend to have more classic associations with females, and people often think of body image and dieting as being driving forces. However these same drivers also exist with men. Athletes have a higher rate of eating disorders, and incidence is also high in other subcultures.

As higher valuation is placed on slimness in the gay community, gay males are also more likely develop an eating disorder. The ideal body image portrayed by magazines and publications shows men with an extremely low body fat and perfect physique, more often airbrushed than not.

Studies have shown that viewing and purchasing of muscle and fitness magazines is positively correlated with levels of body dissatisfaction for both gay and heterosexual men¹, and that media use for all men predicts attitudes of preference for personal thinness and dieting².

Missing the Signs of Eating Disorders in The Male Population

As women are the primary seekers of healthcare, and individuals with eating disorders tend to have a desire for secrecy, the confounding issue of being a male with an eating disorder leads to less individuals seeking and receive appropriate care.

Because eating disorders are less common in men, doctors often may miss eating disorder warning signs or not ask screening questions when males seek medical care for other issues³. The many subtleties of eating disorder behaviors and symptoms can be missed or dismissed as other medical concerns, or mislabeled as other diagnosis more common in men.

Co-Existing Mental Health Problems

Eating disorders can co-exist with other psychiatric diagnosis. Dual diagnosis classically refers to the co-occurrence of mood disorders in conjunction with substance use or alcoholism. However as the behaviors of eating disorders have addictive patterns they also can generally be classified as a dual diagnosis when occurring with another mood disorder.

Depression, anxiety, and obsessive compulsive disorder are very common in individuals with eating disorders. Other issues may include:

• Bipolar disorder
• Self-injury
• Substance abuse
• Schizophrenia
• Personality disorders

Post-traumatic stress disorder may contribute if historic events such as abuse or an intense environment such as military combat was experienced. When males have eating disorders some of these other issues may initially be recognized as concerns, however with further investigation an eating disorder may come to light.

When an individual has mood disorders in conjunction with an eating disorder both conditions may require specific treatment protocols to address both concerns.

Suicide and Eating Disorders

Suicide attempts are more common in both males and females with eating disorders. In males, the peak age of risk for diagnosis with anorexia nervosa is at 13 years old, and in males and females with anorexia nervosa the age at which suicidality is the greatest risk is 15 years old⁴.

Overall, males with an eating disorder have an increased risk for psychiatric co-occurring issues and a higher rate of suicide attempts⁵. Because of the under diagnosis of eating disorders in the male population in general, and the overall inability of an individual at the age of 13 to seek help and medical care, this issue is something which needs to be more discussed both in medical settings and schools where teacher and other individuals may be in a position to recognize this risk.

Treatment of Eating Disorders in The Male Population

The treatment of eating disorders in males also may require a slightly different focus if there are specific male related themes that come to mind. For this reason, when selecting a counselor or therapist to work with it may be appropriate to select an individual from a similar demographic, ie a male counselor or individual with an LGBT focus.

Although the topics of therapy will be similar, it often is easier to have discussions concerning intimate topics with someone that is perceived to have personal understanding of the issues one is dealing with.

If you or someone you know is experiencing problems associated with an eating disorder, one of the first steps to freedom from the burden inherently associated is speaking up, talking to a friend, asking for help. The walk of recovery at times may not be obvious, but it never is a burden that has to be carried alone.

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References:

1. Duggan SJ, McCreary DR. Body image, eating disorders, and the drive for muscularity in gay and heterosexual men: the influence of media images. J Homosex. 2004;47(3-4):45-58.
2. Harrison K, Cantor J. The relationship between media consumption and eating disorders. J Commun. 1997;47(1):40–67.
3. Strother E, et al. Eating disorders in men: underdiagnosed, undertreated, and misunderstood. Eat Disord. 2012;20(5):346-55.
4. Zerwas S, et al. The Incidence of Eating Disorders in a Danish Nationwide Register Study Associations with Suicide Risk and Mortality. J Psychiatr Res. Available online 13 March 2015.
5. Bramon-Bosch E, et al. Eating disorders in males: a comparison with female patients. Eur Eat Disord Rev. 2000;8(4):321-328.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

Last Updated & Reviewed June 19, 2019, By Jacquelyn Ekern, MS, LPC
Published March 31, 2015, on EatingDisorderHope.com