Why Eating Disorders in Men Often Go Unrecognized
Thu, February 2, 2023

Why Eating Disorders in Men Often Go Unrecognized

There are existing stigma and isolation for men who suffer from an eating disorder / Photo Credit: 123RF


Eating disorders are more commonly known to affect women even if cases occur in both genders. This leaves occurrences in men not only underrepresented but also undiagnosed and untreated. What's more, body dissatisfaction and pathological levels are increasing among the male population as destructive body shaming affects everyone regardless of sex.

Prevalence of eating disorders

Eating disorders are classified as a formal psychiatric condition that affects a person's mental and physical health. These disorders can range from excessive eating (binge eating disorder) or eating too little (anorexia nervosa). Women were once seen as the only people affected by these disorders until recent studies suggested eating disorders happen regardless of gender.

"Despite the stereotype that eating disorders only occur in women, about one in three people struggling with an eating disorder is male," the National Eating Disorder Association (NEDA) in the US said, adding that subclinical eating disorder behaviors are nearly as common in men as they are in women.

"In the United States alone, eating disorders will affect 10 million males at some point in their lives," the group added.


The occurrence of eating disorders is widespread

Recent research also shows men compromise 15 percent of all US cases while 22 percent turn to dangerous methods to build their muscles with disordered eating behaviors, according to WebMD, an American online publisher of news and information pertaining to human health and drugs.

Studies also indicated a larger number of cases of bulimia in males compared to cases of females with anorexia, as per the National Center for Eating Disorders in the UK.



"Males may account for approximately 1 to 5 percent of patients with anorexia nervosa although prior to puberty the risk increases and approximately 50 percent of sufferers in children are boys. Males account for 5 to 10 percent of patients with bulimia nervosa," the NCED said.

The Butterfly Association in Australia, meanwhile, said over 360,000 men living Down Under have an eating disorder, with two-thirds of young men reportedly making specific changes in their diet to increase muscle gain. Men also make up 25 percent of all anorexia nervosa and bulimia nervosa sufferers in the country.

However, knowing the exact number of men suffering from an eating disorder is a difficult task. This is possibly due to the fact that, socially, people are more sensitive to low weight among women.

We're missing a lot

Men are more likely to avoid seeking help when they are faced with eating problems. Those who have anorexia nervosa may face "harsher stigmatization from their peers," leading to the disorder going undiagnosed, WebMD said. It added that this is due to the stereotype that anorexia nervosa is seen as a disorder for women.

A study published earlier this year highlighted the stigma, shame, and isolation that manifest in men that affect and delay their treatment. It doesn't help that risk assessment tools for eating disorders are likely to reinforce gender stereotypes.

These assessment tools were designed for use with females, according to Verywell Mind, a trusted and compassionate online resource that provides the guidance people need to improve their mental health and find balance, which means these instruments may not "adequately identify an eating disorder in a male."



For instance, one of the items in the Eating Disorders Inventory is: "I think my thighs are too large," which males may be less likely to endorse since it doesn't reflect their concerns on body image.

These stigma and stereotypes are what make diagnosing and providing treatment to males with eating disorders difficult. It even reaches the point where men needed to be nourished with an IV, as revealed by Jeffrey Mechanick, MD, an endocrinologist at Mount Sinai Hospital in New York City.

"Men with eating disorders do often get very sick because in general, they are not seeking out medical care or being identified as having a problem until much later in the natural history of the disease process compared to women," said Mechanick, who have been called for such cases. "We are probably missing a lot of these patients."


There's a large number of men who suffer from an eating disorder / Photo Credit: 123RF

Notions of the male body

Men have varying and misconceived notions about their weight and physique, specifically the importance of muscularity. According to NEDA, most males deem being lean and muscular as the "ideal" body type for them. So exposure to unachievable images in media may lead to body dissatisfaction while sexual objectification drives for muscularity.

"The desire for increased musculature is not uncommon, and it crosses age groups," the agency said. "Twenty-five percent of normal-weight males perceive themselves to be underweight and 90 percent of teenage boys exercised with the goal of bulking up."

This muscularity-oriented disordered eating is called muscle dysmorphia, which Verywell Mind said is a more common presentation of eating disorders among men. Muscle dysmorphia is an emerging condition in which males, specifically bodybuilders, obsess about being adequately muscular.
The overwhelmingly unrecognized manifestations of eating disorders among men are making it difficult for doctors to help patients, and it will continue to be this way as long as the gender stereotypes attached to the disorders persist. Providing the needed help to men with eating disorders can only be done by eliminating the stigma that surrounds them, which is crucial since the disorders themselves are treatable.