Eating Disorders in Men

When most people think of someone with an eating disorder, the first image to come to mind is that of a young girl or woman, dangerously underweight, striving and starving to achieve an image of feminine beauty that has been imposed upon her by, her peers, her family, society, or by the media.

This picture is a common one, but it is extremely inaccurate in a surprisingly high number of eating disorder cases. One of the statistics about people suffering from eating disorders that many find most surprising is that, by most estimates, approximately 10% of eating disorder cases are men or boys.

I had a close friend in high school who was consumed by his caloric intake, and his behavior was confusing to me. I knew several of my female classmates at that time suffered from eating disorders, and Ryan's changes in behavior and appearance seemed to mirror the transformations they were experiencing. Unacquainted with the true nature of eating disorders, I considered them to be a purely female problem, and I believed his protestations that he had a gastrointestinal problem that would make him feel sick if he ever consumed more than a very small number of calories in a sitting. I remember feeling very concerned for his physical health as he wasted down to little more than a skeleton. However, I was never concerned about the state of his mental or emotional health, as I was about my female peers struggling with their own eating disorders.

Several years later, I became reacquainted with Ryan. Still alarmingly thin, he remained reluctant to acknowledge that he was suffering from an eating disorder, but he did confirm that he had never been diagnosed with any gastrointestinal problems. "I just prefer to be thin," he asserted. "It takes a lot of work for me to not gain weight." As it turns out, men and boys are far more reluctant than women and girls to admit that they suffer from eating disorders, even when they have progressed to the point of medical crisis. As did I, society generally considers eating disorders to be a female problem. In men and boys suffering from eating disorders, the stigma of the condition is compounded by the perception that suffering from the condition is somehow a feminine trait. Therefore, eating disorders are commonly under-reported and under under-diagnosed in men and boys.

The manifestation of eating disorders in men and boys resemble those experienced by women and girls. As in females, common factors in the histories of eating disordered males include childhood experiences with being fat or overweight, history of dieting, jobs or participation in athletic sports that demand thinness (models, actors, runners, jockeys, etc.), and living in a culture driven by physical appearance, which places a high emphasis on thinness as a criteria for physical attractiveness. (HealthyPlace.com)

In a 2001 study published in the American Journal of Psychiatry, a team of researchers lead by Dr. D. Blake Woodside determined that there were clinical similarities between men with eating disorders and women with eating disorders. The study compared 62 men with eating disorders with 212 women who had similar eating disorders, and 3,769 men who had no eating disorders. The researchers found that the ratios of anorexia nervosa and bulimia nervosa were similar across gender lines, as were the patterns of the patients' ages at the time of the onset of their eating disorders. (Am J Psychiatry 158:570-574, April 2001)

Furthermore, the underlying psychological factors that lead to eating disorders are also the same in men and women. Some of these factors include low self-esteem, a need for acceptance, depression, anxiety or other existing psychological illness, and difficulty with coping with emotions and personal issues. Additionally, family and social factors, including family problems, relationship issues, presence of an alcoholic/addictive parent, abuse, societal pressure, are also the same for men and women with eating disorders. (SomethingFishy.org)

Despite the consistency of the manifestations of eating disorders among men and women, cases in men are far more likely to be missed than they are in women. The societal perception of eating disorders as feminine concerns allows men greater ability to hide their problems than women tend to experience, with the greater scrutiny placed on the body weights and eating habits of women.

Further compounding the problem of correctly recognizing eating disorders in men is the reluctance of men to acknowledge that they are in need of help. Many treatment programs for people suffering from eating disorders are designed primarily for female patients, and address issues commonly experienced by women and girls. "Males report feeling uncomfortable and out of place in discussions of lost menstrual periods, women's socio-cultural issues, female-oriented advertising, and similar topics." (HealthyPlace.com)

Over the past year or so, my friend Ryan has begun to acknowledge that he has a problem and is seeking treatment for his eating disorders. However, like many men, Ryan is reluctant to submit to treatment in an inpatient setting, or join a formal eating disorders support group. He says that, as a man, he does not feel supported in these environments that he perceives to be geared toward the issues faced by women, and has chosen to seek private therapy instead. While he continues to struggle, and his body weight does not appear to have noticeably improved, acknowledging his problem, and seeking professional treatment for his eating disorders are positive first steps along the road to his recovery.

If you are a man struggling with an eating disorder, or if you know a man who needs help, there are a couple of programs in the U.S. for people with eating disorders that specifically address the needs of men. Thank you to HealthyLiving.com.

Rogers Memorial Hospital, Oconomowoc, WI
(800) 767-4411
Has the only all-male eating disorders center in the U.S. Runs separate residential programs for men and women.

University of Iowa Hospital and Clinics, Iowa City, IA
(800) 777-8442
The clinic is known its expertise in treating men with eating disorders.

For more options, or to locate treatment closer to your home, consult your primary care physician, or your local yellow pages for treatment facilities or licensed psychologists that might assist you in locating treatment specializing in men with eating disorders.