According to the World Health Organization (2019), approximately 14 million people worldwide will struggle with an eating disorder. It is very common for people to assume that most, if not all, of those 14 million people will be females. This false assumption has led to a stigma against males with eating disorders. The reality is that up to 2.4% of young men will be diagnosed with a clinically-significant eating disorder by early adulthood. With this amount of men being diagnosed with an eating disorder, it is important that awareness is brought to this issue. This post will explore the causes, types, signs, and treatment options for eating disorders in males.
Understanding Eating Disorders in Males
Eating disorders, like most mental health conditions, do not discriminate against gender. Men can be diagnosed with anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder (ARFID), or other specified eating disorder. Today’s media promotes lean and muscular male physiques with often very low body fat as the ideal male body. These influences, plus genetic and other factors, can lead to eating disorders in males. Here are ways each of these disorders can present in males.
- Anorexia Nervosa
- Male anorexia can focus on becoming leaner and more muscular rather than achieving a specific look or weight. Like others with anorexia, males will begin to reduce their food intake and may obsess about the size of their body and their muscles. Common signs include: intense fear of gaining weight, focus on body fat percentage or body size, frequent thoughts about consuming or avoiding certain foods or food groups, checking nutritional information on food packaging, body image concerns, and being driven to lose weight through extreme measures such as restricting food, excessive exercise, or purging.
- Males who are at risk for developing anorexia are more likely to be self-critical, anxious, perfectionistic, and have OCD behaviors. There are also some sports, activities or hobbies that have been linked to anorexia in males due to a required appearance or weight standard. This includes wrestling, gymnastics, swimming, track, horse racing, football, and weight lifting.
- Bulimia Nervosa
- Bulimia presents very similarly in males as other genders. A person with BN will engage in binge eating and then purge what they have eaten either through vomiting, laxatives, or excessive exercise. One significant difference in males from other genders is their desire to gain muscle which can make binges look like “cheat meals” or part of a diet. Males have also reported less loss of control during binge episodes and express less concerns over eating.
- Common signs of bulimia in males include preoccupation with body shape, muscle mass, and body fat, excessive exercise regimes, taking part in “cheat meals” where they consume large amounts of food and then “work it off” or purge, and lowered testosterone levels. They also may engage in rigid eating rituals, have discomfort eating around others, feel anxious or depressed, or have low self-esteem.
- Binge Eating Disorder
- Binge Eating Disorder (BED) is the most common eating disorder for males. According to the Binge Eating Disorder Association, 40% of Americans who report binge eating are men. Binge eating is described as consuming large amounts of food within a two hour period at least once a week while feeling out of control over eating during that time. This can look like consuming thousands of calories in one sitting followed by feelings of shame and self-loathing.
- Males who binge eat may suffer from low self-esteem, past trauma, weight-related bullying, or use food to numb emotions and cope with stress. BED can be a very secretive eating disorder, which entices males who may believe that eating disorders are “female disorders” only. They are more likely to keep their binges a secret or frame it in a way that does not bring attention to them.
- ARFID
- AFRID is one of the newest eating disorders to be found in diagnostic material. It was first recognized in the DSM-V in 2013. Since then, it has been identified that male youth tend to be the most diagnosed with ARFID. A study published in the Journal of Eating Disorders in January of 2025, found that males with ARFID had greater medical complication including lower heart rate, lower total cholesterol, and higher hemoglobin levels than females with ARFID. Males with ARFID also required more nutrition at discharge to restore medical stability.
- ARFID is very similar to picky eating but is differentiated by the level of physical and mental distress that eating causes. Males with ARFID experience a lot of anxiety around eating for a variety of reasons. For some, there is a fear of an adverse reaction (e.g. choking, vomiting) occurring when they eat certain foods. There are others who feel anxious over different textures of foods. And lastly, there are people who have a low appetite and “feel full” after eating very little. The one thing males with ARFID do not have is a fear of gaining weight.
Causes and Contributing Factors
In the world of eating disorders, no matter what your gender is, there is no one direct causal factor in the development of an eating disorder. The development of an eating disorder in males is complex and includes biological, psychological, and sociocultural factors. There is typically never just one thing that causes an eating disorder, but a conglomeration of multiple factors occurring all together at just the right time that leads to disordered eating. Let’s take a look into how each of these factors play out for males specifically.
- Biological Factors
- The strongest biological factors or genetic components in the development of eating disorders in males is if a relative has had an eating disorder. Studies have shown that eating disorders can be genetic and provide a predisposition for someone to develop one. Other factors include hormonal imbalances and medical conditions that impact weight and shape (e.g. diabetes, celiac disease).
- Psychological Factors
- There are many psychological factors that can contribute to the development of eating disorders in males. Someone who has other mental health conditions, like anxiety or depression, may also develop an eating disorder. These disorders, along with perfectionism, feed into the foundations of an eating disorder due to the shame and guilt many feel.
- Sociocultural Factors
- Sociocultural factors may be some of the most influential factors in the development of eating disorders. For men, they appear to be more concerned about their appearance above the waist: chest, shoulders, arms, and abs. The “ideal” male body in the media is someone who is muscular and has low body fat. Eating disorders can develop as men attempt to achieve this look through exercise and eating habits.
Treatment and Support for Males with Eating Disorders
Treatment for males with eating disorders is very similar to treatment for people of other genders. Unfortunately, males are less likely to be diagnosed with an eating disorder due to the stigma and misconceptions about eating disorders. This stigma results in men being less likely to talk about their eating concerns as well as can make it difficult to find treatment programs who take males. Once this stigma is able to be overcome, the following are the different types of treatment for eating disorders.
- Medical Treatment
- When one is diagnosed with an eating disorder, it is important that they are connected with a physician who is informed on treating eating disorders. A physician’s role is to monitor one’s physical health and ensure that the patient does not need medical care from a hospital. Physicians can also provide nutrition support to help one to gain weight.
- Psychotherapy
- Psychotherapy is also necessary for someone who has an eating disorder. A therapist can help someone develop the skills necessary to recover from an eating disorder and support them in recovery. The most common forms of therapy for treating eating disorders are Cognitive-Behavioral Therapy (CBT) and Family-Based Therapy (FBT). CBT is effective for older adolescents/young adults and FBT is most effective for children and adolescents and relies on parents to help bring their son into recovery.
- Support Groups
- Support groups are a great way for men recovering or in recovery from an eating disorder to get peer support. Support groups are a way for men to discuss their triggers and successes as well as receive support to keep them in recovery. For more information on local St. Petersburg/Tampa Bay support groups, check out Integrated Care Clinic’s page for support groups.
Eating disorders in males are a critical but often overlooked issue that needs more attention and understanding in order to decrease the stigma around them. Society has long associated eating disorders with women, but the reality is that men are just as vulnerable. By breaking down stereotypes, fostering open conversations, and providing targeted support, we can help ensure that men feel empowered to seek help and begin their journey to recovery. If you or someone you love is struggling with an eating disorder, please reach out to us here at Integrated Care Clinic. We have several highly trained psychologists who would love the opportunity to walk alongside you and help you reach your goal of recovery.
