Eating Disorders in Men
Eating disorders are a silent epidemic among men — potentially 40% of all cases by some estimates.
Stigma and gender bias keep eating disorders in men from being discovered or taken seriously.
Binge eating disorder, muscle dysphoria, and orthorexia tend to affect men more than women.
Eating disorders in men are much more common than we think. The statistic that is most often quoted, originally attributable to the National Eating Disorders Association, is that one-tenth of all eating disorders happen in men (1). The problem with this statistic is that it doesn’t account for all of the eating disorders in men that never come to light. More recent research, designed to include men who do not end up receiving treatment for their eating disorder, indicates that the real number could be as high as 40 percent (2).
One reason for this discrepancy may be that the so-called “ideal body type” for men is different than the one for women. Although this is changing somewhat, women often have a lean build marketed to them whereas men are more often subject to the impossible combination of bulging muscles and lack of body fat. “Six-pack abs” are often touted as an indicator of fitness, whereas the reality is that whether or not the abdominal muscles are visible is primarily determined by genetics.
It follows that, as they are often pursuing a different unrealistic ideal than women, eating disorders in men can look quite different as well. While anorexia and bulimia certainly do happen in men, by focusing on these types of disorders almost exclusively we may be failing to recognize the prevalence of eating disorders that have to do with other metrics.
Muscle dysphoria is one example of an eating disorder that tends to go unrecognized, and largely because it takes place in men more commonly. Whereas in a disorder like anorexia the focus is on attaining thinness, muscle dysphoria is about achieving muscle bulk. As with any eating disorder, perceptions about the actual size and shape of one’s body become skewed. A person may pursue muscle bulk at the expense of other hobbies and sacrifice relationships to hit the gym. They may also harm the body by doing things like taking anabolic steroids to try to achieve the effect they are hoping for. As in every eating disorder, the promise of the “perfect body” is ultimately hollow and so people with this affliction are never satisfied.
More men than women are diagnosed with binge eating disorder (BED). Remember, this statistic is about the number of cases that have been reported of a very secretive disorder. In binge eating disorder, a person consumes large amounts of food in a short period of time. They often report feeling numb or spacy during the episode and have shame and guilt afterward. This condition is especially complicated for men, for whom consuming large quantities of food is socially approved of but carrying weight or feeling that your behavior is out of control is not. Neither, for that matter, are having feelings — a perfect recipe for stuffing feelings with food.
I have recently noticed an increase in orthorexia among men in my own practice, and the research is showing that this disorder is actually more common in men than women at the moment (3). Orthorexia has to do with a rigid obsession about the “quality” of food that one consumes, lack of flexibility about food, and overthinking about nutrition. Ironically, often one’s eating becomes unhealthy because the “food rules” become more and more rigid and lead to a lack of variety in eating. Relationships and other parts of life often suffer.
Men often don’t see themselves as having eating disorders or disordered eating because they erroneously think of eating disorders as a “girls' disease." Add on to that a ton of stigma related to cultural misogyny and the taboo against men having anything about them that could be perceived as feminine, and you have a huge pool of people who do not present for treatment. Even when they do, gender bias plays a tremendous role in whether or not a health professional will recognize disordered eating for what it is.
In this way, the silence about eating disorders in men is self-reinforcing. Nobody talks about it, so nobody knows it’s an issue. So when a man develops an eating disorder, he thinks he’s the only one out there with this “girls' disease." He doesn’t talk about it, so people never realize how common it is….on and on.
If you know any man who struggles with any aspect of his food or his body, please share this post with him. We often don’t know how serious these issues can be and we can’t identify what we cannot name. You never know who you might help to break their silence.