Eating Disorders in Men: EDAW 2023

Eating disorders are a group of serious mental illnesses based on an unhealthy relationship with food. They can affect anyone – any age, sex, race or socioeconomic status (it’s not an illness exclusive to wealthy, white women as it is often depicted in various media).

The most common age of onset is between 12 and 25 years old, but cases have been since in individuals as young as 6 and as old as 70. 

There are eight different eating disorders altogether, the most commonly known being:

  1. Other specified feeding or eating disorder (OSFED) – 47% of cases
  2. Bulimia nervosa – 19% of cases
  3. Binge eating disorder – 22% of cases
  4. Anorexia nervosa – 8% of cases
  5. Avoidant/restrictive food intake disorder (ARFID) – 5% of cases

The exact prevalence rates are difficult to gauge, but the above data shows an estimation based on a 2017 study by Hay et al.

It’s likely that the most common eating disorder – OSFED – is one you’ve not heard of before – eating disorders are far more complex than “just” anorexia, which is arguably the most commonly known disorder. Eating disorders are often extremely misunderstood, and while some EDs exhibit pathologies of eating too little, others will manifest as eating too much. It’s very much dependent on the individual and their relationship with food.

You can learn more about eating disorders themselves here.

As established, there’s no set of rules for who eating disorders impact, and how they impact them, and while they are typically more common in females, males still make up approximately 25% of cases, but men often have their struggles with eating disorders minimised.

Because of this, this year, the UK eating disorder charity, Beat, is using Eating Disorder Awareness Week to raise awareness about eating disorders in men and boys, as they are often overlooked in this particular context.

The number of people suffering from eating disorders in the UK is approximately 1.25 million – a quarter of whom are male, meaning roughly 312500 in total.

Symptoms can present differently – some men may be driven by a desire to become more muscular and ‘masculine’, but this is certainly not the only way they manifest. 

Eating disorders in men – the stats:

  • 33% of males use or have used unhealthy behaviours to attempt to alter their weight.
  • 10 million males will be affected by eating disorders at some point in their lives.
  • Eating disorder-related hospitalisation of males increased by 53% between 1999 and 2009.
  • 15% of gay/bisexual men report struggling with an eating disorder.
  • 5% of straight men report struggling with an eating disorder.
  • Men experiencing eating disorders may have a higher mortality risk than women.

What causes eating disorders in men?

Trauma

Similarly to women, a history of trauma (whether physical, sexual, verbal, and/or emotional) can leave men at a higher risk of developing eating disorders. This can often be more prevalent in men, as it is common to underreport traumatic experiences based on the idea that men have to be ‘strong’, although this narrative has gradually been shifting in recent years – and rightly so.

One study by Strother, E. et al. in 2012 indicated that men who experience physical or sexual trauma are more likely to respond to it by trying to manipulate their bodies to become ‘more masculine’ as a result, whether that’s to protect themselves from future victimisation, or a way of internalising the event.

Athletes

Male athletes are more likely to develop eating disorder behaviours than non-athletes, often led by a drive to lose or gain weight to achieve what they perceive to be a physique that would aid with ‘optimal performance’.

In such instances, it is more common for male athletes to ‘purge’ by exercising excessively or overtraining rather than self-induced vomiting, taking laxatives, and other means of purging commonly associated with eating disorders – particularly bulimia. With that, the other element of bulimia – bingeing – tends to be rationalised by having a ‘big appetite’ or needing to ‘bulk up’ – far more socially accepted reasoning than feeling an uncontrollable urge to eat, which also lends itself to men being less likely to reach out for help.

LGBTQ+

The LGBTQ+ community also experiences a greatly elevated level of ED diagnoses, as evident in the stats above. 

This is partially believed by some to be down to the heightened awareness of mental health problems in the LGBTQ+ community, however, as mentioned, trauma can play a huge factor in ED development, and discrimination can certainly cause and/or lead to trauma. 

Comorbidity 

Men diagnosed with a comorbid mental illness can also increase the risk for ED development. As previously mentioned, the stigma around male mental illness can often lead to internalised pain, which can reach the point of being too much. Men already experiencing mental health problems are more susceptible to developing ED-like behaviours as a coping mechanism.

Treatment

Treatment for men can be more difficult to find than for women, as male-only treatment centres are unfortunately far less common. However, Beat are wonderful for helping those that need treatment a suitable place to receive it, and can help bridge the gap between referral, diagnosis, and treatment onset. 

If you are wanting to help yourself, you can do so through their website here.

If you are wanting to help a friend or loved one, Beat has some guidance on broaching the subject here.

References

Hay, P., Mitchison, D., Collado, A. E. L., González-Chica, D. A., Stocks, N., & Touyz, S. (2017). Burden and health-related quality of life of eating disorders, including Avoidant/Restrictive Food Intake Disorder (ARFID), in the Australian population. Journal of eating disorders, 5, 21. https://doi.org/10.1186/s40337-017-0149-z

Rittenhouse, M., Eating Disorder Hope. (2021). Eating Disorders in Males. [online] Available at: https://www.eatingdisorderhope.com/risk-groups/men.

Strother, E., Lemberg, R., Stanford, S. C., & Turberville, D. (2012). Eating disorders in men: underdiagnosed, undertreated, and misunderstood. Eating disorders, 20(5), 346–355. https://doi.org/10.1080/10640266.2012.715512

Unknown (2021). Anorexia in men and boys: treatment and statistics. American Addiction Centers. Retrieved from https://americanaddictioncenters.org/male-eating-disorders/anorexia.

Unknown (2021). Men and eating disorders. National Eating Disorders Association. Retrieved from https://www.nationaleatingdisorders.org/men-eating-disorders.

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Meghan Foulsham
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Published by Meghan Foulsham

Meghan's fascination with metabolism and the effect of diet on the body covered in her BSc Biochemistry, paired with being a passionate mental health advocate, led her to a Master's degree in Eating Disorders and Clinical Nutrition. Using this, Meghan works with clients to help them reach their goals in the most sustainable way, without sacrificing or risking their mental health.

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