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The Essential Guide to Eating Disorders in Males

In the United States, more than 10 million men live with eating disorders. Males are not typically at the center of conversations about eating disorders—but they should be.

According to one study, 1 in 7 men will experience an eating disorder by the age of 40, and the initial onset of symptoms is highly concentrated around adolescence and young adulthood. Experts believe the ratio of female to male individuals with eating disorders is likely much higher than reported, based on community samples and anonymous surveys.

Eating disorders thrive in isolation, but Veritas Collaborative is shining a spotlight on males living with this struggle so they can access the care they need, receive support from family and loved ones, and be inspired to take positive action towards recovery.

Misconceptions about males and eating disorders.

Perhaps the biggest misconception about males and eating disorders is that men and boys don’t get them. This glaring misconception contributes to other harmful perceptions, including the presumption that males with eating disorders must also be members of the LGBTQ+ community. These misconceptions about males and eating disorders can have an impact on men and boys living with these conditions—here’s how:

They are factually incorrect. As discussed earlier, one in three people with an eating disorder is male.

They create hurdles for healthcare providers to accurately diagnose boys and men with eating disorders. Until very recently, the diagnostic criteria for eating disorders had a strong female bias. According to Anna Tanner, MD, FAAP, FSAHM, CEDS, Vice President of Medical Services at Veritas Collaborative, this diagnostic “blind spot,” resulted in many males being overlooked for eating disorder diagnoses.

“It was hard to accurately diagnose boys and men when a missed period was a key part of the screening,” said Dr. Tanner. “It left an entire population vulnerable to eating disorders because their frontline healthcare providers were unable to make the diagnoses needed to connect patients with the right level of care.”

They ignore the diversity of people who live with eating disorders. While the perception persists that males with eating disorders must also be members of the LGBTQ+ community, Jonathan Levy, MD, CEDS, Medical Director at Veritas Collaborative, cautions against painting the male population with such broad strokes.

“Certainly, there are males in the LGBT community who also live with eating disorders,” said Dr. Levy. “However, anecdotal experience tells us that the majority of men in treatment for eating disorders do not self-identify as LGBT.” Further, eating disorders can affect anyone regardless of gender, race or ethnicity, age, sexual orientation, weight or body size, or socioeconomic level.

They leave men and boys vulnerable to medical complications. Males with eating disorders who go unseen and undiagnosed lose access to critical care that can mitigate medical risk and save lives. This is particularly important for males with eating disorders who are also experiencing the developmental changes of adolescence.

“Boys are at a higher risk for long-term, irreversible complications,” said Dr. Tanner. “It’s important to be aggressive about reversing the course of the eating disorder to prevent long-term damage.”

If you are unsure whether the symptoms you or a loved one are experiencing stem from an eating disorder, it may be time to consider a comprehensive assessment with eating disorder specialists.

Is it an eating disorder—or something else? Know the warning signs in males.

Misconceptions about male eating disorders can make it hard for loved ones and healthcare providers alike to identify worsening symptoms because disordered behaviors in males tend to be viewed in a positive social light.

“Males with eating disorders often outwardly appear to be healthy, fit people,” said Preeti Matkins, MD, FAAP, FSAHM, Executive Director at the Veritas Collaborative Charlotte treatment center. “Which makes it harder to identify males who need an intervention because they appear to be in good shape and consuming a seemingly healthy diet.” 

Three major warning signs of eating disorders to look for in males include:

  1. Changes in activity. Because many males struggling with eating disorders aim to achieve lean muscularity over thinness, many of their disordered behaviors tend to be exercise-driven. Pay attention to any significant changes to your loved one’s activity levels that may suggest overexercising or adhering to a rigid exercise regime that impacts their social behaviors. Dr. Matkins recommends being on the lookout for workout habits that are meant to achieve a specific physical ideal, such as six-pack abdominals or well-defined biceps.
  2. Changes in food intake. The elimination of entire food groups in the diet can be a red flag for an eating disorder. Additionally, major changes to meal structure can reveal an underlying eating disorder. Men tend to experience binge eating over starvation. Be mindful of nutritional changes tied to goals of “getting lean” or “cut.”
  3. Changes in mood and personality. This is by far the most important warning sign. Certainly, there could be a number of healthy, rational explanations for changes to your loved one’s activity levels and nutritional intake. However, if you are also noticing major changes to your loved one’s mood and personality along with drastic changes to their diet and exercise, it may be time to start a conversation with them about your concerns.

Dr. Matkins and colleagues recommend being intentional about recognizing and understanding the social stigmas that create barriers for males with eating disorders to access the help they need. According to Dr. Levy, social structures can foster a culture where males with eating disorders lack the personal insight needed to acknowledge their struggle because society, broadly, affirms the notion that males do not suffer from eating disorders.

“Males often don’t know that they have eating disorders and don’t believe their disordered behavior impacts them because they have an inner belief that says, ‘I can’t have this condition because I’m a man,’” said Dr. Levy.

Because eating disorders are considered ego-syntonic disorders—individuals living with them lack insight into the depth of their condition—it is that much more important for family and loved ones to be aware of and recognize the warning signs of eating disorders in males.

Getting your loved one the care they need to recover.

We can help you, your family and community of support discover the next steps in your recovery journey. Together, we are stronger. Take the first step—contact us today.