The silent illness of eating disorders in males

Men rarely develop an eating disorder; at least that’s the prevailing thought.  Besides, how many of us know of a male with an eating disorder? Yet men and boys can and do develop them and at higher rates than most of us are aware of.  Eating disorders are thought of as a predominately female illness, well-known to afflict girls and women in varying degrees from anorexia to bulimia to binge eating.  But the truth is up to 10% (much likely more) of males of all ages ranging from children to older adults, also have some type of an eating disorder. 

Eating disorders rank among the most serious public health concerns in the U.S and have the highest morality rate of any mental illness.   They are complex illnesses that can have harmful consequences for an individual’s social and emotional well-being but also greatly impacts their physical health.  Eating disorders can compromise every regulatory system in the body including the immune system, digestive system, skeletal system, cardiovascular system, and reproductive system.

Males with eating disorders have similar signs and symptoms as females and suffer comparable physical complications such as osteopenia, reduced sex drive and significant damage to the heart and other organs.

Male eating disorders often overlooked

Men need help but unfortunately, eating disorders in men are often overlooked or have received little attention.  Some of the reasons why male eating disorders have gone under the radar include the following:

·      Scant research on males and eating disorders – less than 1% of all research on eating disorders focus specifically on males

·      Men and their family members may not recognize their eating disorder

·      Eating disorders are thought of as a female illness

·      Men who may be excluded from getting treatment at eating disorder clinics

·      Eating disorders in men have different symptoms than in women

·      Health professionals who are biased in believing a male may have an eating disorder

Part of the problem of a diagnosis of an eating disorder in a male is that a physician would have to be thinking of the possibility in order to know what to look for.  Guys, including teens or younger, also want to lose weight and be in shape just like women.  Females have always been targeted by social and media pressures to be thin.  But even males have been targeted with the message to have masculine bodies that are toned, muscular, and athletic looking.  Marketing aimed at men include weight-loss advertisements, grooming products, cosmetic surgeries, and the fashion industry, all which could be contributing to the rising rates of body dissatisfaction among males.

Fast facts on males and eating disorders

·      Lifetime prevalence rates for eating disorders in males are .3% for anorexia, .5% for bulimia and 2% for binge eating disorder but these numbers significantly underestimate the number of males with an eating disorder due to social stigma

·      Binge eating disorder is the most common eating disorder in males

·      The onset of an eating disorder in males occurs later in life than females.  However, eating disorders in males can occur during childhood, adolescence, and all stages of adulthood

·      Men may develop eating problems as a result of muscle dysmorphia, a body image disorder that compels them to pursue and muscular and lean body.  Muscle dysmorphia is sometimes called bigorexia or of a man wanting to be bigger and more muscular, the traditional societal view of the ideal male body.  They often consume excessive protein, have dietary restrictions, take illicit steroids, and lift weights obsessively.  

·      Certain athletic activities appear to put males at risk for eating disorders. Gymnasts, runners, body builders, rowers, wrestlers, jockeys, dancers, and swimmers since these activities often demand weight restriction.

·      Other factors why men may develop an eating disorder can include depression, anxiety, or addiction, previous weight issues over their lifetime, physical or sexual abuse or trauma, and sexual orientation issues.

·      Men with eating disorders tends to hide their illness by cutting themselves off from friends and family

·      Men are more reluctant to acknowledge they have a problem and are less likely to seek help, worrying they will appear weak and don’t want to be associated with a condition primarily thought of as a female illness

The prevalence of male eating disorders is hard to pinpoint due to the reluctance of males to admit they have one.  The National Association for Males with Eating Disorders estimates that 25% to 40% of people with all eating disorders are males. 

Assessment and treatment of male eating disorders

Traditional assessment tools commonly used are designed for use with females.  Therefore, they may not adequately identify an eating disorder in a male.  There is a more gender-specific eating disorder assessment tool for males that have been developed.  This tool has more questions geared towards males such as asking how frequently they check their body for signs of muscularity. 

Males who have sought and received treatment for their eating disorder have generally been successful, especially if cognitive behavioral therapy and family-based treatment for children and young adults have been used.  Treatments often focus on limiting exercise, preventing excessive protein intake and addressing the stigma males feel about their illness. Males have different and unique needs in an eating disorder recovery program than females. 

The earlier an eating disorder is identified and diagnosed in a male, the sooner he can begin treatment with an improved prognosis for recovery.  The fewer stigmas as a society we place on a male eating disorder, the better for all of us in recognizing this illness and getting males the help they desperately need.