Eating disorders affect men, too

Eating disorders are commonly attributed to females—in particular, the notion of the young teenage girl struggling to achieve an idealistic appearance during adolescence. And while females do have a higher incidence of eating disorders, it is important to note that men experience eating disorders too.

Men and eating disorders

Eating disorders are mental illnesses that do not discriminate by age, race, sexual orientation, or gender expression. However, men are also less likely to seek help for mental health problems, especially when an eating disorder is present, due to the added stigma. For these reasons, eating disorders in men often go undiagnosed.

Why do men develop eating disorders?

Eating disorders are not a lifestyle choice; they are serious conditions, with anorexia having the highest mortality rate of all psychiatric conditions. Although we can argue that the cause for eating disorders is a combination of biology and environment, there may be additional influences leading men to develop eating disorders such as:

• Having a predisposition to perfectionism and mental health problems
• Genetics
• Abuse and/or trauma in childhood
• Having experienced bullying growing up
• Having highly critical parents and a desire to please
• Having relentless high standards to achieve
• Being part of a sports team with extreme standards of fitness

Cultural and social pressures

Over the years, gender norms have shaped how men and women are viewed socially and culturally. Stereotypically, women through time, have been judged for their appearance, whereas men have been judged on what they can achieve externally, such as in work, sport, and relationships. For years, eating disorders have been judged as a ‘female’ disease, but as awareness grows and stigma breaks down, this is changing.

Men are being encouraged to show more of their vulnerable side, which may explain why more men are reaching out for help. On the other hand, social media increasingly puts immense pressure on men to look and behave in a certain way, more so than men generations before.

The fact is, men have always suffered from eating disorders, just at a lower rate than women.

What do eating disorders look like in men today?

Just like with women, men can use food to control their feelings, here are some ways eating disorders may show up in men:

• Skipping meals and fasting
• Becoming obsessed with the gym, body building and protein shakes
• Vomiting after meals
• Vomiting when drinking heavily to counteract the calories and to drink more (possibly overlapping with a substance use disorder)
• Becoming obsessed with body weight and shape and feeling depressed about appearance
• Not being able to take rest days from work outs, or exercising despite pain
• Eating only ‘pure’ foods, then falling off the wagon and bingeing for days
• Joining weight loss groups
• Compulsively overeating and gaining weight
• Fasting and losing weight
• Yo-yo dieting and weight fluctuations
• Mood swings
• Irritability

Men may go through periods of bingeing and fasting, or they may compulsively exercise and work out in the gym to bulk up their muscles and become obsessed with protein shakes and a certain body type. This is referred to as non-purging bulimia where the weight gain is compensated through the use of excessive exercise, or fasting.

Although not all defined as eating disorders, these labels highlight the behaviours that may be seen in men:

• Protorexia – being obsessed or addicted to protein shakes and protein.
• Bigorexia – a desire to keep bulking muscle, but not being able to see their true shape. This is defined in the DSM-5 as ‘muscle dysmorphia’.
• Drunkorexia – Using alcohol to control eating behaviours, such as skipping meals to drink, purging when drunk or not eating to get drunk faster.
• Orthorexia – only eating ‘pure’ or whole foods, and not consuming anything that is ‘dirty’ or fattening. People who struggle with this may cut out entire food groups such as carbs or fats.

If you are concerned with your or someone else’s eating behaviours, it is important you reach out for help. Contact your health provider, a counsellor, or your assistance programme for support.

This information is provided to supplement the care provided by your physician or mental health professional and is not to be used as a substitute for professional medical advice. Always seek the advice of your physician or another qualified health or mental health professional if you have questions about a medical condition or plan of treatment.