What to Know About Anorexia in Men

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Anorexia and other eating disorders are often associated with women and girls; however, men and boys suffer from eating disorders too, and the consequences can be severe. In fact, because there is a stigma that men don’t suffer from anorexia, they are less likely to seek treatment, and when they do, they often go undiagnosed and untreated.

This article will give an overview of the statistics about anorexia in men, discuss the differences in how anorexia presents itself in both men and women, and discuss potential causes, symptoms, and treatment for men and boys with anorexia.

How Common Is Anorexia in Men?

For a majority of the 20th Century, it was believed that eating disorders didn’t affect men, and since diagnostic criteria for eating disorders often included menstruation issues like missing periods, (something people without uteruses can't experience), men were rarely considered in eating disorders research and treatment.

However, by the 1990s, it was thought that 1 in 10 men had an eating disorder. Today, that number has risen substantially, as approximately 10 million American men deal with an eating disorder in their lifetime.

Research involving general population surveys indicates that disordered eating, including behaviors associated with anorexia such as extreme dieting, is increasing faster in men than in women. It’s estimated that between 0.1% and 0.3% of all men will develop anorexia and that 25% of people with anorexia are men.

Does Anorexia in Men Differ From Anorexia in Women?

The criteria for anorexia in the latest edition of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-5), isn’t gender specific. It specifies that to be diagnosed with the condition, people must display the following symptoms:

  • Restricting the number of calories consumed relative to one’s requirements, leading to low body weight
  • Feeling extreme fear about the possibility of gaining weight
  • Seeing body weight as central to one’s assessment of themselves

What Are the Differences?

Yet, while men and women must both meet these criteria to be diagnosed for anorexia, there are some differences in the results each is trying to achieve.

Men and Women Aim for Different Outcomes

For instance, women with anorexia want to be thin while men are hoping to be lean and muscular. Perhaps, as a result, men with anorexia are more likely to fast and exercise excessively while women are more likely to abuse laxatives and force themselves to vomit.

Meanwhile, research has repeatedly shown that men are more likely to have been overweight before the onset of anorexia and have higher body mass indexes (BMI) over the course of the disorder than women.

Furthermore, severe anorexia tends to occur at a later age in men than in women, and while men weren’t more likely to die from the condition than women, those who did were more likely to die sooner after being hospitalized.

What Risk Factors Can Lead to Anorexia in Men?

There isn’t a definitive list of causes for anorexia, but there are a number of biological, psychological, and sociocultural risk factors that may leave some men more vulnerable to developing an eating disorder.

Risk factors include:

  • Body dissatisfaction
  • External or internal pressure to achieve the “ideal body” as prescribed by media and pop culture
  • A past history of mild to moderate obesity
  • Mental health issues like depression, anxiety, or obsessive-compulsive disorder
  • Low self-esteem or perfectionism
  • Substance-use disorder, including the use of appetite suppressants, steroids, or illegal drugs
  • Engaging in competitive sports, activities, or occupations that emphasize body weight, including modeling, athletic performance, or dancing
  • A history of being bullied in childhood
  • A history of sexual abuse

Some studies have found that gay men may be more predisposed to becoming anorexic due to greater pressure to attain a body that’s attractive to other men, however many researchers have disputed this claim.

According to the National Eating Disorder Association (NEDA), although many gay and bisexual men have eating disorders, most men with eating disorders are heterosexual.

What Are the Symptoms of Anorexia in Men?

Even if a man or boy has an eating disorder, it may be difficult to detect because parents and loved ones are less likely to think of that as a possible explanation for the signs and symptoms they see, and men themselves can be especially reluctant to admit they have an issue.

Moreover, some men may not show any obvious outward symptoms. In general, many symptoms of anorexia are not gender-specific, however, here are some that are especially prevalent in men:

  • Preoccupation with body shape and muscles
  • Sudden weight loss or gain, or fluctuating weight
  • Inability to maintain a normal body weight based on age and height
  • Change in physical appearance, particularly an increase in muscles
  • Lowered testosterone
  • Exercising even when hurt or sick
  • Distress over missed workouts
  • Frequent trips to the bathroom during or soon after eating
  • Being secretive about eating habits
  • Following strict patterns around eating
  • Social withdrawal
  • Trying to hide one’s body by wearing layers of clothing

Treatment for Men With Anorexia

Men tend to score lower on measures of eating disorder symptoms because many of these measures were developed specifically for use with women. Therefore, men are often misdiagnosed, which delays the time it takes to get proper treatment and resulting in more severe illness by the time a man is treated.

Early Treatment Is Best

Delays in getting treatment are problematic because the earlier an individual gets into treatment, the better their chances of recovery.

Yet, while clinicians concur there's a need to adapt current approaches to treating anorexia to men, there isn’t strong agreement about what these adaptations should be. As a result, clinicians lack specific guidelines for treating men with anorexia.

That said, treatment for men with anorexia is possible and can be successful. Those seeking treatment should look for doctors, clinicians, and treatment centers that take a gender-sensitive approach and, if possible, have all-male treatment groups, which are more likely to allow men to feel safe enough to open up about their struggles.

In particular, treatment should focus on issues specific to men including sexual abuse, body image, exercise abuse, pressure from media depictions, and their experiences of depression and low self-esteem.

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