Recognizing Eating Disorders in Men

Some people may think that only females, especially young women and girls, struggle with negative thoughts about their body weight or image. However, boys and men can also struggle with eating disorders and disordered eating. About 1 out of every 4 people diagnosed with an eating disorder is male.

Types of Eating Disorders in Men

Eating disorders are serious psychiatric disorders that affect individuals of all sexes and genders. In this article, we focus on eating disorders and disordered eating in males. Research shows that in the U.S., about 10 million males will have an eating disorder during their lifetime.

Someone managing an eating disorder may worry excessively about their weight and/or body shape and have anxiety about eating food. They may make unhealthy choices about food, such as severely restricting their diet or purging after eating. They may also exercise excessively, to a point where it is dangerous for their health.

Eating disorder diagnoses include:

  • Anorexia nervosa, in which a person severely restricts their calorie intake and/or
    engages in behaviors that lead to a significantly low body weight.
  • Bulimia, in which a person experiences cycles of binge eating and compensatory behaviors,
    such as purging by vomiting, using laxatives, fasting, or excessive exercise.
  • Binge eating disorder, ·
    in which a person routinely experiences binge eating in which
    they feel a sense of loss of control over eating while eating large amounts of
    food in a short amount of time, which may be followed by feeling embarrassed,
    disgusted with oneself, or depressed.

Common symptoms of eating disorders can differ across sexes and genders. Although more research to date has focused on eating disorders among females, recent studies are providing new insights into eating disorders and disordered eating symptoms among males and members of LGBTQIA+ populations.

Women managing an eating disorder most commonly strive to make themselves thin, such as through purging (e.g. vomiting or laxatives), particularly in cultures that promote thinness as a societal value. In contrast, men and boys managing an eating disorder most commonly take actions to make their body lean to show off muscles. They may exercise compulsively and limit their intake of food.

Eating disorders can cause both physical and emotional health problems. Someone managing an eating disorder may hide their behaviors, or may appear to be fitting in with societal expectations, making it a difficult problem to detect. Severe weight loss is or rigidity regarding eating and weight-related behavior are some of the most obvious signs of an eating disorder.

Common Signs of Eating Disorders for Males

Eating disorders in men can be hard to identify. Common eating disorders for men include bulimia and binge eating disorder. Unlike presentations of anorexia, bulimia and binge eating disorder do not usually cause severe weight loss, making them more difficult to detect.

Someone engaging in disordered eating can be at risk to develop an eating disorder. Disordered eating includes having an unhealthy relationship with food and eating. Examples include skipping meals, extreme dieting, and feeling a loss of control over eating.

If you think you or someone you know may have an eating disorder, look for these common eating disorder symptoms in men:

  • Being preoccupied with muscle definition, like “having a 6-pack.”
  • Participating in regular, compulsive exercise, sometimes
    spending hours at the gym or exercising despite weather, fatigue, illness,
    injury, etc.
  • Having a strict eating pattern or referring to certain meals as “cheat meals.”
  • Feeling unhappy or dissatisfied with body shape or size.

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Men and Body Image

For some people, obsessing over their body image can lead to something called muscle dysmorphia.

Muscle dysmorphia is not an eating disorder but rather a type of body dysmorphic disorder. This is a psychiatric disorder in which a person obsessively focuses on what they consider to be a flawed appearance, even if this does not reflect reality. In the case of muscle dysmorphia, someone will feel that they are not muscular, or not muscular enough.

It’s thought that about 0.5% of men have muscle dysmorphia. Although more common in men, women can also develop muscle dysmorphia.

Muscle Dysmorphia Symptoms

Muscle dysmorphia symptoms can overlap with those of an eating disorder. Some people refer to muscle dysmorphia as “reverse anorexia.” While anorexia is characterized by thoughts of being too large or overweight, those with muscle dysmorphia believe they’re too skinny or have smaller muscles than they really do.

Someone with muscle dysmorphia may:

  • Have constant thoughts that they don’t have enough muscle.
  • Believe that other people find them too thin or not muscular.
  • Work out or lift weights sometimes several times a day.
  • Frequently check themselves in mirrors (or avoid mirrors if they are not comfortable with their appearance)
  • Have rigid eating habits like eating large amounts of protein for muscle building.
  • Use anabolic steroids or other performance-enhancing drugs to grow larger muscles.

Muscle dysmorphia can affect your life in many ways. Those with muscle dysmorphia often have poor self-esteem. Symptoms can negatively affect their work or school performance, as well as their relationships.

Using performance-enhancing drugs to grow muscle can cause serious side effects, including heart or liver problems.

How to Help

Someone struggling with an eating disorder or muscle dysmorphia may go to great lengths to mask or hide any symptoms or unhealthy habits. It’s important to be aware of the long-term health, social, and emotional risks of these conditions.

If you think you or a loved one is struggling with an eating disorder or muscle dysmorphia, encourage them to talk to their doctor. Mental health counseling and sometimes medicines can help manage these conditions.

The UPMC Center for Eating Disorders provides support and treatment for eating disorders among individuals of all sexes and genders, including males.

To learn more about services at UPMC Western Psychiatric Hospital and UPMC Western Behavioral Health, call 412-235-5444.

Sources

Child and Adolescent Psychiatric Clinics of North America. Eating Disorders in Males. LINK

American Journal of Men's Health. Eating Disorders in Males: How Primary Care Providers Can Improve Recognition, Diagnosis, and Treatment. LINK

International OCD Foundation. Muscle Dysmorphia. LINK

About UPMC Western Behavioral Health

UPMC Western Psychiatric Hospital is the hub of UPMC Behavioral Health, a network of community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors. Our mission is to provide comprehensive, compassionate care to people of all ages with mental health conditions. UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. We are here to help at every stage of your care and recovery.