Eating Disorders – The Male Perspective

Most mental health conditions vary to some degree in terms of their prevalence across sex and gender. However, I’d wager that eating disorders carry with them a perception of gender disparity that far outstrips most other mental health conditions.

Author: Patrick Carson

These conditions, particularly those such as Anorexia Nervosa and Bulimia Nervosa, have a reputation as “female disorders” – conditions experienced almost exclusively by women. This information, while not completely unfounded, absolutely does not tell us the complete story. It also has very real consequences in terms of the desire and even the ability of men suffering from an eating disorder to receive high-quality care.

Due to their reputation as “female disorders”, men may be less informed about the warning signs of an eating disorder, and less likely to share any concerns with their loved ones for fear that they won’t be understood. They may be less willing to seek treatment due to stigma, and less likely to receive quality treatment if they do. After all, medical and health professionals are not immune from biases and misconceptions, and under-diagnosis or misdiagnosis of eating disorders is likely more common for men than for women.

One caveat before proceeding – while eating disorders are under-reported and under-researched in men, they are even more so when it comes to non-binary and gender-diverse individuals. While this is a vital area for research and discussion, it won’t be the focus of this blog content, simply because I don’t believe I have the space to do it justice. Eating disorders in non-binary individuals are just as complex, dangerous, and important as those in cisgender individuals, and I hope to be able to provide further information on this subject in a future post.

The Numbers

First things first – research suggests that eating disorders of most types are indeed more common in women. However, the rates of gender disparity vary significantly, and even at their most significant, eating disorders in men aren’t remarkably uncommon. Current estimates are that 15-25% of those who experience anorexia nervosa and bulimia nervosa are men. With Binge Eating Disorder, that number jumps up to around 40%. Presentations such as Avoidant Restrictive Food Intake Disorder (ARFID) or Otherwise Specified Feeding and Eating Disorders (OSFED) may even be more common in men than in women.

The Presentation

If a significant proportion of eating disorders are experienced by men, then the question must be raised as to why this stigma exists. Some of it may be cyclical – men who are concerned about stigma are less likely to seek treatment, which means that prevalence rates may be underestimated, and health professionals are less likely to see the condition, which could feed back into stigma. That could explain the perpetuation of the belief, but not the origins.

One contributing factor towards under-diagnosis may be that eating disorders can sometimes present differently in men, making them difficult to detect. Societal expectations for attractiveness, while not universal, tend to place more of an emphasis on a muscular figure for men, rather than a slim one. As a result, men may be at a greater risk of experiencing muscle dysmorphia – a type of body dysmorphia characterised by the belief that one’s body is too small, too thin, or just insufficiently muscular. Just like other forms of body dysmorphia, it can result in obsessive, precise dietary rules and excessive exercise, as well as substance abuse in order to increase muscle mass. However, it may be less likely to attract concern from others, as well as from the individual themselves, reducing the likelihood of seeking treatment.

Excessive exercise, in general, tends to be used more commonly by men suffering from an eating disorder relative to women and is a behaviour that often appears health-positive to onlookers. Even in psychological treatment, consistent exercise is often considered a protective factor and an effective part of treatment for a variety of psychological conditions. However, in those of us more vulnerable to developing an eating disorder, it can rapidly slip from a protective behaviour to a disordered one if it occurs without moderation.

The Conclusion

Eating disorders are both more common than many of us would like to believe, and are highly lethal. They won’t ignore you just because of your gender, and you cannot afford to ignore them either. If you’re struggling or preoccupied with food, or eating, or the way you look, talk to a health professional. The sooner an eating disorder is identified, the quicker the recovery, and the sooner you can start to feel good about the body you’re in.

Better Self Psychology specialises in helping children, teenagers, and young adults.

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