By Hugh C. McBride

Eating disorders most commonly occur in teen girls and young women, but it has been well-established that the disorders can affect boys, girls, men and women of virtually all ages. As experts continue to gain a greater understanding of the prevalence of eating disorders, they have begun to explore how the disorders (including anorexia, bulimia, binge eating and related conditions) affect members of different demographic groups.

For example, in 2007, one of the first significant research efforts was conducted into eating disorders within the gay community. This study, which was undertaken at Columbia University's Mailman School of Public Health, found that gay and bisexual men are at higher risk for developing eating disorders than are heterosexual men.

The Scope of the Problem

According to an April 11, 2007 Columbia press release, the study involved 516 subjects (126 straight men and 390 gay or bisexual men and women). Findings included the following:

  • More than 15 percent of gay or bisexual men had at some time suffered anorexia, bulimia or binge eating disorder, or at least certain symptoms of those disorders (which is referred to as "subclinical eating disorder.")
  • Less than 5 percent of heterosexual men were found to have suffered from anorexia, bulimia, binge eating disorder or subclinical eating disorder.
  • Sexual orientation did not seem to influence the risk of eating disorder symptoms among women.
  • About 10 percent of lesbian and bisexual women and 8 percent of heterosexual women had ever reported having a subclinical eating disorder.


"It is not clear why gay men have high rates of eating disorders," reported the study's principal investigator, Ilan H. Meyer, PhD, and associate professor of clinical Sociomedical Sciences at the Mailman School of Public Health.

Dr. Meyer is quoted in the release as theorizing that the increased risk of eating disorders among homosexual men could be related to "the values and norms in the gay men's community [that] promote a body-centered focus and high expectations about physical appearance, so that, similar to what has been theorized about heterosexual women, they may feel pressure to maintain an ideal body image."

The Impact of Emotional Trauma

In a 2007 article about the documentary film "Do I Look Fat?" (which explored eating disorders and body image among gay men), Marc Breindel wrote about the impact that self-esteem issues may have on the heightened prevalence of disordered eating among homosexual men:

One crucial common factor that unites the men in "Do I Look Fat?" is low self-esteem. Whether because they're gay or because they've been overweight, all the subjects of the film have been put down for being who they are, and all have used food to deal with that pain -- through anorexia, bulimia, overeating or in other ways.

Several of the men in "Do I Look Fat?" have denied themselves food through either anorexia (extreme dieting) or bulimia (overeating and then throwing up – "bingeing and purging"). The doctors in the film say such behavior often has roots in childhood trauma.

"Once a young person internalizes the negative messages repeated by bullies and others, he's vulnerable to self-abuse," Breindel wrote on the website gay.com. "And if he's been taught that he's responsible for being as 'masculine' as possible, he may become obsessed with looking lean and hard."

Obstacles to Diagnosis and Treatment

The "Do I Look Fat?" website features an interview with Ted Weltzin, M.D., the Director of Eating Disorder Services at Rogers Memorial Hospital in Milwaukee, Wisconsin. In addition to the typical challenges in the diagnosis and treatment of eating disorders, Dr. Weltzin notes, a number of other obstacles often prevent gay men from getting the help they need:

  • Males typically don’t seek health treatment and they don’t seek treatment for this problem, so it’s impossible to get an accurate reflection of how prevalent male eating disorders are in the population.
  • Typical health care providers often don’t consider the possibility of eating disorders in males.
  • The majority of eating disorder literature and resources are geared toward female patients.
  • Stigma also plays a role. Family members link eating disorders and homosexuality, asking without any other evidence, "If he has an eating disorder, does that mean my son is gay?"


Whether suffering from the continued pain of childhood trauma or attempting to process feelings of confusion or inadequacy in adulthood, many gay men develop eating disorders as a means of either punishing themselves or establishing control over a life that can seem to be beyond their ability to influence, Dr. Weltzin said during the "Do I Look Fat?" interview.

"When people are questioning their self-esteem, not quite sure about who they are, feeling ashamed, feeling like there’s no one they can talk to, they tend to isolate and think, how can I deal with these feelings, and one of the ways is developing an eating disorder," he said.

Help Is Available

As is the case with teen girls, young women and anyone else who is suffering from an eating disorder, gay men who have anorexia, bulimia, binge eating disorder or any related conditions should not consider their situations to be hopeless. Eating disorders are not death sentences, though if left untreated, they can be fatal.

One of the most important steps in effectively treating an eating disorder is finding a program that can identify and address the specific needs, and possible co-occurring conditions, of each patient. If you or someone you love is showing symptoms of an eating disorder, get help today. Consult with your physician, contact an eating disorder support group in your area or visit an established eating disorder help website such as Something Fishy.

Eating disorders can be isolating, life-threatening illnesses, but help is available and recovery is possible.