Historically, eating disorders have been almost exclusively associated with females. Research as recently as the 1990s posited that only 10% of all individuals with eating disorders were male. In February 2007, a Harvard study reported shocking results. The survey found that in a population of 3,000 adults, one-quarter of those with eating disorders and 40% of binge eaters were male. Up until recently, diagnosis and treatment of eating disorders has been geared almost entirely for women. However, some experts are now paying more attention to addressing what appears to be a growing problem among boys and men.
As early as 2000, a researcher at Iowa University, Dr. Arnold Andersen, had similar findings. According to his research, men are far more likely to develop eating disorders than previously thought, and in the case of osteoporosis, the consequences of eating disorders can be more severe for men. Dr. Andersen's research also highlighted some important differences between males and females with eating disorders. Dr. Anderson found that men tend to fixate on the shape of their bodies, or a certain body type, rather than their weight; they tend to be more concerned with their torsos and arms, less concerned with their lower bodies; and men tend to have specific short-term reasons or goals for their bodies, such as athletic competition.
Almost all diagnostic criteria and tools developed for eating disorders are female-oriented. Two primary symptoms listed in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) for anorexia include menstrual irregularity and an intense fear of gaining weight. A male battling anorexia would almost certainly miss the mark for these two criteria. Experts say that males with eating disorders tend to obsess over particular body types, rather than weight, and that these types can vary drastically. One may want to be lean, another extremely muscular.
Males tend to develop eating disorders in connection with athletic performance. They typically obsess about their percentage of body fat. They develop food phobias based on what will and won't give them a competitive edge. This fixation with performance often leads them to other drastic measures such as steroids and compulsive exercise. In addition, athletic teams and coaches often encourage unhealthy eating and exercise practices as a part of physical conditioning. Sports that require weigh-ins, such as wrestling, boxing, and crew, are the most susceptible to extreme eating and exercise regimens. Males may choose to go along with these habits, rather than risk being labeled a wimp.
In contrast to other males with eating disorders, research has found that homosexual males do obsess over weight, rather than athletic performance. Homosexual males may have increased risk of developing eating disorders, especially anorexia, because of cultural pressure to be thin.
The 2007 Harvard study also recognized that binge-eating (without purging) is the most prevalent eating disorder in the United States, and that up to 40% of binge eaters are male. As a disorder, binge-eating presents a drastically different picture than anorexia or bulimia. Binge-eating is strongly linked obesity and with genetics. Like other eating disorders, however, binge-eating does possess an emotional component. Experts have connected male binge eating with low self-esteem, especially relating to physical competitiveness and sexual attractiveness.
Currently, there are several significant obstacles to treating men with eating disorders. Because male eating disorders do not tend to fit prevailing social perceptions, men are less likely to recognize their own problems. The social stigma around eating disorders may be stronger for males. Males are more reluctant to admit that they are suffering, and may worry that they will be seen as feminine for having an eating disorder. These factors make males more reluctant to seek help. In addition, inpatient treatment programs for males are rare. In addition, it can be difficult for a man to find a program that offers male-only group therapy and rehabilitation activities. Experts have found that eating disorders are best treated in same-sex only settings; emotional issues relevant to these disorders tend to be gender-specific, and men may be particularly embarrassed to discuss their concerns in front of women.
Although scientists do not fully understand the root causes of eating disorders among women or men, new work is being done to develop diagnostic criteria, treatments, and facilities to meet the particular needs of males with these disorders.
Andersen et al. Osteoporosis and osteopenia in men with eating disorders. The Lancet, Vol. 355; June 3, 2000: pp: 1967-1968
Hudson, James I. M.D., Sc.D., et al. The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. Biological Psychiatry. February 2007.
Bernstein, Elizabeth. Men, Boys Lack Options to Treat Eating Disorders. The Wall Street Journal. April 17, 2007.