09 Jun How to Treat Eating Disorders in Men

Eating disorders are mental health conditions, classified in the DSM-5- The Diagnostic and Statistical Manual of Mental Disorders. The American Psychological Association writes that boys and men make up almost 1/3 of those diagnosed with eating disorders. In a month that is dedicated to dads and men’s health, we want to address eating disorders, body dysmorphia, and disordered eating in men.

More importantly, we want you to know that treatment is available and recovery is possible.

Why are eating disorders in males often overlooked?

Eating disorders are often viewed through a female-centric lens. Statistically, more women than men struggle with anorexia, bulimia, BED, and disordered eating. This, though, can lead to a significant oversight of the impact of eating disorders on boys, men, and adolescents.

Cultural Stereotypes and Societal Expectations

For so long, studies and information about eating disorders have focused on women. Many men are conditioned to believe that seeking help for mental health issues, including eating disorders, is a sign of weakness. This belief is deeply rooted in traditional notions of masculinity that equate emotional vulnerability with femininity. Consequently, men may suppress their struggles, fearing judgment or a loss of societal stature. This internalized stigma not only deters them from seeking assistance but also perpetuates the misconception that eating disorders are predominantly female issues.​

Signs and Symptoms of Eating Disorders in Males:

Another obstacle to seeking help and early diagnosis is how eating disorders manifest themselves in males compared to females. Though they look different, they are just as serious.

1. Muscle Building: Males with eating disorders might prioritize gaining muscle mass to the point of excessive gym sessions, using supplements or steroids, or unhealthy eating practices to “bulk up.”

2. Sudden Changes in Weight: Rapid weight loss or gain is a red flag. This might be from strict dieting or overeating.

3. Excessive Exercise: For some, working out becomes more about control than fitness. A short workout can turn into hours at the gym. Be aware of injuries and exhaustion.

4. Distorted Body Image: Body dysmorphia is something many boys, adolescents, and men experience. If you constantly feel dissatisfied with your appearance (or notice that someone you love is struggling with this), it is important to get support.

5. Avoiding Meals in Social Settings: If you or someone you love has started to avoid eating around others, making excuses to skip meals during social gatherings, be alert. This is a coping mechanism to hide struggles with food. This isn’t healthy eating behavior.

6. Constant Worry About Food and Weight: If food, dieting, or weight become a daily obsession, it might be a sign of a deeper issue. Restricting food, binge eating, or compensating for meals through intense exercise are common behaviors.

7. Mood Changes: Eating disorders can bring on feelings of anxiety, depression, or irritability. Again, if you or someone you care about is withdrawing from social interactions, seems distant, struggles with their self-image and mental health, you should seek medical attention.

8. Physical Effects:  Do you feel tired all the time? Is your hair thinning? Are you experiencing digestive problems? These are all signs of eating disorders. In severe cases, men may experience heart problems or hormone imbalances due to unhealthy eating habit

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​Who is at risk for male eating disorders?

• Teens and Young Adults: Body image concerns often start in adolescence, when the pressure to fit in or look a certain way is high.

• Athletes:  Boys and adolescents in sports like bodybuilding or wrestling, where weight and appearance are critical to compete, may develop disordered eating to meet expectations. What starts as an athlete meeting their weight requirement can turn into disordered eating and an eating disorder.

• Mental Health Struggles: Adolescents and men dealing with anxiety, depression, or OCD may turn to eating disorders as a way of coping. Also, some boys with ADHD and autism struggle to establish a healthy relationship with food. They require extra support from a team that includes a pediatrician, therapist, and pediatric dietitian.

• Family History: If eating disorders or mental health issues run in the family, it becomes a risk factor as children might develop similar struggles.

• Gay and Bisexual Men: The LGBTQ+ community has an increased risk of experiencing eating disorders. NEDA outlines the risk factors, which include:

  • Fear or Rejection: Experiences of rejection from friends, family, or colleagues.

  • Negative Self-Beliefs: Internalized negative messages about oneself related to sexual orientation or gender identity.

  • Violence and PTSD: Experiences of violence and trauma, which increase the risk of developing an eating disorder.

  • Discrimination and Stigma: Facing stigma or discrimination due to sexual orientation or gender identity.

  • Bullying: Being bullied because of one’s sexual orientation or gender identity.

  • Body Image Pressure: Struggling to meet body image ideals within some LGBTQIA+ cultural contexts.

Outpatient Medical Nutrition Therapy with Eating Disorder Dietitian Nutritionists in New York- Achieve Recovery

The first thing we need to do as a community and healthcare providers is talk about eating disorders in men. So many go undiagnosed and untreated simply because they feel ashamed, don’t recognize their disordered eating or eating disorder, or think they have it “in control.” Another issue men face is that they often feel alienated, especially in group settings. So, treatment options are similar to that of women with some modifications.  As is with women, there needs to be a treatment team that includes a therapist, psychiatrist (when needed), primary care physician, and dietitian nutritionist. We work with your treatment team to ensure comprehensive care.

1. Assessment and Diagnosis: After understanding your medical and psychological evaluations, we can help identify specific eating disorder behaviors, including restrictive eating, bingeing, purging, and excessive exercise.

2. Nutritional Rehabilitation: A dietitian nutritionist can develop an individualized meal plan to help you restore nutritional balance. We will also help you implement healthy eating habits, focusing on balanced meals with appropriate calorie intake. In cases of significant weight loss, we will work toward healthy, slow weight restoration.

3. Monitor and Address Excessive Exercise: This is one of the key signs of eating disorders in males — excessive exercise as a compensatory behavior. We can work to establish a healthy exercise plan that includes rest, balance in physical activity, and body healing. We can also work with your coach or trainer to make sure everyone is working toward the same healthy goals.

4. Support Body Image Healing: It is essential to address body image issues through therapy with the support of your dietitian nutritionist.

5. Ongoing Support and Monitoring: You or your loved one didn’t develop an eating disorder overnight, and recovery takes time, constancy, and continued support. This can involve family and close friends, your coach and trainer, and, of course, your RDN.

Eating disorder treatment in men requires a comprehensive, individualized approach. With the right treatment, men can recover fom eating disorders and build a healthier relationship with food and their bodies.