Although it isn't as widely known or talked about, men are also susceptible to disordered eating, exercise, and body image issues. It's estimated that:
- 10 to 15% of people with bulimia are male.
- 5 to 10% of people with anorexia are male.
- 40% of people with binge eating disorder are male.
- 5 to 20% of male university students are at risk.
- The typical age of onset for eating disorders in men is at 14 to 16 years of age.
There are some important differences in the way men and women experience eating and exercise disorders. According to Dr. Roberto Olivardia, researcher and co-author of The Adonis Complex, males tend to:
- Experience greater weight fluctuations, and to have been overweight or obese when the disorder started
- Have a clearer perception of their ideal body weight
- Pursue leanness and muscularity over thinness per se
- Binge more often, especially on carbohydrates
- Exercise excessively
- Have an increased prevalence for substance abuse
- Have more sexual conflicts
- Be less likely to seek treatment
This last characteristic is the most critical, say experts. Delays in receiving treatment result in a risk of reduced treatment effectiveness, and an increased risk of medical complications. Delays also increase the risk for depression and problems with school, work, and relationships.
Experts in the field have found that gay men are not at higher risk for eating disorders. Gay men, having already confronted perceptions of not being masculine, are simply more likely to discuss, dialogue, and get support for eating, body image, and exercise issues than heterosexual men.
There are certain factors which can predispose men to eating disorders:
- A transition to puberty that feels overwhelming
- Being a “late bloomer”
- Being perfectionistic and having a high need for control on various levels
- Having low self-esteem or low assertiveness
- Being an athlete (wrestlers, gymnasts, jockeys, runners, bodybuilders)
- Experiencing depression, substance abuse, obsessive-compulsive disorder, or obsessive-compulsive personality disorder.
In our culture, muscularity equals masculinity for many men. Strength, power, respect, threat, admiration, attractiveness, confidence, and sexual virility become conflated with muscularity, making this facet of appearance feel emotionally paramount for some men.
That’s where steroid use comes in. Say the authors of The Adonis Complex:
“…steroids have created athletes, actors, and models bigger and stronger than any ordinary man, and the media have promulgated their images everywhere. These images have glorified the steroid-pumped body, portraying it as a model of health, athletic prowess, hard work, and dedication—while almost never admitting that it was a product of dangerous chemicals.”
And the prevalence of use of these dangerous chemicals by males is much higher than people think: it’s estimated that 1 to 3 million males in the U.S. have used steroids.
Short term consequences include:
- Gynecomastia (breast enlargement)
- Testicular shrinkage
- Hair loss
Longer-term consequences include:
- Negative changes in the ratio of HDL (“good” cholesterol) to LDL (“bad” cholesterol)
- Atherosclerosis (hardening of the arteries) eventually leading to heart attacks, strokes, and other complications at an early age
- Risk of prostate cancer
- Liver damage
Consequences of steroid use also involve psychological effects:
- Unpredictable mood changes (depression, mania)
- Psychotic delusions
- Increased likelihood of violence against women
It can be difficult to understand why anyone would repeatedly engage in a behavior that is ultimately harmful, but it’s important to know that eating and exercise disorders are foremost, an attempt at a solution.
And in a culture that glorifies body types radically at odds with physiological health, and that normalizes extremes of behavior with eating and exercise, it can be difficult for someone with a disorder to believe that he has a problem with food, exercise, or shape. This struggle is even worse for men, because they aren’t “supposed” to be vulnerable to these issues. Even if a man is able to acknowledge some personal concern, the fear of losing what might feel like his primary source of identity or self-esteem is often powerful enough to make a him want to defend or preserve this way of coping.
Dan Reiff, MPH RD, and co-author of Eating Disorders: Nutrition Therapy in the Recovery Process, uses an analogy he calls “The Helicopter Story.” In it, he likens the ambivalence of someone considering eating disorder recovery to a person, unable to swim, who has been stranded in the middle of the ocean with only a life-jacket to keep him afloat. Rescue by helicopter will prevent him from ultimately drowning or dying of hypothermia, but the helicopter team tells the swimmer that he will need to give up his life-jacket in order to be pulled on board. It’s a daunting prospect, and it’s also the reason why men with eating disorders need time and lots of expert support in order to give up their behaviors and recover completely.
When medical support, nutrition work, and psychotherapy are utilized, recovery is completely possible for men with eating disorders. Chances for complete recovery are highest when men receive early, expert treatment at the right level of intensity.
If you are worried that a friend has an eating disorder, click for information and resources.
BWell Health Promotion 401.863-2794
Located on the third floor of Health Services.
Confidential information or care is available through individual appointments or phone consultation with a Nutritionist. Students can discuss personal eating concerns, as well as any concerns they may have regarding a friend, a roommate, or a teammate. Health Promotion also offers workshops, pamphlets, and reading materials covering these and related issues. There are no fees for Health Promotion services.
University Health Services 401.863-3953
Located at the corner of Brown and Charlesfield streets.
Confidential information and care is available on a walk-in, or by scheduled appointment basis. Care is available for initial, current or past disordered eating patients. There are no fees for medical care at Health Services. However, there may be fees incurred if laboratory tests, medications, specialist or emergency hospital care is needed.
Counseling and Psychological Services 401.863-3476
Located on the fifth floor of J. Walter Wilson.
Confidential appointments are available at Counseling and Psychological Services for students concerned about their eating issues. Guidance is also available for those who are concerned about a friend, roommate, or teammates' eating. Services include crisis intervention, short-term psychotherapy and referrals. There are no fees for appointments at Counseling and Psychological Services.
This site looks at ways we can feel good in the bodies we have. One of their slogans: "Remember, your body hears everything you think." Other topics on the web site: Size Acceptance; What do you say when everyone around you is dieting? 200 Ways to Love the Body You Have; Dieting Detox; Evaluating Weight Loss Programs: What are the Red Flags? Free subscription to email newsletter "Body Positive Pages."
This site provides signs of eating disorders, motivational support talks, information on cultural issues and how to help loved ones.
National Eating Disorders Association
This site provides general information about eating disorders and body image concerns, tips for helping a friend and referral sources.
Eating Disorders Referral and Information Center
Provides information and treatment resources for all forms of eating disorders.
The American Dietetic Association
Articles from the ADA on eating disorders, including The Female Athlete, Compulsive Eating and Anorexia.
Disclaimer: BWell Health Promotion is part of Health Services at Brown University. Health Promotion maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Promotion offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.