Prevalence of Eating Disorders in Males

Eating disorders have long been considered the afflictions of young, affluent, white females.  New research shows, however, that at least one of these stereotypes may be outdated.  Eating disorders among boys and men are on the rise.  Several factors may contribute to this phenomenon.  Theories that account for the sudden increase in eating disorders among males include a greater likelihood that males will report having an eating disorder, evolving cultural norms regarding the male physique, and a broadening definition of what may constitute disordered eating.

As recently as the 1990s, research maintained a broad consensus that only 10% of disordered eaters were male.  Some research also made the distinction that only 10% of disordered eaters that came to the attention of mental health professionals were male.  This distinction may partially account for the recent increase in eating disorders among males, if males are becoming more likely to report their behaviors to health professionals.  Historically, the social stigma around eating disorders has been much stronger for males.  Males have been more reluctant to admit that they are suffering, and more likely to worry that they will be seen as feminine for having an eating disorder. 

In February 2007, a Harvard study of eating disorders upset the accepted male-female paradigm.  The Harvard study found that in a population of 3,000 adults, one-quarter of those with eating disorders and 40% of binge eaters were male.  In 2000, Iowa University researcher Dr. Arnold Andersen also found that men are far more likely to develop eating disorders than previously thought.  He also found that the physical effects of disordered eating can differ between men and women.   Dr. Andersen’s research found, among other things, that osteoporosis as a consequence of disordered eating can be more severe for men. 

Dr. Andersen’s research also revealed some significant variances between the manifested attitudes of males and females with eating disorders.  Dr. Anderson found that men are more likely to obsess over the general shape of their bodies, or a certain body type, than their weight; they focus on their torsos and arms, giving less attention to their lower bodies; and they are more likely to establish short-term, performance-based goals for their bodies, as opposed to simply trying to lose weight.

Until recently, research in the area of eating disorders concluded that eating disorders among males were clinically indistinguishable from those among females.  Traditionally, diagnosis and treatment of eating disorders has been geared almost entirely for women.  However, some experts are now questioning whether accepted diagnostic criteria and treatment programs can adequately address what appears to be a growing problem among boys and men.  For example, 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.  Males with eating disorders obviously don’t fit these two criteria.

However, research has found that homosexual males do obsess over weight, rather than athletic performance, in contrast to other males with eating disorders.  Research shows that homosexual males are also more likely to develop eating disorders than heterosexual men.  Homosexual men may have increased risk of developing eating disorders, especially anorexia, because of cultural pressure to be thin. 

A broadening definition of what constitutes an eating disorder may also account for greater recognition of eating disorders in males.  The 2007 Harvard study indicates 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.  Society condones binge eating among males, but not among females.  Consuming large amounts of food has long been considered a masculine activity; it has never been positively associated with females.  However, in a society where machines perform more and more of the necessary manual labor and humans spend more and more time in front of computers and televisions, the biological need for humans to consume large quantities of food is diminishing.  Research links male binge eating with low self-esteem, especially relating to physical competitiveness and sexual attractiveness. Binge-eating is also strongly linked obesity and with genetics.

Anorexic and bulimic males often develop eating disorders in connection with athletic performance.  They focus on their percentage of body fat and severely restrict their diets (or purge certain foods) based on which foods they believe will and won’t give them a competitive edge.  Males who are fixated on athletic performance to this extreme may also engage in other drastic behaviors such as steroid use and compulsive exercise.  In addition, athletic teams and coaches often instill unhealthy eating and exercise habits as components of physical conditioning. 

References

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.