Key Takeaways
- Eating disorders affect men, and the signs are often mistaken for discipline or fitness
- Anorexia, bulimia and binge eating disorder all occur in men
- Some men restrict to get lean or build muscle rather than to be thin
- Trauma, PTSD and substance use often sit underneath, and are best treated together
- Close to half of the people in our Las Vegas eating disorder program are men
When people picture an eating disorder, they rarely picture a man. That is a large part of why men with eating disorders go so long without help. Their restriction gets called discipline, their purging stays hidden, and their binge eating gets treated as a willpower problem.
At Virtue Recovery Center, close to half of the people in our eating disorder program are men. This guide is for them and for the people who love them: how common eating disorders in men really are, the signs that get missed, and what treatment looks like.
How Common Are Eating Disorders in Men?
More common than most people think. Eating disorders affect people of all ages, backgrounds, body weights and sexes, and researchers now describe eating disorder symptoms in a substantial minority of men.[1][2]
A 2017 review in Current Psychiatry Reports put it plainly: eating disorder symptoms are more common in men than previously understood[2]. In our own program the men are not the exception; they sit at the same table, in the same groups and in the same villa as everyone else, with private rooms for every person.
Why Do Men With Eating Disorders Get Missed?
Mostly because nobody is looking for them. Eating disorders are still pictured as something that happens to young women, so a man who is restricting, purging or bingeing often hears that he is disciplined, into fitness, or just stressed.
Men also tend to describe the problem differently. Instead of wanting to be thin, many talk about getting lean, cutting, or building muscle. Research has increasingly focused on this muscularity-oriented side of disordered eating in men[2], and one study found men with muscle dysmorphia and men with anorexia shared widespread similarities in body image, eating and exercise behavior[3]. Signs that are easy to read as healthy habits:
- "Disciplined" training that never takes a day off
- Cutting food groups in the name of fitness
- Eating alone or in secret
- Anxiety when a workout or meal plan is disrupted
Anorexia, Bulimia and Binge Eating in Men: The Signs
The core symptoms are the same for every sex[1]. What changes is how they get explained away.
Male Anorexia: What Anorexia in Men Looks Like
Anorexia involves extremely restricted eating, an intense fear of gaining weight and a distorted body image[1]. Male anorexia can look like an athlete who keeps cutting, a man who has turned every meal into a rule, or someone whose body image is fixed on looking lean. Anorexia can be fatal[1], in men as in anyone. Our page on anorexia treatment explains how we treat it.
Bulimia in Men
Bulimia involves cycles of eating and then compensating, by throwing up, using laxatives or exercising excessively[1]. When the compensating is exercise, it is easy to miss, because it looks like training. More on how we treat it: bulimia treatment.
Binge Eating in Men
Binge eating disorder means eating unusually large amounts of food in a short time, often alone or in secret[1]. Men who binge often hear that it is a willpower problem. It is a disorder, not a character flaw. See our page on binge eating disorder treatment.
"Eating disorders are not a choice."
What Often Sits Underneath an Eating Disorder in Men
Among the men we treat, the eating disorder is rarely the whole story. Trauma, PTSD, anxiety and depression are common, and so is drinking or drug use that started as a way to cope. For veterans, restriction often started with military weigh-ins and body standards, and military sexual trauma or PTSD can sit underneath it.
Our program is built for that overlap. When a mental health condition or substance use is active alongside the eating disorder, it is treated at the same time, in the same plan, by the same team. If substance use is part of it, our page on eating disorders and addiction explains how that works.
Why Men With Eating Disorders Often Wait to Ask for Help
For many men, the hardest part is not admitting something is wrong. It is picturing themselves in eating disorder treatment at all. They expect to be the only man in the room, or to be told their problem is not serious enough to count.
If that is what is stopping you, here is what our program actually looks like. Close to half of the people in it are men. Groups are mixed, every room is private, and the clinical team treats a man who restricts to stay lean, purges after training or binges at night with the same seriousness as anyone else. You do not need to be sure it is an eating disorder before you call. That is what a clinical assessment is for.
A few questions worth asking yourself honestly: Does missing a workout or breaking a food rule leave you anxious for the rest of the day? Are you eating in secret, or hiding how much you exercise? Have friends, a partner or a doctor said they are worried? If the answer to any of these is yes, it is worth a conversation.
Eating Disorder Treatment for Men at Virtue
Our residential eating disorder treatment runs in its own villa on the Corbett campus in Las Vegas, for adults 18 and older. Every room is private. Specialty eating disorder techs and a chef prepare each meal to the person's plan, and our dietitian, Laura De Fiesta, MS, RD, LD, leads nutrition care. Therapy includes CBT, DBT, motivational interviewing and trauma-informed care, alongside food exposure work and an intuitive eating approach.
For men whose eating disorder grew out of training, the intuitive eating approach is a big part of the work. It moves eating away from rules, macros and punishment, and toward noticing hunger and fullness again. In food exposure groups, men prepare and eat the foods they have cut, at a pace they help set, with staff beside them.
Veterans can be referred through VA Community Care, and stays the VA authorizes can be extended when more time is needed. Read more about treatment for veterans. If you are not sure whether what you are dealing with counts, call. Admissions can talk it through and arrange a clinical assessment.
Sources
- [1] National Institute of Mental Health. Eating Disorders: What You Need to Know. National Institutes of Health.
- [2] Lavender, J. M., Brown, T. A., & Murray, S. B. (2017). Men, Muscles, and Eating Disorders: an Overview of Traditional and Muscularity-Oriented Disordered Eating. Current Psychiatry Reports, 19(6), 32.
- [3] Murray, S. B., et al. (2012). A comparison of eating, exercise, shape, and weight related symptomatology in males with muscle dysmorphia and anorexia nervosa. Body Image, 9(2), 193 to 200.
- [4] National Institute of Mental Health. Eating Disorders. National Institutes of Health.
- [5] Veterans Crisis Line. Dial 988 then press 1.
Written by
Director of Nursing
Dani Jo Turnbo is a Registered Nurse and Director of Nursing at Virtue Recovery Center Killeen, a behavioral health and addiction recovery leader passionate about clinical excellence and changing lives. In her role, she leads the nursing team in delivering safe, attentive medical care for clients throughout treatment, helping ensure that each person receives compassionate, whole-person support at every stage of recovery.
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