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  • Writer's pictureDr Charlotte Ord

Eating Disorders in Boys and Men

Search “eating disorders” on Google, and you’ll find a wealth of images of young women. Despite this harmful stereotype, eating, weight and body image issues affect people of all ages and are becoming increasingly prevalent among boys and men. Indeed, approximately 1 in 4 eating disorder sufferers are male [1], and the long-term survival rate for males with eating disorders is lower than for females [2][3]. Research suggests that men and boys of racial/ethnic, gender and sexual minority groups are particularly susceptible to developing eating disorders of all types, including Binge Eating Disorder (BED), Bulimia Nervosa (BN), Anorexia Nervosa (AN), and Avoidant/Restrictive Food Intake Disorder (ARFID) [4][5][6].

The presentation of eating disorders among males may, or may not, vary greatly from female populations. For some, concerns about muscularity, leanness and body size are central to the development of disordered eating behaviours, which may lead to the development of muscle dysmorphia (MD). Studies suggest that around 22% of boys engage in activities driven by a desire to build muscle [7], including dietary adjustments to support muscle growth, weight training regimes, supplementation, and steroid use. Prepubescent boys as young as 6 have been found to prefer a lean, muscular physique, despite lacking the hormonal profile necessary to build muscle effectively [8]. Being of a higher weight also increases the likelihood of young men engaging in disordered eating behaviours such as restricting, fasting, missing meals, vomiting, binge eating and taking laxatives or diuretics, as seen in BED, BN, and AN [9]. Individuals who take part in aesthetic or weight-based sports such as boxing, dance, horse racing, bodybuilding and gymnastics are also at particular risk due to pressure to ‘make weight’ or meet sport-specific aesthetic ideals, meaning they engage in disordered behaviours to achieve these highly pressurised standards [10].

Whilst more emphasis, and certainly more research, has focused on the pressure girls and women are placed under to conform to unrealistic body ideals, there is undoubtedly also pressure on men and boys. Idealised traits typically associated with masculinity such as height, size, strength, muscularity and even aggression have contributed to widespread body dissatisfaction. Statistics from the Mental Health Foundation suggest that millions of UK men are affected by body image issues.

Despite the rise in eating disorders within the male population, many go undiagnosed and untreated. Doctors can be inclined to misdiagnose due to the assumption that eating disorders mainly affect women coupled with outdated eating disorder assessment tools which have historically been developed based primarily on female aetiology and symptomology. Additionally, male sufferers are less likely to seek support due to the double stigma they may face, with both eating disorders and psychological therapy characterised as “feminine” or “gay”. In order to tackle this, improved training for doctors, the use of assessment tools specifically for men based on user feedback and lived experience, more male-only treatment services and a more open conversation around the topic are called for.

More recently, and encouragingly, diagnostic tools such as the Eating Disorder Assessment for Men (EDAM), and measures of muscularity-oriented eating attitudes and behaviours such as the Eating for Muscularity Scale (EMS) have contributed to the improved clinical understanding, support, and treatment outcomes for boys and men [11] and campaigns such as those spearheaded by BEAT and Time To Change are tackling the unhelpful gender bias surrounding eating disorders and mental health more broadly.

If you are a male and are concerned you may be suffering from an eating disorder, or if you are concerned about a loved one, there is a lot of help available. Your GP will be able to support you in understanding more about assessment and treatment options and how to access these, and eating disorder charity organisations such as BEAT, the National Centre for Eating Disorders, Anorexia and Bulimia Care and TalkED offer free, helplines and support.

Above all remember that full recovery is possible. Early intervention has been shown to improve treatment outcomes [12] so it is important not to delay accessing support. Services can facilitate early intervention by removing arbitrary access criteria such as body mass index (BMI) and comorbidities [13] and friends and family can support boys and men in seeking help by creating a wider dialogue around eating disorders in males and normalising accessing treatment.

Having an eating disorder can be an incredibly isolating and engulfing experience. But there is hope. Reach out.


[1] Hudson J. Hiripi E. Pope H. Kessler R. The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biological Psychiatry. 2007;61:348–358.

[2] Fichter MM, Naab S, Voderholzer U, Quadflieg N. Mortality in males as compared to females treated for an eating disorder: a large prospective controlled study. Eat Weight Disord. 2021 Jun;26(5):1627-1637. doi: 10.1007/s40519-020-00960-1. Epub 2020 Aug 13. PMID: 32789622.

[3] Raevuoni, A., Keski-Rahkonen, Hoek, H. (2014) “A review of eating disorders in males.” Current Opinions on Psychiatry, 27-6, 426-430.

[4] Burke, N., Hazzard, V., Schaefer, L., Simone, M., O'Flynn, J., & Rodgers, R. (2022). Socioeconomic status and eating disorder prevalence: At the intersections of gender identity, sexual orientation, and race/ethnicity. Psychological Medicine, 1-11. doi:10.1017/S0033291722001015

[5] Jankowski GS, Diedrichs PC, Halliwell E. Can appearance conversations explain differences between gay and heterosexual men’s body dissatisfaction? Psychol Men Masc. 2014;15:68–77.

[6] Nagata JM, Ganson KT, Murray SB. Eating disorders in adolescent boys and young men: an update. Curr Opin Pediatr. 2020 Aug;32(4):476-481. doi: 10.1097/MOP.0000000000000911. PMID: 32520822; PMCID: PMC7867380.

[7] Nagata JM, Murray SB, Bibbins-Domingo K, Garber AK, Mitchison D, Griffiths S. Predictors of muscularity-oriented disordered eating behaviors in U.S. young adults: A prospective cohort study. Int J Eat Disord. 2019 Dec;52(12):1380-1388. doi: 10.1002/eat.23094. Epub 2019 Jun 20. PMID: 31220361; PMCID: PMC6901753.

[8] McLean, Sian, Wertheim, EH and Paxton, SJ (2018) Preferences for being muscular and thin in 6-year-old boys. Body Image, 26. 98 - 102. ISSN 1740-1445

[9] Nagata JM, Garber AK, Tabler J, et al. Prevalence and Correlates of Disordered Eating Behaviors among Young Adults with Overweight or Obesity. J Gen Intern Med 2018, 33:1337–1343.

[10] Karrer Y, Halioua R, Mötteli S, et alDisordered eating and eating disorders in male elite athletes: a scoping reviewBMJ Open Sport & Exercise Medicine 2020;6:e000801. doi: 10.1136/bmjsem-2020-000801

[11] Cooper, M., Griffiths, K. M., & Burns, R. (2020). Getting shredded: Development and validation of a measure of muscularity-oriented disordered eating. Psychological Assessment, 32(5), 451–460.

[12] BEAT(2018) www.

[13] Royal College of Psychiatrists (2019). Position statement on early intervention for eating disorders. Accessed via

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