The first clinical reporting of a man with an eating disorder occurred in 1689, yet men have often been left out or sidelined in eating disorder research, prevention, and treatment. There is a pervasive stereotype that eating disorders predominately impact women, particularly white, cisgender, heterosexual, and economically advantaged women. While eating disorders certainly impact this population, they can also impact individuals of any gender, sexual orientation, race, ethnicity, or socioeconomic class. However, the eating disorder stereotype has shaped eating disorder assessment, research, and treatment leaving large gaps in how we understand, diagnose, and treat eating disorders in men.
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Eating Disorders Diagnosis in Men
Eating disorder diagnostic tools were primarily developed and validated among European American female samples. As such, these tools often miss the ways in which POC and white men experience eating disorders. For example, diagnostic tools that assess eating disorders often measure an individual’s drive for thinness. While a strong drive for thinness may be an important precursor to an eating disorder among certain populations of women, it may not be relevant for certain populations of men. Current research suggests that precursors for eating disorders in white men are a drive for muscularity and a tendency to use steroids to change body and weight. As such, measurements that assess thinness as opposed to muscularity may miss white men with eating disorders, leading not only to underreporting of eating disorders in men but also to underdiagnosis. Without a diagnosis, men have limited options for treatment and subsequently little hope for recovery.
Eating disorders can also be a reflection of how an individual experiences their body. When thinking about gender in binary terms, men and women experience their bodies differently. For example, the female body is often culturally construed as an object with an emphasis on appearance (i.e., objectification). In contrast, the male body is often constructed as functional and instrumental, focusing on physical ability and muscularity. These differences can lead to different social pressures and associated behaviors around appropriate body and weight. And although the pressures are different, both men and women suffer in response to one-dimensional cultural expectations. Furthermore, experiences of racism, acculturative stress, homophobia, and transphobia can greatly impact racial and ethnic minority men, men who have sex with men, and transmen, influencing eating disorder diagnosis. Although there is scant research on eating disorders in men who identify as people of color, the prevalence of eating disorders among transmen and sexual minority men is up to 4x higher than their cisgender, heterosexual counterparts.
Eating Disorders Treatment in Men
Even with limitations in eating disorder tools and gaps in research that assesses men with eating disorders, 12.8% of adolescent boys met the criteria for an eating disorder diagnosis and 15% of young men engage in disordered eating behavior. Men represent 25% of all eating disorders and 40% of those with Binge Eating Disorder. Yet the stigma and stereotypes around eating disorders often serve as a barrier to treatment. Research on men in eating disorder treatment found that many men feel isolated and stigmatized during interactions with physicians, counselors, and therapists. Research also showed that men feel judged and unsupported by other female patients with eating disorders, hindering their treatment and recovery process. Men who do seek treatment have much higher eating disorder symptomatology at follow-up and higher rates of relapse post-treatment than females, indicating that better gender-based treatment is needed. There is both a need and an imperative to reduce the stigma and stereotypes associated with eating disorders to better serve, treat, and prevent eating disorders among men.
At the National Alliance for Eating Disorders, we work to reduce the stigma surrounding eating disorders in men. Regardless of gender, sexual orientation, race, ethnicity, or socioeconomic class, we believe that every individual deserves access to eating disorders treatment. If you or someone you love is struggling with an eating disorder, please reach out to us at The Alliance. Our team is uniquely qualified to connect you with the support needed to begin your recovery journey. Visit our national, interactive database to find eating disorder treatment near you today or reach out to us for more help and resources.
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Nina Taylor, MPH graduated from Lesley University with BA in graphic design, from George Washington University with an MPH, and is a candidate for a PhD in Public Health from Oregon State University. Since completing her undergraduate degree, Nina has been involved with program development, evaluation and dissemination to improve health outcomes among underserved populations. During her PhD, Nina’s research has been focused on weight stigma and disordered eating. More specifically, Nina’s research aims to understand how social and cultural norms impact weight bias and influence disordered eating behavior, especially among adolescents and young adults. When not working, you can find Nina teaching yoga or swimming in the ocean.