Male Eating Disorders: Why Boys Are Often Overlooked in Eating Disorder Conversations

Eating disorders have long been stereotyped as a female issue, leading to underdiagnosis and lack of awareness about their prevalence in boys. However, research shows that one in three people with an eating disorder is male, highlighting the need for greater recognition and support. Despite this, boys and young men often go unnoticed in discussions about eating disorders due to misconceptions, social stigma, and gender biases in diagnosis (Murray et al., 2017).

The Growing Awareness of Eating Disorders in Boys

·         Underreported Cases

o    Due to the societal perception that eating disorders predominantly affect females, many boys with eating disorders go undiagnosed or untreated.

§  Studies estimate that males make up about 25% of all cases of anorexia nervosa and bulimia nervosa and nearly 40% of binge-eating disorder cases (Hudson et al., 2007).

o    Boys with eating disorders often face delayed diagnosis because their symptoms can present differently than in girls.

o    Increased media attention on male body image pressures (muscularity, athleticism) has helped raise awareness of male eating disorders, but more education and research are still needed.

How Eating Disorders in Boys Differ from Those in Girls

·         Different Body Image Concerns

• While girls with eating disorders often strive for thinness, boys are more likely to be concerned with muscularity and leanness

• Muscle dysmorphia (also called "bigorexia") is a growing issue among boys, where they obsess over increasing muscle mass while fearing they are too small or weak(Griffiths et al., 2018).

• Boys may engage in extreme exercise, strict dieting, steroid use or excessive protein consumption to achieve an "ideal" physique.

• Underdiagnosis and Atypical Symptoms

·         Many diagnostic criteria for eating disorders were developed based on female cases, leading to misdiagnosis or overlooked symptoms in boys(Strother et al., 2012).

·         Boys are less likely to report fear of weight gain, but they may still struggle with food control, excessive exercise, and body dissatisfaction.

·         Binge eating disorder (BED) is particularly common among boys but often goes unrecognized.

·          Lack of Awareness Among Healthcare Providers

o    Many healthcare professionals receive limited training on eating disorders in males, leading to missed or delayed diagnoses.

o    Symptoms may be misinterpreted or dismissed, particularly if the individual does not fit the stereotypical profile of someone with an eating disorder (Nagata et al., 2020).

·         Social and Cultural Stigma

o    There is a false perception that eating disorders are a "women’s issue," making it harder for boys to seek help(Strother et al., 2012).

o    Boys may feel ashamed or worry about being seen as weak if they admit to struggling with food and body image.

o    The pressure to "tough it out" or ignore emotional distress can lead to worsening symptoms and reluctance to seek treatment.

o    Media portrayals of the "ideal male body" emphasize lean, muscular physiques, creating unrealistic expectations for boys and men.

o    Social media, fitness culture, and celebrity influences contribute to body dissatisfaction and disordered eating behaviors (Leit et al., 2002).

·         Sports and Performance Pressures

o    Boys involved in sports that emphasize weight categories (e.g., wrestling, rowing, gymnastics) may be at increased risk for developing disordered eating patterns.

o    The pressure to maintain a specific body composition for performance reasons can encourage unhealthy habits such as food restriction or excessive exercise

Encouraging Early Recognition and Support for Boys

·         Raising Awareness

• Schools, doctors, and parents need to recognize that eating disorders affect all genders and be aware of the unique ways they manifest in boys.

• More education on male-specific body image pressures and eating disorders should be included in health curricula and awareness campaigns.

•  Changing Diagnostic Criteria and Treatment Approaches

• Medical professionals should be trained to recognize male-specific symptoms, such as excessive exercise, compulsive muscle-building behaviors, and supplement misuse.

• Treatment programs should be inclusive of boys' experiences, addressing their unique struggles with body image and societal expectations (Murray et al., 2017).

• Creating Safe Spaces for Boys to Seek Help

• Schools, sports teams, and community groups should foster open conversations about male body image and eating disorders.

• Encourage non-judgmental support systems where boys feel comfortable discussing their struggles without fear of stigma.

• Promote healthy eating and exercise habits that focus on well-being rather than unrealistic physical ideals.

Conclusion

The stigma and misconceptions surrounding male eating disorders have led to underdiagnosis, lack of treatment, and silent suffering for many boys. By raising awareness, improving diagnostic criteria, and fostering supportive environments, we can ensure that boys struggling with eating disorders receive the recognition, care, and support they need. Recognizing that eating disorders affect all genders is a critical step toward breaking stereotypes and providing inclusive treatment options.

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Disclaimer: This information is provided for educational purposes and is not a substitute for professional medical advice. If you suspect your child is experiencing issues related to disordered eating, please consult a healthcare professional immediately.

References:

1. Griffiths, S., Murray, S. B., Krug, I., & McLean, S. A. (2018). The role of muscularity concerns in the relationship between exercise addiction and eating disorder symptoms in men. Eating Behaviors, 29, 1-5.

2. Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3), 348-358.

3. Leit, R. A., Pope, H. G., & Gray, J. J. (2002). Cultural expectations of muscularity in men: The evolution of playgirl centerfolds. International Journal of Eating Disorders, 29(1), 90-93.

4. Murray, S. B., Nagata, J. M., Griffiths, S., Calzo, J. P., Brown, T. A., Mitchison, D., & Blashill, A. J. (2017). The enigma of male eating disorders: A critical review and synthesis. Clinical Psychology Review, 57, 1-11.

5. Nagata, J. M., Murray, S. B., Compte, E. J., Pak, Y. S., Scharf, R. J., & Garber, A. K. (2020). Underdiagnosis of eating disorders among adolescent boys: A call for action. Journal of Adolescent Health, 66(4), 436-439.

6. Strother, E., Lemberg, R., Stanford, S. C., & Turberville, D. (2012). Eating disorders in men: Underdiagnosed, undertreated, and misunderstood. Eating Disorders, 20(5), 346-355.