Men and Eating Disorders
When you think of someone with an eating disorder, chances are you imagine a young, cisgender woman—thin, anxious, and often running for exercise. Women are indeed at least four times more likely to have eating disorders than men—but that doesn’t mean they’re non-existent in cisgender men. In fact, we have good evidence that more and more men are experiencing a range of eating disorders.
According to most peer-reviewed studies, between 0.7% and 2.2% of males do experience an eating disorder during their lifetime, including sub-threshold or atypical eating disorders (that is, ones that cause significant distress but doesn't meet the full diagnostic criteria for anorexia nervosa or other conditions). That’s roughly a quarter of all people who have an eating disorder. It’s hard to say how accurate those numbers are, however, because eating disorders in men present so differently from the way they do in women, which means they’re less likely to be screened and diagnosed—and men are vastly less likely than women to self-refer for eating disorders treatment.
Symptoms can be subtle. A young man might insist on bringing his own high-protein meal to a family gathering. He might panic if he misses a workout. He might speak constantly about macros and muscle definition, masking disordered behaviors as “fitness discipline.” These patterns can be just as harmful as the classic signs of anorexia or bulimia—leading to nutrient deficiencies, injury, depression, and social isolation—but they don’t always fit the diagnostic boxes we’ve built with women in mind.
What does an eating disorder look like for cis men and boys?
Muscularity. For many boys and men, the cultural pressure isn’t to be thin—it’s to be big. They chase a body that is lean but muscular, one that broadcasts strength and control. This drive can manifest in muscularity-oriented disordered eating behaviors: strict bulking and cutting cycles, excessive protein consumption, compulsive weight-training, dehydrating, and even misusing supplements or anabolic steroids. While women may more often restrict calories to shrink their bodies, men may overeat in pursuit of size or a hyper-defined physique.
Weight loss desires from social pressures. While there are men who want to bulk up—and certainly that is a driving force—there are also boys and men who want to slim down, for many reasons that have nothing to do with health. Perhaps they were bullied as boys for being fat, or they are gay men who feel intense social pressure to look a certain way.
Caloric imbalance arising from depression and anxiety. In some cases, it’s not an issue with body image that created the eating disorder. Men and boys who get depressed can lose their appetite. This leads to caloric restriction, which can lead to mood disorders—which can drive eating-disorder thoughts, like being excited about the restrictions. I had a young cis male client in his early 20’s in my therapy practice who talked about dealing with depression and losing his appetite in high school, which led to body-image issues. I remember being confused when I was seeing him, as I tend to see body-image concerns as driving the eating disorder; it didn’t occur to me that what I see are female patterns; for men and boys with caloric imbalances, their eating disorders thought processes are different. It’s often from restrictions that body-image concerns arise.
Hidden and glamorized behaviors. In some cases, the glamorization of the behaviors can help hide the seriousness of their impact. "Males tend to hide the disorder behind strict dietary regimens and intense sports practices,” finds one 2025 study. “They are often involved in physical activities emphasizing muscularity and are more inclined than females to engage in excessive physical exercise.” When everyone around the man praises and admires these activities, we can miss the toll they’re taking.
Not seeking treatment. As the 2025 study cited above says, “Men with EDs often delay help-seeking and tend to present later in the course of their illness when ED behaviors and symptoms are more severe and less tractable to intervention.” When they do seek treatment, they feel they’re risking a double stigmatization: “the shame of having a disease considered typically female on one hand, and the conflict with masculine identity on the other one.” These combine to discourage treatment-seeking.
Not being screened. Even if a man gets into a clinician’s office, the provider may simply not be looking for an eating disorder because the patient is a man—or they may be looking for signs that are common in women but not in men.
Which men are most at risk? According to a 2019 study by Jason Nagata and colleagues, it’s Black men, and many men who might have felt themselves too skinny in adolescence, who may have been prone to depression and drinking. Other studies have found that body-conscious gay and bisexual men are more at risk. For example, one 2000 paper by S.M. Strong and colleagues found that gay and bisexual men were ten times more likely than heterosexual men to show symptoms related to disordered eating. In short, eating disorders are much more prevalent among our most historically marginalized populations of men—which is probably yet another factor in their relative invisibility, in both academic research and popular culture.
So, how do we make eating disorder services work better for men?
First, we need to make them visible in the conversation. Too many public-health campaigns, treatment center brochures, and media portrayals center only on thin women. When men see themselves reflected in awareness efforts—whether that’s through images of athletes, stories from male survivors, or frank discussions about muscularity and masculinity—they’re more likely to recognize their own struggles.
Second, the language we use matters. Terms like “muscle dysmorphia” or “body-image concerns” may resonate more with men who recoil from words like “dieting” or “eating disorder.” Clinicians can invite disclosure by asking open-ended questions about fitness routines, supplement use, and body goals, not just about calorie restriction or weight loss.
Third, treatment models should adapt. Men may benefit from therapy groups that address the specific cultural pressures they face, including the expectation to appear strong and unemotional. Bringing in male peers or facilitators can help break the silence, creating a space where vulnerability feels less like a threat to masculinity and more like a step toward health. And of course, clinicians just need more training and awareness. The link between caloric restriction and depression could be especially helpful in spotting and treating depression in boys.
We need more research, too, and we need to change the way we recruit for studies. According to a 2025 paper by Piotr Maron, “Psychiatric and psychological research has confirmed that less than 1% of the research on eating disorders is focused on males.” In recruiting participants for eating-disorder studies, language almost always explicitly focuses on women, saying, for example, “Are you a female?” Or requesting, “women only.”
Finally, we can’t overlook the role of prevention. Schools, sports programs, and youth organizations can teach boys to critically examine media images, value body function over appearance, and recognize the signs of unhealthy behaviors in themselves and their teammates. Coaches, in particular, can be powerful allies if trained to spot red flags and refer athletes to help early.
Men’s eating disorders have been hiding in plain sight for decades, and they seem to be more prevalent than ever before. Seeing them clearly—and reshaping our services accordingly—may save lives.
References
Maron, P. (2025), The Emergence of (Male) Eating Disorders as a Clinical Entity. Sociol Health Illn, 47: e70045. https://doi.org/10.1111/1467-9566.70045
Capuano, E. I., Ruocco, A., Scazzocchio, B., Zanchi, G., Lombardo, C., Silenzi, A., ... & Varì, R. (2025). Gender differences in eating disorders. Frontiers in Nutrition, 12, 1583672.
RESOURCES
Boys and Men Get Eating Disorders Too - Equip Academy
Andrew Walen, LCSW: Podcast Episode: Misconceptions About Men with Eating Disorders with Andrew Walen
Man Up to Eating Disorders: a memoir and self-help book for men and boys struggling with body image, self-esteem, fat shaming, and eating disorders
Aaron Flores, RDN - Men Unscripted Podcast