Eating Disorders in Men: Understanding Disordered Eating, Body Image and Male Athletes
Eating disorders in men are more common than many people realise. Despite the stereotype that eating disorders primarily affect women and girls, men can experience anorexia nervosa, bulimia nervosa, binge-eating disorder, other specified feeding or eating disorder (OSFED), avoidant/restrictive food intake disorder (ARFID) and other forms of disordered eating.
In Australia, it is estimated that more than 1.1 million people are impacted by an eating disorder each year, and recent Australian reporting indicates that men account for around one-quarter to one-third of people experiencing eating disorders.
Yet eating disorders in men remain significantly under-recognised and under-researched.
For some men, concerns may centre on losing weight. For others, the focus may be on becoming more muscular, leaner, stronger or achieving a particular body composition. This can make eating disorders in men particularly difficult to recognise.
How common are eating disorders in men?
Eating disorders affect people of all genders.
Australian data demonstrates that men represent a substantial proportion of people experiencing eating disorders. The National Eating Disorders Collaboration (NEDC) reports that males account for approximately 25% of people with anorexia nervosa or bulimia nervosa and around 40% of people with binge-eating disorder.
These figures are important, but they may still underestimate the true number of men experiencing eating disorders. Why?
Because men are less likely to be recognised, diagnosed or referred for treatment.
Traditional ideas about what an eating disorder “looks like” can mean that symptoms in men are overlooked — particularly when a man is muscular, athletic or does not have a low body weight.
Eating disorders don’t have a “look”
One of the biggest misconceptions about eating disorders is that you can identify one simply by looking at someone’s body.
You can’t.
A person with an eating disorder can be:
- Underweight
- A healthy or average weight
- Overweight
- Muscular
- Lean
- An elite athlete
- A recreational exerciser
- Someone who appears physically healthy.
This is particularly important when considering eating disorders in men.
A man experiencing significant restriction, binge eating, purging, compulsive exercise or intense body image concerns may not look like the stereotypical image of someone with an eating disorder.
Body size does not determine whether someone has an eating disorder.
What is disordered eating?
Disordered eating refers to problematic or concerning eating behaviours that may not meet the full diagnostic criteria for an eating disorder.
Examples can include:
- Restricting food intake
- Skipping meals
- Fasting for weight loss
- Rigid food rules
- Avoiding particular food groups
- Binge eating
- Purging
- Using laxatives or other compensatory behaviours
- Exercising to compensate for eating
- Excessive calorie or macronutrient tracking
- Frequent dieting
- Significant anxiety around food
- Eating according to increasingly rigid rules.
Disordered eating is important to take seriously.
It can negatively affect physical and psychological health and may increase the risk of developing a clinical eating disorder.
Importantly, someone does not need to meet the diagnostic criteria for an eating disorder before their relationship with food, exercise or their body warrants professional attention.
Eating disorders in men can look different
Eating disorders in men do not always involve a desire to be thinner.
For some men, the primary concern is muscularity.
A man may feel that he is not muscular enough despite having a significant amount of muscle. He may become increasingly preoccupied with his physique and organise his eating, exercise and social life around achieving a particular body.
This can involve:
- Strict dieting
- High protein intake
- Eliminating foods perceived as “unhealthy”
- Excessive resistance training
- Avoiding situations where food cannot be controlled
- Repeated body checking
- Comparing muscularity with other men
- Taking photographs to monitor physique changes
- Feeling intense distress when unable to exercise
- Believing that becoming more muscular will resolve feelings of inadequacy.
These concerns can overlap with muscle dysmorphia, in which a person becomes preoccupied with the belief that their body is insufficiently muscular or developed.
The important distinction is that the behaviour may look “healthy” from the outside.
Going to the gym, eating protein-rich foods and wanting to build muscle are not inherently problematic.
The concern arises when food, exercise and body composition become rigid, compulsive or central to a person’s self-worth and daily functioning.
Why are eating disorders in men often missed?
There are several reasons eating disorders in men can remain hidden.
Eating disorders are still seen as a “women’s issue”
The stereotype that eating disorders primarily affect young women can make it difficult for men to recognise their own symptoms.
Research and clinical resources have also historically focused heavily on female presentations, contributing to gaps in recognition and assessment.
Men may focus on muscularity rather than thinness
A man may not say:
“I want to be thinner.”
Instead, he may say:
“I need to get bigger.”
or:
“I need to get leaner.”
The underlying distress around body image can be similar, even when the desired body shape is different.
Disordered exercise can be socially rewarded
Intense exercise is often viewed positively.
Training every day, never missing a session and following an extremely restrictive diet can be interpreted as evidence of motivation and discipline.
However, there is an important difference between healthy commitment and compulsive behaviour.
If a person experiences significant anxiety, guilt or distress when they cannot exercise or follow their eating rules, it may be time to look more closely at what is happening.
Men may be less likely to seek help
Stigma can make it difficult for men to acknowledge concerns about food, body image or mental health.
This can contribute to delayed recognition and treatment.
Eating disorders and male athletes
Male athletes represent an important population when considering eating disorders and disordered eating.
Sport can create legitimate nutritional and body composition demands. Athletes may need to manipulate body composition, make weight, manage training loads or follow specific nutritional strategies.
However, these demands can sometimes overlap with eating disorder behaviours.
A recent systematic review and meta-analysis involving 70,957 athletes across 177 studies found that approximately 19% of athletes reported disordered eating behaviours, around one in five athletes.
Research specifically examining elite male athletes has found substantial variation in reported rates, with studies reporting disordered eating prevalence ranging from 0% to 85.8%, depending on the population and assessment method. Reported rates of clinical eating disorders ranged from 1.3% to 32.5%.
These wide ranges demonstrate why prevalence figures need to be interpreted carefully. Different studies use different definitions, screening tools, sporting populations and levels of competition.
Nevertheless, the message is clear:
Male athletes can and do experience eating disorders and disordered eating.
Male athletes may be particularly vulnerable to body image pressures
Athletes can experience pressure to achieve a body that is perceived to optimise performance.
Depending on the sport, this might mean:
- Being lighter
- Being leaner
- Increasing muscle mass
- Increasing strength
- Reducing body fat
- Maintaining a particular weight
- Changing body composition.
Sports involving weight categories, endurance, aesthetics, strength or particular physique expectations may present additional challenges.
However, eating disorders and disordered eating can occur in any sport.
A recent meta-analysis found that disordered eating was present across a wide range of sporting contexts, highlighting that the issue is not limited to traditionally recognised “high-risk” sports.
Getting help for eating disorders and disordered eating in men
Eating disorders in men deserve the same level of recognition, assessment and treatment as eating disorders in women.
You do not have to be underweight. You do not have to look visibly unwell. You do not have to wait until your eating or exercise behaviours become severe.
Early intervention matters.
Treatment may involve a multidisciplinary team including a psychologist, Accredited Practising Dietitian, GP, sports physician and other health professionals depending on the individual’s needs.
