Under-Recognition of Eating Disorders in Male Athletes
Why Eating Disorders in Male Athletes Are Still Being Missed
Eating disorders are often misunderstood as a “female issue”, but emerging research shows this is not only outdated, it is harmful. Among athletes, this misconception becomes even more pronounced, contributing to the under-recognition and under-treatment of eating disorders in men.
For any psychologist working with eating disorders, particularly in sport, understanding this gap is critical.
Eating Disorders in Male Athletes: What the Research Says
Recent research continues to challenge assumptions about prevalence. While rates are typically reported as lower in males, the gap is far smaller than many believe:
- Up to 19% of male athletes experience disordered eating behaviours
- Male athletes show ~19% higher rates of disordered eating than non-athletes
- Around 6–7% of male elite athletes meet criteria for an eating disorder diagnosis
- In mixed-sport samples, over 38% of athletes are at risk, including males
At face value, these numbers suggest a significant issue. However, they likely underestimate the true prevalence.
Why Eating Disorders in Male Athletes Are Under-Recognised
- Different Body Ideals: Lean vs Muscular
Unlike the traditional thin-ideal associated with eating disorders, male athletes often pursue leanness and muscularity simultaneously.
Research highlights that men are more likely to:
- Engage in muscle-building behaviours
- Experience dissatisfaction related to size (too small, not just too large)
- Present with behaviours not captured by traditional diagnostic tools
This means many symptoms fall outside stereotypical eating disorder presentations.
- Diagnostic & Screening Limitations
Most eating disorder screening tools were developed using female populations. As a result:
- Muscle-focused behaviours (e.g., “bulking and cutting”) may be overlooked
- Binge eating or compulsive exercise may be misinterpreted as “training dedication”
- Male-specific symptom profiles are under-detected
This creates a clinical blind spot, even for experienced practitioners.
- Stigma & Masculinity
Stigma plays a major role. Many male athletes:
- Do not identify their behaviours as problematic
- Associate eating disorders with weakness or femininity
- Delay help-seeking
Research suggests underreporting is common in males due to stigma and gender norms
- Sporting Culture Reinforces Risk
Sporting environments can normalise behaviours that mirror eating disorder pathology:
- Weight manipulation for performance
- Obsession with body composition
- Praise for extreme discipline
In some sports, these behaviours are not only accepted, they are rewarded.
- The “Healthy Athlete” Assumption
Athletes are often perceived as the picture of health. This creates a paradox:
- Visible fitness masks underlying psychological distress
- Warning signs (e.g., rigidity, restriction) are reframed as commitment
- Clinicians, coaches, and peers may miss early indicators
Unique Risk Factors for Male Athletes
Emerging research points to several male-specific risk patterns:
- Drive for muscularity rather than thinness
- Compulsive exercise, sometimes independent of eating pathology (seen in ~18% of elite male athletes)
- High training loads, which are linked to increased psychological vulnerability
- Sport-specific pressures, particularly in endurance, weight-class, and aesthetic sports
Additionally, binge eating may be more common in male athletes than previously thought.
Why This Matters for Psychologists
For any psychologist working with eating disorders or athletes, under-recognition has real consequences:
- Delayed intervention
- Increased medical risk (e.g., low energy availability, REDs)
- Greater entrenchment of behaviours
- Impact on performance, identity, and long-term mental health
Recognising eating disorders in male athletes requires moving beyond stereotypes and understanding how these presentations differ.
What Needs to Change
- Broader Definitions of Eating Disorders
We need to move beyond weight-centric and thinness-focused models to include:
- Muscle dysmorphia
- Performance-driven restriction
- Exercise compulsion
- Better Screening in Sport
Routine screening, especially using athlete-specific tools, can identify risk earlier and more accurately.
- Cultural Shift in Sport
Reducing:
- Weight-focused language
- Normalisation of extreme behaviours
- Reinforcement of “suffering = success” narratives
- Targeted Support for Male Athletes
Interventions should:
- Address identity and masculinity
- Normalise help-seeking
- Integrate performance and wellbeing
Eating disorders in male athletes are not rare, they are under-recognised.
As awareness grows, so too does the responsibility for clinicians, coaches, and sporting systems to respond appropriately. For psychologists, this means developing a more nuanced understanding of how eating disorders present in male athletes, and ensuring that support is accessible, relevant, and stigma-free.
