Men and Eating Disorders
Approximately 10% of eating disordered individuals coming to the attention of mental health professionals are male

There is a broad consensus, however, that eating disorders in males are clinically similar to, if not indistinguishable from, eating disorders in females

A national survey of 11,467 high school students and 60,861 adults revealed the following gender differences

Among the adults, 38% of the women and 24% of the men were trying to lose weight.

Among high school students, 44% of the females and 15% of the males were attempting to lose weight.

Based on a questionnaire administered to 226 college students (98 males and 128 females) concerning weight, body shape, dieting, and exercise history, the authors found that 26% of the men and 48% of the women described themselves as overweight. Women dieted to lose weight whereas men usually exercised

A sample of 1,373 high school students revealed that girls (63%) were four times more likely than boys (16%) to be attempting to reduce weight through exercise and caloric intake reduction. Boys were three times more likely than girls to be trying to gain weight (28% versus 9%). The cultural ideal for body shape for men versus women continues to favor slender women and athletic, V-shaped muscular men

In general, men appear to be more comfortable with their weight and perceive less pressure to be thin than women. A national survey indicated that only 41% of men are dissatisfied with their weight as compared with 55% of women; moreover, 77% of underweight men liked their appearance as opposed to 83% of underweight women. Males were more likely than females to claim that if they were fit and exercised regularly, they felt good about their bodies. Women were more concerned with aspects of their appearance, particularly weight

Men with eating disorders tend to have dependent, avoidant, and passive-aggressive personality styles, and to have experienced negative reactions to their bodies from their peers while growing up. They tend to be closer to their mothers than their fathers. The authors concluded that "in our culture, muscular build, overt physical aggression, competence at athletics, competitiveness, and independence generally are regarded as desirable for males, whereas dependency, passivity, inhibition of physical aggression, smallness, and neatness are seen as more appropriate for females. Boys who later develop eating disorders do not conform to the cultural expectations for masculinity; they tend to be more dependent, passive, and non-athletic, traits which may lead to feelings of isolation and disparagement of body."

Males with anorexia saw themselves and were seen by others as more feminine than other men, both in attitudes and behavior. In general the males with anorexia appeared to identify more closely with their mothers than with their fathers.

Homosexuals are over-represented in many samples of eating disordered men. While the proportion of male homosexuals in the general population cross-culturally is estimated to be 3%-5%, samples of eating-disordered men are commonly twice as high or greater

Several authors have noted that homosexual conflict preceded the onset of an eating disorder in up to 50% of male patients .

Conflict over gender identity or over sexual orientation may precipitate the development of an eating disorder in many males. It may be that by reducing their sexual drive through starvation, patients can temporarily resolve their sexual conflicts

Homosexual men may be at an increased risk for developing an eating disorder because of cultural pressures within the homosexual community to be thin, found that homosexual men weighed significantly less than heterosexual men, were more likely to be underweight and to desire an underweight ideal weight. Compared to the heterosexuals, homosexual men were less satisfied with their body build, and scored significantly higher on the "Drive for Thinness" scale of the Eating Disorders Inventory (EDI).

Although eating disorders in males have been recognized since the late 1600s, they have been neglected for cultural reasons primarily because they do not conform to the female-centered explanations of these disorders. It has long been assumed that males account for only five percent or less of the eating-disordered population. However, more recent studies suggest that up to one out of six eating-disordered individuals are men, and in certain forms of the illness, such as binge-eating disorder, the ratio between males and females is almost equivalent. A basic question then is whether the lower prevalence of eating disorders in males is due to an increased hardiness in men or to men's reduced exposure to social and cultural norms.

Apart from their different genetic makeup, males from the time of birth on have a different social learning experience than females. They are socialized to be less expressive of emotions and more action-oriented, to use their bodies as vehicles for achievement rather than attractiveness, and to view food as fuel rather than a threat to appearance. In general, boys are more shape-oriented whereas girls are more weight-oriented. Boys tend to be dissatisfied from the waist up, whereas girls tend to be dissatisfied from the waist down. Generally, girls do not need a specific reason for dieting. For them, dieting is the cultural endorsement of a pubertal right. Males who diet almost always diet for specific personal reasons.

New facts:

There are four reasons why males diet, none of which are commonly found in females: to improve athletic performance; to avoid being teased for having been a fat child; to avoid getting medical diseases associated with males in the family; and to improve a gay relationship. In one study only seven out of 104 females dieted for one of these four reasons, while 54 out of 104 males met at least one of these criteria.

One form of eating disorder almost exclusively found in men is reverse anorexia nervosa. The disorder is also referred to as muscle dysphoria. In this condition the adolescent or early-20s male is large "ripped," "chiseled," or "buffed," but he still feels tiny and weak. In contrast to the girl who can never be thin enough, this boy can never be big enough. This is not a delusion but rather an overvalued belief whereby his biology cannot meet his desired body size and shape.

In regard to bulimia nervosa, there is a reasonable gender neutrality about diagnosis. Although males are more likely to go for a long time without bringing their bulimic symptoms to attention, in both genders, bulimia usually leads to medical and psychological distress, followed by some form of compensation, including self-induced vomiting or laxative abuse in 80 percent of patients, and extreme restriction of food or heroic exercise in the other 20 percent.

A recently recognized form of eating disorder is binge eating. In this condition there is relentless bingeing and often grazing but no compensation at all. These individuals, often in their 30's and 40's, represent 25 percent of people with medical obesity. Here again, there is a gender neutrality in regard to the prevalence.
This information has been gathered from several sources, email me if you wish to know more.
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