Are eating disorders “just a female problem?”

Studies say “no”, and eating disorder professionals know that to be true, but many factors nevertheless leave many cases of eating disorders undiagnosed in many males.

Factor One: Diagnostic Criteria

While eating disorder professionals believe that anorexia is under-diagnosed in both genders, certain diagnostic considerations may make this of particular concern for males. For example, the DSM-IV-TR diagnostic criteria for anorexia includes amenorrhea, which is, of course, a strictly female concern (the
ICD-10does include a male gender counterpart criterion of abnormal gonadotropin functioning).

As simple as it sounds, this may be one reason why healthcare professionals are less accustomed to
suspecting anorexia in their male patients. Regardless, the danger is that some doctors may overlook, ignore, or misdiagnose male patients with this disorder.

Factor Two: Socialization

Leigh Cohn, author of Making Weight: Men’s conflicts with food, weight, shape, and appearance, along with other noted specialists, suggest that some men with disordered eating behaviors may be unaware that they have an eating disorder, viewing symptoms such as excessive exercise and body shape concerns as just “a guy thing.” When does “working out hard” become a problem of disordered eating for men? is the standard different for men than for women?

Studies do highlight some differences in males versus female eating disorder symptoms. For example, research shows that men are more likely to engage in excessive exercise and less likely to engage in self-induced vomiting, use laxatives, or take diet pills to achieve desired weight loss.

Factor Three: Gender stereotyping

As much as we might like to think otherwise, gender stereotyping (e.g., regarding anorexia nervosa as a “female” condition) may be the root of what invariably is the underdiagnosis of eating disorders in males and which also causes some males to refrain from seeking treatment. And unfortunately, when men and boys do seek treatment, they find that there are far fewer residential treatment programs available to men than to women.

Some co-ed programs do offer specially designed treatment “tracks” that address uniquely male concerns, but there is a need for many more such programs. Consequently, males with eating disorders often report feeling isolated in treatment support groups composed of predominantly female patients.

Nevertheless, the course of treatment for males is similar to treatment for female patients and generally has the same rates of efficacy. We have been making strides in recent years toward improving
the diagnosis and treatment of males with eating disorders, and this is indeed promising.

Source: Shepphird (2010). 100 Questions and Answers about Anorexia Nervosa. Sudbury, MA: Jones & Bartlett Publishers.

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