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Clementine Portland Student Intern Donald Marks works closely with families and clients in his current role. In this week’s blog post, Donald dives into a very important topic –men and eating disorders. 

At Clementine Portland, I work closely with the families and clients, as well as run groups and eat meals/snacks with the clients.

Eating disorders have long been stigmatized as primarily affecting women, and rarely affect men. In reality, eating disorders affect both men and women although gender and sexuality may impact their presentations. In this post four considerations regarding men and eating disorders will be examined.

1) According to the National Eating Disorder Association, up to 25% of individuals diagnosed with anorexia nervosa and bulimia nervosa and 36% of those diagnosed with binge eating disorder are men. It is estimated that 10 million men in the United States will experience a clinically significant eating disorder in their lifetime. It is also noted that homosexual males are three times more likely (15%) to be diagnosed with an eating disorder than heterosexual males (5%). When those statistics are applied to the general population, however, the majority of men diagnosed with an eating disorder are heterosexual.

2) Men may be less likely to be diagnosed for a number of reasons. Men face the stigmas of eating disorders being seen as ‘a feminine problem’ or ‘gay’ as well as social stigmas against men seeking psychological help. Part of this societal bias is that the majority of diagnostic tests for eating disorders have a gender bias in the language that is used. One study by Leigh Cohn (2017), found that 99% of the books on eating disorders have a female bias.

3) Men in media are most often portrayed as having one idea body type-lean and muscular. Research shows that this is the current ideal body type for men and a desire for a more muscular physique is not uncommon among men. In fact, Gardner (2014) found that 9 out of 10 adolescent males report exercising with the main goal of ‘bulking up’ and 1 in 4 males of normal weight perceive themselves as being underweight. Further, the thin-ideal internalization construct associated with eating disorders does not often apply to men who instead report internalization of the muscular or lean ideal, again pointing to a female bias in research, practice and even diagnoses.

4) Symptoms of eating disorders in males may be different than those typically expressed in females. Men are more likely to have an obsession regarding being inadequately muscular. Compulsions that some men may experience include spending hours at the gym daily, taking copious amounts of supplements, hyper focus on body fat percentage being as low as possible and exercising/weight lifting when injured. Men may also experience lower testosterone levels and a decreased interest in sex and/or fears around sex related to body image. Men may also use muscle gain, ‘bulking season’, and ‘cutting (weight) season’ to disguise their strict and rigid eating rituals. Some of these rituals include ‘clean eating’ and an obsession with micro- and macro- nutrients in foods.

Men and eating disorders is a topic that requires more study, as well as more consideration from clinicians, treatment facilities, and medical care providers. As more men are reflecting a decrease in body satisfaction, the percentage of men diagnosed with an eating disorder is going to increase. As discussed above, there are some special considerations when working with men experiencing symptoms of an eating disorder.


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