Anorexia — and eating disorders in general — are often considered disorders that only affect women and girls but this is wildly incorrect. While it’s true that disordered eating and body dysmorphia are more common in those who identify as women, men can have anorexia, too.

The primary reason for this misconception is that anorexia symptoms manifest themselves differently in males than they do in women. Therefore, anorexia in males can appear vastly different than mainstream expectations which have largely been shaped by female characters in pop culture. As a result, male signs of anorexia are frequently overlooked and often go undetected.

Anorexia Symptoms in Males vs. Females

The most common symptom of anorexia in males is excessive weightlifting, which may or may not be accompanied by strict restrictions on food intake or malnourishment, whereas anorexia in women is centered around severe restrictions on food intake. 

A muscular physique can mask when a male is underweight, especially when they appear to be continuing to put on muscle. The natural differences between male and female physique (plus the perception that male bodies react quickly to diet and exercise) can make it more challenging to spot when physical changes have occurred due to undereating.

Many of the other behavioral signs of anorexia in males are also associated with the pursuit of fitness, though not all are. These may include:

  • Extreme distress at the prospect of missing a workout
  • Missing important events to stick to their fitness routine
  • Working out despite illness or injury
  • Constantly taking body measurements or weighing themselves
  • Lack of interest in sex
  • Severe dieting

However, the above behavior alone may not be enough to distinguish between an unhealthy obsession with physical fitness and anorexia nervosa. It’s helpful to also look for physical side effects which would primarily be caused by a lack of adequate food intake. 

  • Fatigue and exhaustion
  • Hair loss
  • Cold hands and feet
  • Constipation
  • Digestive issues
  • Dry skin
  • Weakness

Why do symptoms of anorexia differ by gender?

In both males and females, eating disorders are at least partially fueled by some level of pressure (which can be real or perceived) to fit a “societal ideal”. However, these ideals fall along gender norms: thinness for women, and a muscular physique for men (this may vary among specific communities). 

There may be some overlap as eating disorders in women can also involve excessive exercise. However, since the end goals are different, women with anorexia are more likely to engage in cardio activities whereas men with anorexia tend to skew towards muscle-building strength training. 

How Common is Anorexia in Males?

It’s estimated that approximately one million males suffer from anorexia nervosa. That number is likely much higher because research on anorexia in males is underlooked and social stigma can make men less likely to admit they need help. 

It’s often stated that approximately 1 out of every 10 anorexia cases are male but more recent studies have found that figure to be closer to 1 out of every 4. Additionally, prevalence appears to increase significantly in older males aged 40 and up — a cohort whose eating disorder is even more likely to go undetected. 

Male Anorexia Risk Factors

Certain populations also face an increased risk of anorexia. Gay and bisexual men are 10 times more likely to exhibit eating disorder behaviors than heterosexual men (though heterosexual women are still far more likely to have anorexia than gay men so, not being heterosexual does not inherently put someone at risk). 

Professional athletes also face increased anorexia risk due to things like weight requirements, a grueling training schedule, or simply the pressure of being in the public eye. There have been several high-profile athlete deaths due to eating disorders. In most cases, however, athletes tend to have subclinical anorexia — meaning they exhibit many of the behaviors but do not fully meet the diagnostic criteria. 

Another potential risk factor is weight history. Males who struggled with being overweight showed a greater likelihood of developing an eating disorder. In sharp contrast are anorexia, at-risk women who perceived themselves as being overweight prior to their eating disorder but actually were normal weight.  

Treating Anorexia in Males

Anorexia is one of the deadliest eating disorders, but its mortality is particularly high for male cases due to the combination of strenuous exercise and undereating. 

Treatment will first focus on restoring them back to physical health which can mean medical intervention or the restoration of a healthy body weight. Fixing disordered eating or body dysmorphia will require a longer-term approach that will likely involve some form of therapy like cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT) and medication like anti-depressants. 

To get started, talk to a mental health professional today who can properly diagnose male cases of anorexia and prescribe the correct treatment approach.