According to data recorded in the US, almost seven million men have faced an eating disorder at some point in their lives, which most often develops during adolescence.
Disturbing data from a 2023 Canadian study showed a 416 percent increase in hospitalizations of young men due to eating disorders between 2000 and 2019.
“Eating disorders in boys are most often noticed as early as around age 10, and become most apparent between ages 14 and 16,” Jonathan Levine, a therapist and clinical supervisor at the Equip Health treatment center, explains to Parents.com.
He adds that boys are generally most vulnerable during puberty and at the beginning of college, although a major catalyst, such as trauma or comments from peers, can also be a trigger.
How eating disorders differ in boys and girls
While anorexia and bulimia, disorders related to body image and fear of gaining weight, remain more common in girls, the percentage of male patients is steadily increasing, according to Dr. Paul Houser, medical director of the eating disorders program at Children's Hospital Dayton.
"Unfortunately, this increase does not surprise me," says Dr. Houser, adding that eating disorders are difficult to recognize in young people, and this is even more pronounced in boys and young men.
According to him, the reason for this is stereotypes that eating disorders only occur in young women, as well as greater stigma and shame among young men, which can delay seeking help and lead to more severe symptoms.
New category of disorders
In addition to traditional disorders, a relatively new category has emerged that worries experts, and it is more common in men: avoidant or restrictive food intake disorder, or ARFID.
"ARFID is a condition in which young people avoid or restrict their food intake for reasons unrelated to poor body image or fear of gaining weight. This may be due to a fear of negative consequences of eating, such as choking or vomiting, lack of appetite, or a strong aversion to certain foods," explains Dr. Houser.
Regardless of the differences in manifestation, the consequences can be lifelong for both sexes. From a mental health perspective, eating disorders can have a devastating impact and carry a higher risk of suicide than depression. Physical consequences include stunted growth, affecting height and bone density, and an increased risk of fractures.
They can also affect every organ system in the body, weaken the heart, and cause dangerous electrolyte changes.
"These changes are reversible with timely treatment, but without it they can be life-threatening," warns Dr. Houser.
The role of social networks and unrealistic ideals
According to therapist Levin, eating disorders in boys have historically been underdiagnosed.
"It's likely that boys experience eating disorders at the same rate as girls, but this is unclear because cases are often underreported," he says.
This, combined with the rise of content on social media that is overly focused on dieting, exercise, and appearance, is likely why experts are seeing an increase in cases in both sexes, and especially in boys.
"Social media content, such as short videos on TikTok, often emphasizes physical characteristics that are easy to portray, rather than character traits," says Dr. Houser.
He points out that young men are more susceptible to these influences if they lack strong male role models or positive peer groups that emphasize skills and character over appearance.
Levin adds that cultural changes have also played a big role.
"The 2000s were the hotbed of 'thinspo' culture, with a hyper-fixation on bodies, and the media making horrible comments about bodies without holding back. This normalization of judgment and comparison has extended to boys, who are now being criticized for their appearance and muscles in ways they never were before."
As an example, he cites Marvel superhero characters who normalize unrealistic appearances such as chiseled abs and low body fat percentage, which directly encourages an increase in hospitalizations.
Symptoms that parents should not ignore
Although both boys and girls may feel a fear of gaining weight, these concerns may manifest differently. Girls focus more on being thin, while boys may focus more on being muscular.
“Eating disorders in boys often overlap with a condition called muscle dysmorphia, where a young person obsessively focuses on building as many muscles as possible,” says Dr. Houser.
He believes this is why boys are more likely to engage in excessive weight lifting, as opposed to extreme dieting and cardio exercises. This can also lead to the use of dangerous dietary supplements or illegal substances, such as anabolic steroids.
Dr. Houser lists key signs to look out for: a sudden decrease in appetite or food intake, excessive concern about whether food is “healthy” or refusing favorite foods, arguing or defensiveness when you encourage them to eat more, hiding or throwing food, and intentionally vomiting after eating.
Other signs include an excessive focus on physical appearance, such as constantly looking in the mirror, feeling dizzy, tired, or cold, thinning hair or brittle nails, unexplained stomach upset, and sudden weight loss that makes clothes too big.
What can parents do?
If you suspect your child has an eating disorder, the first step is a direct conversation.
"A good approach might be to ask your child what they've seen online or heard from friends about what their body should look like," advises Dr. Houser.
He also recommends asking direct questions like “Are you trying to lose weight?” or “Have you ever intentionally vomited to lose weight?” despite fears that this could encourage such behavior.
"There is no evidence that asking these kinds of questions encourages such behavior in teenagers. On the contrary, direct questions may make it easier for them to be honest about their feelings," says Dr. Houser.
The most important thing is to seek professional help as soon as possible, either from a general practitioner or therapist, especially if you notice that your child is hiding food, vomiting, or resisting eating.
"It's easy to fall into the trap of blaming, wondering how you missed it, what you could have done differently, and feeling like you've failed as a parent. But you haven't," says Levin.
He notes that eating disorders are a complex problem with many factors. What he would do is urge parents to take action and not worry about the cause. The reason will come later, first of all, you should seek help.
