Do Men Have Bulimia?

Reprinted from Bulimia: A Guide to Recovery
By Lindsey Hall and Leigh Cohn

While the actual numbers of men with eating disorders are unknown and are certainly less than for women, more men have bulimia than anyone thought in the early ’80s, or even just a few years ago. While the incidence of bulimia in women has stayed fairly constant over the years, male eating disorders have noticeably risen. Historically it was believed that about 10% of individuals with eating disorders were male, however recent figures put the prevalence around 33% (Hudson, 2007). Also, unlike women, some men become obsessed with getting larger and more muscular—a condition called “reverse anorexia” or “body dysmorphic disorder” which can also become addictive.

The stigma of having a “women’s disease” prevents many men from seeking professional help, which is one reason why the male prevalence rate is sketchy. It also means that men often don’t realize they have an eating disorder, nor do the people closest to them. Further, the purge of choice for a lot of men seems to be overexercise, which can masquerade as a healthy escape instead of eating-disordered behavior. Incidentally, some men do binge and vomit.

There are far more similarities than differences when comparing men and women with bulimia. Men are equally influenced by culture, family, genetics, etc., and the diagnosis and behaviors are the same, regardless of gender, as are the approaches to treatment. Men are under pressure to appear strong, in control, and independent, and as such, their roles in our culture have limitations and drawbacks, just like women’s. Many have difficulty expressing feelings and have had little experience in emotionally intimate relationships. Most feel tremendous pressure to be in charge, to shoulder financial worries and be the foundation for their families. Few would want to be labeled as obsessed with their appearance. All these situations might make them more susceptible to using bulimia as a coping mechanism, as well as extremely reluctant to seek help.

When comparing scores on clinical assessments, men and women with eating disorders have similar ratings in areas such as drive for thinness, body dissatisfaction, perfectionism, and fear of growing up, although women tend to have slightly higher degrees of severity. At any given time, about 80% of women would like to lose weight, and likewise, 80% of men would like to change their weight, as well. However, here’s one of the differences: Only half of those men would like to be thinner; the others want to be more muscular, even if it means putting on a few pounds (Andersen, 2000).

Men are even more affected in certain areas than women. The media deluges them with idealized standards of muscularity and advertisements for improving sexual competence, losing love handles, and adding or removing hair. They are also more susceptible to developing eating disorders and overzealous attitudes about exercise as a result of a father’s health problems. Furthermore, the very act of binge eating—so impermissible for women—is often viewed as “typical guy behavior.”

Some male athletes, such as jockeys and gymnasts, use bulimia to maintain or lose weight and become hooked on it, just as is the case for many female athletes. Purging behaviors among wrestlers became so commonplace that the NCAA wrote guidelines to outlaw severe weight- loss methods like self-induced vomiting, diuretics, and exercising in saunas.

Homosexual men—as compared to heterosexuals—are at particularly high risk for developing eating disorders because of their preference for a thin, muscular appearance, as well as greater body dissatisfaction, higher levels of depression, lower self esteem, and discomfort with sexual orientation. However, eating disorders are not exculsive to the gay community and the likelihood exists that (due to the vastly higher numbers of heterosexuals in the general population) more straight men may have eating disorders than those who are gay.

As you know, the language of this book primarily addresses women, but most of the underlying messages and suggested activities are equally worthwhile for men. Moreover, I want to raise awareness of the problem for those who suspect that a man they know or love has an eating disorder. This might even be the father, son, or partner of a person with bulimia.