Anorexia Nervosa in Men: What You Need to Know

Anorexia nervosa is a serious eating disorder characterized by extreme weight loss, an intense fear of gaining weight, and a distorted body image. While often associated with women, anorexia in men is a growing concern that remains underdiagnosed and misunderstood. According to the National Eating Disorders Association (NEDA), about 25% of individuals with anorexia are men, but the real number may be higher due to stigma and lack of awareness.

This chart illustrates the hospitalization rates for anorexia nervosa among men and women in the USA in 2022. Women experience significantly higher hospitalization rates compared to men, highlighting a gender disparity in eating disorder-related hospital admissions.

Why Is Anorexia in Men Overlooked?

Historically, eating disorders have been framed as a female issue, which has led to several misconceptions about male anorexia. Many men struggling with anorexia go unnoticed because their symptoms may present differently than in women. Instead of the stereotypical desire for thinness, men with anorexia often pursue extreme leanness or muscle definition, making their condition harder to recognize.

Triggers for Anorexia Nervosa in Men (% of Cases Linked to Each Factor)

This chart presents the primary triggers associated with anorexia nervosa in men. Social pressure and athletic demands play a significant role, alongside factors like trauma and family issues.

Symptoms of Anorexia in Men

While the core features of anorexia nervosa remain the same across genders, men may experience distinct symptoms, including:

• Excessive Exercise: Men with anorexia often engage in compulsive exercise routines, prioritizing workouts over social, professional, and even medical obligations. Unlike general fitness enthusiasts, they feel severe anxiety and guilt if they miss a workout, leading to exhaustion, injuries, and overtraining syndrome. Pay attention to extreme rigidity in workout schedules and refusal to rest despite physical pain.
• Obsessive Calorie Counting: Individuals with anorexia track every calorie consumed and burned, often using apps or strict meal plans. Unlike general diet-conscious individuals, they view food as an enemy and may eliminate entire macronutrient groups (e.g., carbs, fats). They feel immense distress when unable to calculate their intake precisely, leading to avoidance of social eating.
• Gastrointestinal Issues: Chronic bloating, constipation, and acid reflux arise due to prolonged malnutrition and lack of essential digestive enzymes. Unlike common digestive disorders like IBS, these symptoms persist regardless of diet changes and worsen as weight loss progresses. Patients may also experience early satiety (feeling full too quickly), which reinforces their restrictive eating patterns.
• Low Testosterone Levels: Prolonged starvation and excessive exercise can severely impact hormone production, leading to reduced testosterone levels. Unlike typical age-related testosterone decline, men with anorexia experience drastic drops, resulting in low libido, erectile dysfunction, infertility, chronic fatigue, and muscle wasting. These symptoms may be misdiagnosed as hormonal imbalances unrelated to eating disorders, delaying proper treatment.
• Increased Social Withdrawal: Anorexic men avoid gatherings involving food, preferring isolation to prevent judgment or pressure to eat. Unlike general introversion, their withdrawal is driven by fear of losing control over their diet. They may create excuses to avoid family meals or business dinners and exhibit high levels of irritability and secrecy around their eating habits.
• Severe Body Dysmorphia: Despite being underweight, individuals see themselves as overweight or “not lean enough.” Unlike standard concerns about appearance, this distortion is unshakable, even when confronted with evidence. They may excessively check mirrors, measure body parts, or compare themselves to athletes and models, reinforcing their self-destructive behaviors.

Common Symptoms of Anorexia Nervosa in Men (Survey Data, % Reporting Each Symptom)

This chart presents the most commonly reported symptoms of anorexia nervosa in men based on survey data. Extreme weight loss and food avoidance are the most frequently experienced, followed by over-exercising and low self-esteem.

How Is Anorexia Diagnosed?

A proper diagnosis involves a combination of physical and psychological assessments. Here are some key diagnostic methods:

This chart highlights the prevalence of psychiatric comorbidities among men with anorexia nervosa. Depression and anxiety are the most common, followed by OCD, substance abuse, and PTSD.

Treatment Innovations for Male Anorexia

Recent advancements in eating disorder treatment now address the specific needs of men. Here are some of the most promising options:

Testosterone Therapy

Testosterone therapy is often recommended for men experiencing hormonal imbalances due to extreme weight loss. This treatment helps restore testosterone levels, improving libido, energy, and muscle mass. Patients may receive testosterone through injections, patches, or gels. The process typically lasts 6 to 12 months, with an effectiveness rating of 8/10. The cost ranges from $100 to $500 per month, depending on the type of treatment.

Cognitive-Behavioral Therapy (CBT)

CBT is a psychological treatment designed to help individuals identify and change harmful thought patterns related to food and body image. A therapist works with the patient weekly to challenge distorted beliefs and develop healthier behaviors. This therapy typically lasts 3 to 6 months and has an effectiveness rating of 9/10. Costs range from $80 to $250 per session, depending on location and insurance coverage.

Nutritional Rehabilitation Programs

These programs focus on restoring a balanced diet and replenishing essential nutrients. A registered dietitian creates a meal plan tailored to the patient’s needs, emphasizing muscle restoration and healthy weight gain. Nutritional rehab is often combined with medical supervision and lasts several months to a year, depending on severity. The effectiveness rating is 9/10, and the cost varies from $200 to $800 per month.

Virtual Therapy Platforms

Online platforms like BetterHelp and Talkspace provide convenient access to eating disorder specialists. Patients can receive therapy through video calls, messaging, or chat sessions. Virtual therapy is ideal for those hesitant to seek in-person help, with a success rate of 7/10. Subscriptions cost between $60 and $90 per week.

Medical Supervision and Inpatient Programs

Severe cases of anorexia may require hospitalization or inpatient care. These programs include 24/7 medical monitoring, supervised meal plans, and psychological support. The average hospital stay lasts 4 to 8 weeks, followed by outpatient follow-ups. The effectiveness rating is 10/10, and costs range from $1,000 to $3,500 per day, depending on the facility and level of care provided.

Recovery Rates of Men with Anorexia Nervosa (Longitudinal Study, % Recovery After X Years)

This chart illustrates the recovery rates of men with anorexia nervosa over different time periods. The data shows a steady increase in recovery percentages over time, indicating that long-term treatment and support significantly improve outcomes.

Editorial Advice

Reyus Mammadli, healthcare advisor, emphasizes the importance of early intervention. “Men with anorexia often wait too long to seek help due to stigma. If you or a loved one exhibit signs of disordered eating, consult a specialist immediately. The sooner treatment begins, the better the recovery outcomes.”

If you suspect someone is struggling with anorexia, encourage them to reach out to a professional. Male anorexia is real, and recovery is possible with the right support and treatment.

References

• National Eating Disorders Association (NEDA)
• American Psychiatric Association (APA)
• Mayo Clinic – Eating Disorders
• National Institute of Mental Health (NIMH)
• Journal of Eating Disorders – Research Studies on Male Anorexia