Eating disorders in men and boys: signs, causes and getting help in the UK

The NHS describes an eating disorder as a mental health condition where you use the control of food to cope with feelings and other situations. Unhealthy eating behaviours may include eating too much or too little or worrying about your weight or body shape. The most common types it lists are anorexia nervosa, bulimia and binge eating disorder, along with other specified feeding or eating disorder (OSFED), which it says is the most common, and avoidant/restrictive food intake disorder (ARFID).

NHS inform states that eating disorders are serious mental health conditions that can affect people of all ages, genders, cultures, ethnicities and backgrounds. The idea that they are a female illness is a myth, and it is one reason men are overlooked.

Beat says there has not been a lot of research on eating disorders in men, but that an estimate based on existing research suggests around 1 in 4 people with an eating disorder are male. It points out that research focuses mainly on white cisgender men, so the true number might be much higher.

Eating disorders are heavily gendered and often associated with femininity, Beat explains. This means men may be less likely to view themselves as someone with an eating disorder, and those around them may be less likely to suspect one. Men may also feel embarrassed and worry they will not be taken seriously.

The signs of an eating disorder are the same for all genders. The NHS lists spending a lot of time worrying about your weight and body shape, avoiding socialising when food will be involved, eating very little, making yourself sick or taking laxatives after eating, exercising too much, very strict food routines and mood changes such as being withdrawn, anxious or depressed. Physical signs can include feeling cold, tired or dizzy, pains or tingling in the limbs, a racing heart, fainting, and digestive problems.

Beat adds that binge eating, compulsive exercise and a drive for masculinity may be more common in men, with greater tendency to muscle dysmorphia, but warns that pointing to male and female symptoms adds to gender stereotyping. Everyone experiences an eating disorder in a way that is unique to them.

• Preoccupation with food, weight, shape or muscle size.

• Rigid exercise routines, or exercising despite injury or illness.

• Strict rules about food, or eating a large amount quickly and feeling out of control.

• Avoiding meals with others, or secrecy about eating.

• Making yourself sick or misusing laxatives.

• Low mood, anxiety or withdrawal, and feeling cold, tired or dizzy.

The NHS says the exact cause of eating disorders is unknown. You may be more likely to get one if you or a family member has a history of eating disorders, depression, or alcohol or drug misuse, if you have been criticised for your eating habits, body shape or weight, if you are worried about being slim particularly with pressure from society or your job (it mentions ballet dancers, models or athletes), if you have anxiety, low self-esteem, an obsessive personality or are a perfectionist, or if you have been sexually abused.

NHS inform adds that the causes are usually more complex than social pressure to be thin and can be psychological, environmental and biological. Eating disorders often occur alongside other conditions such as anxiety, depression, autism, ADHD, OCD and, for some people, type 1 diabetes.

The NHS advises seeing a GP as soon as you can. A GP will ask about eating habits and feelings, check your overall health and weight, and may refer you to an eating disorder specialist or team. It may make things easier to bring a friend or loved one. Beat also recommends getting in touch with your GP and says its helpline can support you, and it provides guidance on how to tell people you know about an eating disorder.

If you are worried about someone else, the NHS says to let them know you are worried and encourage them to see a GP, and offer to go along. They may deny it, or be secretive or defensive about eating or weight, so patience matters. Beat suggests raising concerns without judgement and listening rather than talking at them.

The NHS says treatment depends on the type of eating disorder but usually includes a talking therapy, with regular health checks if your physical health is affected. Guided self-help may be used for bulimia or binge eating disorder, and most people are offered individual therapy while those with binge eating disorder may be offered group therapy. NHS inform adds that specialist dietitians may be part of treatment, and that medication alone is not usually effective.

Treatment of OSFED depends on the type the symptoms most resemble, the NHS says. The NHS also notes that you can recover, but that it may take time and recovery will be different for everyone.

Seek urgent medical help if someone with an eating disorder is fainting, has a racing heart or is very unwell. The NHS describes fainting and a racing heart among the physical signs of an eating disorder. If you have thoughts of suicide or self-harm, call 999 or go to A&E, or use NHS 111 and choose the mental health option.

On the NHS the route is through your GP to community eating disorder services or a specialist team. Charities such as Beat offer information, helplines and peer support in the UK. Some men also see a private psychiatrist, psychologist or dietitian for faster appointments or alongside NHS care, in which case it is worth checking that the clinician has specific experience of eating disorders and that they will share information with your GP.