Anorexia Nervosa in Males: A Life-Threatening but Treatable Eating Disorder

Anorexia nervosa, generally associated with females, is a life-threatening eating disorder that affects both males and females. However, the condition is often overlooked and underdiagnosed in males. A recent article in the Canadian Medical Association Journal (CMAJ) highlights the alarming sixfold higher mortality rate in males affected by anorexia nervosa compared to males in the general population. The article emphasizes the need for early identification, prompt treatment, and how to provide effective care for adolescent males with anorexia nervosa.

The Prevalence of Anorexia Nervosa in Males

An estimated one in three people suffering from anorexia nervosa is male, and it's believed that around 10 million American boys and men will grapple with the condition at some point in their lives. However, the prevalence may be substantially higher, as societal stigma and ignorance surrounding eating disorders in men often lead to late diagnosis. Certain groups, particularly gay, bisexual, trans, and queer individuals, as well as those involved in body- and strength-focused sports, are at higher risk.

Understanding the Risk Factors and Complications

The current societal masculine body ideal of being big and muscular can lead to muscle dysmorphia, also known as reverse anorexia or bigorexia, where individuals become obsessed with gaining more muscle. This obsession often results in over-exercise, restriction of carbohydrates and fats, and overconsumption of protein, leading to energy deficits. These behaviors are particularly prevalent in boy athletes who develop eating disorders. However, if left untreated, anorexia nervosa can lead to serious health effects.

Screening and Warning Signs

Early detection of anorexia nervosa in males is crucial. Parents, guardians, and healthcare professionals should be vigilant for signs such as a preoccupation or obsession with food, exercise, appearance, or weight that impairs school or daily functioning and affects quality of life. Other warning signs include muscle-enhancing goals, diet changes, vomiting, over-exercising, and the use of supplements and anabolic steroids.

Effective Treatment and the Role of Family

Most adolescent males with anorexia nervosa can be treated as outpatients with family-based treatment and ongoing medical monitoring. This approach involves the entire family in the recovery process, providing a supportive environment for the affected individual. However, some adolescents may require treatment in a hospital setting, particularly in severe cases where the individual's physical health is significantly compromised.

Raising awareness of anorexia nervosa in males is essential to combat the stigma, improve early detection, and ensure access to effective treatment. A variety of resources, including eating disorder hotlines and mental health support services, are available for individuals dealing with this condition. It's important to remember that anorexia nervosa is not a choice, but an illness that requires professional help.