I’ve done previous posts about other eating disorders and today I want to talk about anorexia nervosa (also known simply as anorexia) and specifically, anorexia in men.

If you want to check out my previous run-downs of other eating disorders they are:

• Eating disorders in men
• Binge eating disorder
• Bulimia nervosa in men
• Orthorexia in men

What Is Anorexia?

I think when someone heard the term “eating disorder”, anorexia is the first thing that comes to mind.

I suspect it is the most common one depicted in media and the dramatic impact it can have on someone’s weight and body shape is visually very noticeable.

Quoting directly from the NHS anorexia page, anorexia is:

…an eating disorder where sufferers try to keep their weight as low as possible by under-nourishing or over-exercising, or a combination of both. It often stems from distorted self-image and no matter how slim someone is, they may still think they need to lose weight.

The most commonly affected demographic is girls and young women, but it can affect anyone regardless of age, gender, ethnicity, or background.

How Common Is Anorexia In Men?

Getting stats on how common is anorexia in men has been proving difficult.

I found a few different studies that I tried to use to piece together something. And there is no scientific merit really to the method I used but it is the best I could do to get to something vaguely resembling a number.

The National Centre For Eating Disorders in the UK estimates that males make up 1-5% of anorexia cases.

Something to bear in mind with that statistic is that men are generally less likely to seek out a diagnosis or support for anorexia or any eating disorder, so studies may also under-report how prominent it is in men.

Then I found another article by the UK eating disorder charity, BEAT, which estimates that 1.25 million people in the UK have an eating disorder, of which 8% are thought to be anorexia.

Combining those studies (which as I said, doesn’t have a huge amount of merit but it’s the best I could do!):

• 8% of 1.25 million is 100,000 – so that would be 100,000 people with anorexia in the UK.
• 1-5% of 100,000 would be 1,000 to 5,000 cases of anorexia in men in the UK.

Having said that, I did find another article by NEDA in the US that suggests up to 25% of people with anorexia are male and that 0.1-0.3% of all men will develop anorexia in their lifetime.

So with those percentages, the estimate of actual cases of anorexia in men would be quite a lot higher.

Hence the difficulty in figuring out a ballpark figure.

The main thing to take away is that while anorexia is much more prominent in females, it very definitely does affect men too and if you are a man dealing with anorexia, you are very definitely not alone.

Warning Signs And Symptoms Of Anorexia

I don’t personally like to refer to symptoms just as symptoms and tend to also call them warning signs. Purely because the behaviours exhibited with an eating disorder and with any other mental condition are somewhat of a spectrum and can manifest differently for different people.

And if you bear that in mind, you may catch yourself or someone else starting to show early signs of one of these behaviours.

And if you catch it early, recovering from an eating disorder can be somewhat simpler than going further down that road.

But here are some of the most common symptoms and warning signs to look out for with anorexia:

• Dramatic weight changes. If someone is undernourishing themselves substantially, you will expect to see that manifest in their body weight changing, and often sudden weight loss.
• Fixating on food or calories.
• Low self-esteem or lacking confidence.
• Fixating on specific body parts, commonly the waistline, always feeling like it’s too big.
• Avoiding food, skipping meals or eating in secret, or trying to hide how much food someone is eating to the extent of not wanting to eat around other people at all.
• Feeling anxious, nervous or restless around food, at mealtimes and in social situations that involve food.
• Avoiding certain foods that you see as fattening.
• Believing that you are “fat” even if you are in a healthy weight range.
• Taking appetite suppressants or trying to suppress hunger.
• In females, either periods stopping or depending on age, maybe not starting in the first place.
• In males, low testosterone.
• Physical issues such as dry skin, hair loss, and lightheadedness.
• Social withdrawal.
• Wearing baggy clothes which can be either due to embarrassment about someone’s current body size/shape or trying to hide the change that has happened.

Diagnosis For Anorexia

The American Psychiatric Association does have a 3 part criterion for diagnosing anorexia, which is as follows:

• Intense fear of gaining weight: People with anorexia typically fear weight gain and dread becoming “fat.” This fear often manifests itself by depriving the body of food.
• Food intake restriction: People with anorexia tend to eat less food than the body needs to function correctly. This may lead to significantly low body weight for the person’s age and height.
• Distorted body image: This has to do with a person’s perception of their body size. People with anorexia often have exaggerated views of their bodies. They generally view themselves as overweight, even if they’re dangerously underweight.

In short, diagnosis ties in with exhibiting the symptoms and warning signs I just mentioned, which is somewhat unsurprising to be fair.

Health Impact Of Anorexia

I always try to choose my words carefully when talking about how bad eating disorders can be.

No single eating disorder is “better” or “worse” to have than any other. Everyone’s experience is unique to them, and they’re all just as challenging for the person battling it as they are for anyone else. I can vouch for that from my own eating disorder experience.

But there are some specific health challenges that come from severe undernourishment in anorexia that can present their own unique set of circumstances and complications that you’re not as likely to see with other specific eating disorders.

And that is purely because with other eating disorders you may still be providing your body with somewhat more fuel and nutrition than anorexia battlers do.

Some of the specific health impacts of anorexia include:

• Muscle wastage and feeling weak
• Bone issues and conditions such as osteoporosis
• Fertility problems – which can impact both men and women – and low sex drive
• Circulatory problems including poor circulation, irregular heartbeat, low blood pressure and in more extreme cases, heart failure
• Issues with the nervous system leading to fits or seizures and difficulties with concentration and memory
• Digestive issues such as kidney or bowel problems
• Weakened immune system and subsequent health conditions such as anaemia
• Fatigue, low stamina and low energy
• Exacerbating or compounding any existing mental health conditions

And all of this in-turn can have a knock-on impact on your personality, your relationships, your work or school life, and your general sense of wellbeing.

Causes And Triggers For Anorexia In Men

As with any mental health condition, there is no single specific known cause for anorexia but there are some links that can be associated with a higher risk of developing the condition:

• If you or a member of your family have a history of depression, eating disorders or alcohol or drug addiction.
• If you’ve been criticised or shamed for your eating habits, weight or body shape and this has led to predominantly negative feelings round those.
• You are concerned about being slim, and feel like you need to be slim to fit in with the “acceptable” body shape that the media seems to promote.
• Being in a sport that requires specific weight targets can lead to behaviours that lead down the road to anorexia.
• Issues around anxiety, self-esteem or having an obsessive or perfectionist personality can also have an impact.

Another thing that can have an impact is if you have previously been overweight or obese and this is something I touched on when I talked about orthorexia in men. When I started to lose weight, I got praised for my weight loss and being thinner.

So in my mind, being thinner was always seen as better and my focus became on getting as light as possible for a while. I never undernourished myself to the extent that someone with anorexia is likely to do but I can see how that association in your mind can lead down that road.

If you’ve ever been bullied about your weight, that can also contribute here.

Something else that I am very definitely not qualified to interpret or analyse, hence just linking to the source I found, is a study that suggests that anorexia in men can also be linked to a history of sexual abuse.

Getting Help For Anorexia

In terms of getting help or treatment, your first point of call should probably be to speak to your GP or family doctor.

If that’s something you can’t do for any reason, a registered dietician or nutritional therapist might be an option.

And 100% of the time, those should be your first avenues to at least look at pursuing.

If for any reason those don’t feel accessible, then online therapy might not be a bad option at least as a starting point. Some online therapy services allow you to communicate with a therapist over text or chat, which can be less intimidating or scary than doing it face-to-face or in-person.

This can help break down some of the barriers and help you get started before you look at speaking to someone in person.

Sometimes the first step is the hardest, so if you can make that first step a bit easier then by all means go for it.

Professional Treatment For Anorexia

In terms of professional treatment options for anorexia, it will depend on your specific circumstances and your history.

In some cases, medication such as antidepressants may be prescribed.

And in terms of types of therapy available, the NHS in the UK lists a few options:

• Cognitive behavioural therapy (CBT) – where you work with a therapist to cope with your feelings, understand nutrition and the effects of starvation and make healthier food choices.
• MANTRA (Maudsley Anorexia Nervosa Treatment for Adults) – where you focus on working with a therapist to understand your eating disorder, learn about nutrition, and get help with changing your eating habits.
• Specialist support clinical management – which involves learning about nutrition, and how your eating habits are causing your symptoms and you’ll start working towards a target weight.
• Focal psychodynamic therapy – which is trying to understand how your eating habits are related to what you think, and how you feel about yourself and the other people in your life.

If you are dealing with any other health issues as a result of your eating disorder, you may also receive clinical treatment to help address those.

Some Extra Resources On Anorexia

The journey to recovery from any eating disorder can feel long and challenging. But it isn’t something you have to should ever need to do on your own.

There are plenty of us out there who – even if we’re not going through the exact same thing as you – can empathise and lend a listening ear and be an extra shoulder to lean on.

There are also plenty of resources available, which I have linked below.

And if you want to reach out to me, please feel free. I can’t treat or diagnose but I can listen.

Resources:

• NHS
• NICE
• Mind

Helplines and support:

• Beat Eating Disorders
• Eating Disorders Anonymous
• National Eating Disorders