Manorexia: Causes & Signs of Anorexia in Men

Anorexia nervosa (AN) is an eating disorder characterized by a distorted body image, obsession with weight, extreme fear of gaining weight or getting fat, and significant food and/or calorie deprivation. It is a serious mental illness that takes a significant toll on mental, physical, and emotional health.

While commonly perceived as an issue that only impacts females, anorexia nervosa and other eating disorders also affect men at significant rates. But since a majority of research and focus has been on the experience of girls and women, many boys and men may go undiagnosed or not recognize symptoms, which can vary slightly from those commonly occurring in females.

How Prevalent Is Anorexia in Men?

Anorexia nervosa can impact people of all genders, races, body shapes and sizes, and ages. Although it is more common in young women, it also impacts young men, boys, and older men, with approximately 20% of AN cases affecting males.¹ Around 6 million men in the United States alone will experience an eating disorder of some type in their lifetime.⁸

Anorexia in men is commonly missed or misdiagnosed, however.² This is due to a number of reasons, including the stigma surrounding this disorder for males, missing or mistaking disordered eating behaviors, valuing certain body sizes and shapes over others, a lack of awareness around eating disorders in men, and even denial that there’s a problem.

What Causes Men to Become Anorexic?

Anorexia nervosa is a complex mental health disorder that stems from a number of interlocking causes. No one issue leads to AN, but rather a number of issues work together to form the unhelpful mindset and behaviors associated with the condition, including:

• Biological aspects: Anorexia commonly runs in families and is a heritable condition. Dysregulation in brain chemistry or circuitry can contribute to the onset of mental health disorders, like anorexia.
• Psychological aspects: These can include obsessive-compulsive tendencies, personality traits like perfectionism and cognitive rigidity, and other mental health disorders that tend to occur with AN, such as anxiety. Negative self-image or low self-esteem are also frequent factors.
• Environmental factors: Social pressures, high levels of stress, and sports that demand a specific body type or weight can all influence the onset of anorexia nervosa in men, as well as a history of trauma, bullying, or abuse.

Trauma and Triggers

Eating disorders often go undiagnosed and untreated in men.³ They can also occur later in life as a result of trauma or triggers, such as divorce, an empty nest, adjusting to retirement, stress caused by unemployment, and feelings of inadequacy or diminished power that often come with aging. In fact, eating disorders among older men seem to be on the rise.⁴

What Are the Signs of Manorexia?

There are a variety of physical, emotional, and behavioral changes and signs to watch for that can indicate anorexia. While many of these are the same regardless of gender, some are different for men than they are for women.^1,2

For example, while restricting food and counting calories are common for both women and men with AN, men are more likely to exercise excessively and use steroids. Men are also more likely to take supplements and try different diet trends to cut fat and build muscle.^1,2

Anorexia in men can often start with what is perceived as “healthy” eating that progresses to disordered eating and a lot of time in the gym to achieve a specific masculine body type. Then, it can develop into an eating disorder as behaviors become more extreme and less under the person’s control. 

Treatment Considerations for Men with Anorexia Nervosa

A gender-sensitive approach is vital for treating men with anorexia to focus on specific issues and considerations for males.

It can be difficult for a man to feel comfortable in a treatment setting made up of mostly women. This can be intimidating and does not address the considerations of men with anorexia. Similarly, men tend to have different symptoms and triggers.For example, men with anorexia often suffer from low levels of testosterone, and testosterone supplementation can often be necessary during treatment.⁶ It is important that treatment programs cater to this and help men develop better habits and coping strategies.⁷

Support for Body Image Issues and Mental Illness

Support groups composed of other men can also be highly beneficial during treatment and recovery. These groups enable men to connect with peers who can understand, empathize with, and support one another.

Treating Anorexia Nervosa and Other Eating Disorders

Anorexia nervosa is a serious mental health disorder that requires professional treatment to overcome. Treatment often begins with medical management to address potentially life-threatening physical complications related to deprivation and starvation. 

Initially, the goal is to achieve a sustainable weight that is appropriate for the individual and combat immediate physical complications, such as dehydration and nutritional deficiencies. Therapeutic and supportive measures that can include individual and family psychotherapy, alternative therapies like music, dance, and art therapy, and support groups manage the behavioral and emotional factors leading to disordered eating, distorted body image, and low self-esteem. 

But full recovery is possible with a comprehensive, multidisciplinary treatment program that’s tailored to the individual needs of each person, no matter their gender.