It’s possible the true number is even higher, as subconscious bias and a variety of other factors can lead to underreporting.
Still, eating disorders, including bulimia nervosa (BN), are serious mental health conditions, no matter who they impact. And learning how BN affects men is an important part of making sure anyone who is struggling with this condition can find the help they need.
Prevalence of Bulimia Nervosa in Males
Eating disorders in general—and bulimia nervosa, specifically—affect men much more often than many people think.
All told, it’s estimated that one in three people with an eating disorder is male, and thought that, overall, around 10 million men in the U.S. struggle with an eating disorder at some time in their lives. 
10 million men in the U.S. struggle with an eating disorder at some point in their lives.
Of these men, around 30% are thought to struggle with bulimia nervosa. 
And other studies reported men participating in many other disordered eating behaviors, including binge eating or purging, fasting, or misusing laxatives to lose weight.
How Bulimia Nervosa Presents in Men
While BN is an individualized condition and can present in any number of different ways in people of all genders, there are some traits that tend to manifest in males who struggle with the ailment.
Some findings suggest that boys and men with bulimia nervosa express less concern over eating and don’t experience as much loss of control during binging episodes. Others guess that these episodes are more likely, in boys and men, to be considered “cheat meals” or part of a diet, especially those focused on gaining muscle. 
In general, it’s thought that cis-gender men and boys with bulimia nervosa fixate on different body types than cis-gender women and girls with the condition. Males are thought to generally strive for more “masculine” shapes, which can be lean but are primarily muscular, compared to women, who tend to focus on thinness. 
Diagnosing Bulimia Nervosa in Men
One of the primary reasons men and boys may not be commonly thought of as people who struggle with eating disorders is this group’s widespread misdiagnosis and underdiagnosis.
Males struggle with body image issues as much as females do, but the standard questions used to diagnose an eating disorder may not flesh out the different ways these concerns are expressed. For example, a healthcare worker may ask someone if they have a desire to be thinner, and a male struggling with BN may be more concerned with gaining muscle.
In fact, much of the current diagnostic framework and historical research on eating disorders is based exclusively on the female perspective. It’s estimated that less than 1% of these studies consider the presentation of bulimia nervosa or other eating disorders in males. 
Less than 1% of studies consider bulimia nervosa or other eating disorders in males.
Signs of Bulimia Nervosa in Males
The lack of historical studies and empirical information has also created somewhat of a blindspot when it comes to early diagnosis of BN in boys. The understanding of the condition is so undeveloped that experts have a difference of opinion on whether the disorder presents earlier or later in males.
Regardless, there are some signs most experts agree on that point to the possibility of BN in cis-gender boys and men, including: 
- Preoccupation with body shape, muscle mass, and body fat
- Participation in excessive exercise regimes
- Taking part in “cheat” meals, where large amounts of calories are consumed and then “worked” off or purged
- Lowered testosterone levels
And most of the other common signs of bulimia nervosa also apply to males with the condition, including:
- Rigid eating rituals
- Discomfort eating around others
- Depression or anxiety
- Low self-esteem
Treatment Barriers for Males With Bulimia
One reason so many cis-gender boys and men may fail to seek help for bulimia nervosa is the stigma associated with the condition.
Many people in this group may consider BN and other eating disorders to be “female” conditions. They may either fail to see the signs in themselves or feel too embarrassed to speak up about what they’re experiencing.
Society also tends to hold different expectations around cis-gender males and cis-gender females. A focus on building muscle mass or even participating in “cheat meals” may not be as readily seen as disordered behavior in men.
And if cis-gender men present as “too thin,” they may be the subject of bullying, which can intensify unhelpful thoughts and behaviors and further discourage people from seeking help.
Finding Treatment for Bulimia Nervosa
Bulimia nervosa is becoming more commonly recognized in males. And with raised awareness often comes decreased stigma. This can open doors to wider outreach and more effective treatment.
But regardless of who is impacted by the condition, BN represents a serious concern with significant mental, emotional, and physical consequences.
If left untreated, the condition can even lead to death. That’s why it’s important to seek help as early as possible.
Today, there are programs that cater specifically to boys and men with bulimia nervosa, helping them to feel supported and accepted in treatment. You can find some of the best available options for your loved one by searching online, speaking with a healthcare company, or asking a mental health professional for a referral.
The road to getting there may be difficult, but the most important thing to remember is that bulimia nervosa is treatable.
With the right help, it’s possible to achieve a better mental balance, learn to effectively cope with triggers that led to binging and purging, and go on to live a happier and healthier life.
- Baragona, L. (2018, March 29). I am A Man with Bulimia, and This Is What It’s Like. Men’s Health. Retrieved September 20, 2022.
- Weisenberger, J. (2021, February 25). Eating Disorders Also Affect Boys and Men. Eat Right Academy of Nutrition and Dietetics. Retrieved September 20, 2022.
- Eating Disorders in Males. National Eating Disorders Collaboration. Retrieved September 20, 2022.
- Gorrell, S., & Murray, S. B. (2019). Eating Disorders in Males. Child and adolescent psychiatric clinics of North America; 28(4):641–651.