Boys and young men are quietly facing a mental health crisis that almost no one is talking about. Eating disorders, long mislabeled as a “female problem,” are now affecting males in ways the medical system often isn't equipped to recognize, much less treat. The behaviors look different. The symptoms are often dismissed. And the effects can be more serious than many people realize.
What's even more troubling is how often these disorders go undetected. Parents, teachers and even health care providers often miss the warning signs in boys because they don't look like the conventional red flags: extreme thinness, fear of weight gain or visible emotional distress around eating. Instead, boys tend to chase leanness and muscle definition.
They follow rigid diet rules, binge in private or use exercise as a form of punishment — all while appearing "normal" on the outside.
This mismatch between how eating disorders show up in boys and how they're officially diagnosed is at the heart of the problem. Most clinical tools were designed with female experiences in mind, and they often don't catch the behaviors that can harm boys' physical and mental health from the inside out. This article explores the latest data on how widespread male eating disorders really are, why they're so often missed and what can help support recovery.
The Eating Disorder Epidemic No One Is Talking About
A 2025 study published in Eating Behaviors set out to determine how common eating disorders are among males — a group that's long been underrepresented in mental health research.1
Using an online survey of 1,553 boys and men ages 15 to 35 years old from across the U.S. and Canada, recruited through Instagram and Snapchat ads, researchers applied an established algorithm, based on a standard self-report eating disorder questionnaire, to estimate who likely met criteria for various eating disorders.
Because there were no clinical interviews, the results reflect probable — not confirmed — diagnoses, and a social media sample may not represent all boys and men. The goal was to get updated, accurate prevalence rates and identify which social and personal factors increase risk.
• More than 1 in 5 males met criteria for a probable eating disorder — The findings were eye-opening: 21.3% of participants qualified for a probable eating disorder. Bulimia nervosa was the most common probable diagnosis at 5.8%, followed by binge eating disorder at 3.3%. Anorexia nervosa was rare by comparison, identified in only 0.3% of the sample.
Figure 1. In a 2025 online survey, 21.3% of boys and men ages 15 to 35 met criteria for a probable eating disorder, with bulimia nervosa the most common type.
• Boys most affected by disordered eating weren't who you'd expect — The highest odds of disordered eating showed up in two main groups: sexual minority males (gay and bisexual) and those with a higher body mass index (BMI).
Gay and bisexual participants had more than double the odds of meeting criteria for a probable eating disorder compared to heterosexual peers. Each unit increase in BMI was also linked to 18% higher odds of a probable eating disorder, which the authors suggest may reflect a combination of weight stigma, self-objectification, and body dissatisfaction.
• Extreme dieting and binge eating were common but often hidden — Participants reported a wide range of disordered behaviors, from strict dieting and detox diets to binge eating, laxative use, and compulsive exercise. The most common, each reported at least four times in the past month, were compulsive exercise (23.6%), strict dieting (20.5%), and binge eating (17.1%). Detox diets (2.9%) and laxative use (0.6%) were far less common.
Figure 2. Compulsive exercise, strict dieting and binge eating were far more common than detox diets or laxative use.
But because many of these behaviors don't match the stereotypical eating disorder profile, like thinness or food aversion, they can be missed in clinical settings. This blind spot can delay diagnosis and treatment.
• Muscle-focused goals can hide how serious the problem is — The study didn't measure muscle-building goals directly, but its authors note that standard questionnaires can miss the drive for muscularity common among boys and men with eating disorders. Many males with eating disorders aren't trying to be thin — they're striving for a lean, "cut" physique — broad shoulders, a narrow waist, and defined abs.
This focus on shape rather than size can lead to bingeing, fasting, or overexercising to sculpt the body. And because someone may still have “normal” or even above-average weight, the severity of the disorder can be underestimated.
Standard Assessments Miss Male Eating Disorders by Design
The 2023 Within Health summit video “Hidden in Plain Sight: Men with Eating Disorders,” presented by Dr. Brad Zehring, founder of the Zehring Clinic, explored why boys and men are underdiagnosed with eating disorders and how current screening tools fail them.2 Eating disorders have been described as among the most gender-biased mental health conditions, a failure that dates back to decades of research built almost exclusively around female experiences.
• Diagnostic criteria were built around female-centered symptoms — According to the video, much of the standard medical understanding of anorexia was originally built around female symptoms like amenorrhea, the absence of menstruation — a criterion that was dropped from the diagnostic manual's definition of anorexia in 2013, though its influence lingers.
Since men don't menstruate, they were excluded by default from decades of research and recognition. Instead of showing up with thinness or dramatic weight loss, men often present with muscle obsession, compulsive exercise and rigid control over their eating habits.
Figure 3. Standard screening tools were built around female-centered signs such as thinness, while boys more often show muscle-focused behaviors those tools can miss.
• Males present different warning signs, but doctors often aren't trained to look for them — For men, binge eating is often hidden inside culturally accepted behaviors like “cheat meals” or strict bulking and cutting cycles. Some consume up to 9,000 calories in one sitting, yet tend to report physical rather than emotional distress. Because of that, many male patients aren't flagged by conventional assessments.
• Male patients are often misjudged due to body size or muscle mass — Many boys with disordered eating have normal or high body weights, which makes them seem "healthy" to clinicians who associate risk with being underweight. Yet these boys are frequently engaging in intense food restriction, diet pill use or punishing workout regimens.
• Muscle dysmorphia plays a central role but is often missed — Muscle dysmorphia is a condition where boys believe they're not muscular enough — no matter how fit they are. It can drive extreme behaviors: constant lifting, extreme supplement use, food rules and social isolation. The video described this as a "pathological pursuit of muscularity," one that mirrors the drive for thinness seen in girls with anorexia but is rarely acknowledged in boys.
Cultural norms around masculinity complicate the picture even more. A boy who overeats is often seen as lacking discipline rather than struggling with an actual mental health condition. This keeps boys from speaking up, asking for help or even recognizing they have a problem in the first place.
• Treatment spaces often feel unwelcoming or alienating to male patients — Many boys report feeling out of place in eating disorder treatment programs, which are often geared toward women. Everything from reading materials to how the treatment is discussed often fail to reflect male experiences. As a result, boys often enter therapy feeling defensive, ashamed or like they don't belong — barriers that reduce their chances of recovery.
How Gut Health May Influence Eating Behavior Through the Gut-Brain Axis
If you've been struggling with disordered eating, intense food rules, or obsessive thoughts about your body — especially if those habits feel out of your control — your gut could be part of the reason. I'm not just talking about digestion.
I'm talking about how your gut communicates with your brain, shapes your mood and regulates your hormones. That connection is called the gut-brain axis, and when it's off, it may be harder to make calm, rational decisions around food and body image.
A 2024 study of people with depression found that those with appetite loss had distinct gut bacteria and inflammation patterns, though the study could only show a correlation,3 and research in mice and a small group of people has linked certain gut bacteria to food addiction-like eating, a pattern related to binge eating.4
The connection also runs the other way. Digestive symptoms are common across eating disorders, including anorexia, bulimia and binge eating disorder.5 Researchers have also noted that people with anorexia often cite digestive discomfort as a reason they can’t eat.6
That’s why any change to how you eat should be worked out with your eating disorder treatment team rather than on your own, with the focus on regular, adequate meals, not new food rules. One change I do recommend for nearly everyone is replacing seed oils like canola, soybean and sunflower oil with grass fed butter, ghee, or tallow. The linoleic acid in these oils may damage your mitochondria and gut lining and lower cellular energy. This is a swap, not a cut: you’re changing the fat you cook with, not eating less.
Restoring your gut isn’t just about digestion — it may also support your thoughts, habits, and emotional resilience. When your gut is balanced, your thinking may feel clearer and cravings may ease, which can make it easier to rebuild a healthy relationship with food.
Whether you’re dealing with anorexia, binge eating, or obsessive food thoughts, caring for your gut can be one supportive piece of recovery — alongside, not instead of, care from a qualified eating disorder treatment team. If you or someone you know is struggling, reach out to a doctor or eating disorder specialist.
FAQs About Eating Disorders in Boys and Men
Q: How common are eating disorders in boys and young men?
A: In a 2025 online survey, 21.3% of boys and men between the ages of 15 and 35 years old met criteria for a probable eating disorder.7 This includes conditions like bulimia, binge eating disorder and atypical anorexia. Many may go undiagnosed, in part because common screening tools were designed around female symptoms, not male behavior patterns.
Q: What do eating disorders look like in boys compared to girls?
A: Boys are more likely to fixate on muscularity and leanness rather than thinness. They often follow strict diets, binge during "cheat meals" and use compulsive exercise as a way to manage emotions. These behaviors don't always trigger alarms in standard assessments, which focus more on weight loss and emotional distress around food.
Q: Who's most at risk for eating disorders among males?
A: In the featured 2025 survey, gay and bisexual boys and men had more than twice the odds of a probable eating disorder compared to heterosexual peers,8 and earlier research cited by eating disorder clinicians found even larger gaps for some behaviors, such as binge eating.9 Boys with higher body mass indexes (BMI) also face elevated odds, possibly due to weight stigma and pressure to meet unrealistic body ideals. These groups are under-supported in both research and treatment.
Q: Why are current diagnostic tools failing boys and men?
A: Most tools were developed around female-centric symptoms like fear of weight gain and menstrual changes. They don't account for behaviors like cheat meals, supplement abuse or muscle dysmorphia. Because of this, many boys may be misdiagnosed or never diagnosed at all, even when their behaviors are severe.
Q: How does gut health influence eating disorder recovery?
A: Early research suggests gut imbalances may influence mood, appetite and eating behavior through your gut-brain axis. Healing your gut — especially by removing vegetable oils, focusing on white rice and fruit before fiber until your gut health improves, then restoring beneficial bacteria like Akkermansia — may help create a more stable foundation for recovery, as a complement to professional eating disorder treatment.
Supporting butyrate production matters too, since this compound helps maintain your gut lining, is thought to help regulate inflammation and may support clearer brain function.
This article is for informational purposes only and does not constitute medical advice. Consult a qualified health care provider before making changes to your health regimen.