Eating Disorders in Men: Treatment in Portland & Vancouver
Eating disorders don't discriminate by gender, yet men face unique barriers to recognition, diagnosis, and treatment. If you're a man struggling with disordered eating, body image concerns, or compulsive exercise—you're not alone, and your experience is valid. At Beyond Eating Recovery, we provide specialized, gender-affirming treatment for men with eating disorders throughout Oregon and Washington, addressing both the symptoms and the societal factors that create silence around men's struggles.
Understanding Eating Disorders in Men
Eating disorders affect men at significant rates, yet cultural stereotypes portray them as "women's issues." This misconception creates devastating consequences: men struggle in silence, go undiagnosed, face stigma when seeking help, and often receive inadequate treatment.
The Reality
- • At least 25% of people with eating disorders are men (likely higher due to underreporting)
- • 1 in 3 people with eating disorders identifying as male
- • Subclinical eating disorders (not meeting full diagnostic criteria) affect up to 16% of men
- • Men experience all types of eating disorders: anorexia, bulimia, binge eating disorder, ARFID, OSFED, orthorexia
- • Men die from eating disorders at higher rates than women (due to later diagnosis and delayed treatment)
Why the Misconception Exists
- • Historical diagnostic criteria based on female bodies (menstruation requirement)
- • Research predominantly conducted on women and girls
- • Media portrayal of eating disorders as exclusively affecting women
- • Cultural narratives about masculinity and mental health
- • Healthcare provider bias and lack of awareness
- • Assessment tools designed for and validated on women
The Harm of Invisibility
When eating disorders are portrayed as "women's problems":
- • Men don't recognize their own symptoms
- • Family and friends miss warning signs
- • Healthcare providers fail to screen or diagnose
- • Men feel shame for having a "female problem"
- • Treatment programs may not feel welcoming or relevant
- • Research funding and resources are limited
Important Affirmation
If you're a man struggling with food, body, or exercise—your experience is real, valid, and deserving of support. Eating disorders are not gendered. They are human conditions that can affect anyone.
Unique Presentations in Men
While men experience all the same eating disorders as people of other genders, certain patterns and presentations may be more common or manifest differently:
Muscle Dysmorphia
A specific form of body dysmorphic disorder more common in men:
- • Preoccupation with being "too small" or not muscular enough
- • Obsessive focus on muscle building and body composition
- • Compulsive weightlifting and exercise
- • Strict dietary regimens (high protein, low fat, timed eating)
- • Use of supplements, protein powders, potentially steroids
- • Avoiding situations where body is visible
- • Anxiety and distress about perceived lack of muscularity
- • Body image distortion (seeing self as small despite being muscular)
See our Body Dysmorphia page and Exercise Addiction page for more.
"Bigorexia" or "Reverse Anorexia"
Another term for muscle dysmorphia—pursuit of larger, more muscular body rather than smaller body.
Bulking and Cutting Cycles
Common in bodybuilding and fitness culture:
- • Extreme caloric restriction alternating with extreme caloric surplus
- • Disordered eating disguised as athletic training
- • Rigid food rules and macro counting
- • Social isolation during "cuts"
- • Mood instability and relationship strain
- • May escalate into clinical eating disorders
Exercise-Focused Eating Disorders
- • Exercise addiction more common in men
- • Compulsive weightlifting and training
- • Compensatory exercise after eating
- • Over-exercise leading to injuries
- • Identity strongly tied to fitness/athletics
See our Exercise Addiction page
"Drunkorexia"
Restricting food to "save calories" for alcohol:
- • More common in college-age men
- • Skipping meals to drink without weight gain
- • Combining restriction with substance use
- • Dangerous metabolic and cognitive effects
Binge Eating Disorder
Actually more common in men than often recognized:
- • Men may represent up to 40% of BED cases
- • Often less recognized due to stereotypes
- • Similar patterns: loss of control, eating large amounts, distress
- • May be masked by "eating competitions" or cultural norms about male appetite
Orthorexia
Obsession with "clean" or "healthy" eating:
- • Often connected to fitness and performance
- • Rigid rules about food quality and purity
- • "Biohacking" and optimization mentality
- • Wellness culture disguise
See our Orthorexia page
Protein Obsession
- • Extreme focus on protein intake
- • Anxiety about meeting protein targets
- • Protein supplements and powders central to eating
- • Eliminating carbs or fats
- • Rigid meal timing
Weight Class Sports
Wrestling, rowing, martial arts, horse racing jockeys:
- • Dangerous weight cutting practices
- • Dehydration and restriction
- • Binge-purge cycles around weigh-ins
- • Normalized disordered eating in sports culture
Signs and Symptoms in Men
Many eating disorder symptoms are the same regardless of gender, but here are manifestations particularly relevant to recognizing eating disorders in men:
Physical & Behavioral Signs
- • Dramatic weight loss or fluctuations
- • Obsessive calorie, macro, or protein tracking
- • Rigid eating schedules and food rules
- • Eating only "clean" or specific foods
- • Excessive supplement or protein powder use
- • Steroid or performance-enhancing drug use
- • Compulsive exercise or weightlifting
- • Exercising despite injury or illness
- • Avoiding eating situations
- • Eating in secret or hiding food
- • Frequent bathroom trips after meals
- • Unusual food rituals or behaviors
Language Men May Use
Men may describe symptoms differently:
Instead of restriction:
- • "Getting shredded" or "getting lean"
- • "Cutting"
- • "Dialing in nutrition"
Instead of binge eating:
- • "Bulking"
- • "Cheat meals"
- • "Refeed day"
Instead of body dysmorphia:
- • "Making gains"
- • "Need to get bigger"
Instead of compulsion:
- • "Tracking macros"
- • "Optimizing"
- • "Discipline"
Why Men Are Underdiagnosed and Undertreated
Diagnostic Barriers
Historical diagnostic criteria:
- • DSM-IV required loss of menstruation for anorexia diagnosis (excluding men by definition)
- • Research samples predominantly female
- • Assessment tools designed for women
- • Diagnostic examples using female pronouns and experiences
Healthcare provider bias:
- • Doctors less likely to screen men for eating disorders
- • Symptoms dismissed or attributed to other causes
- • Assumptions that eating disorders only affect women
- • Lack of training on eating disorders in men
Assessment tool limitations:
- • Eating Disorder Examination (EDE) and similar tools reference female experiences
- • Questions about menstruation, pregnancy
- • Focus on drive for thinness rather than muscularity
- • May not capture male-specific presentations
Cultural and Social Barriers
Masculinity norms:
- • "Real men don't have eating disorders"
- • Mental health struggles seen as weakness
- • Vulnerability and help-seeking discouraged
- • Body image concerns seen as feminine
- • Expected to be strong, independent, not emotional
Stigma and shame:
- • Having a "woman's disease" threatens masculine identity
- • Double stigma: mental illness + gender role violation
- • Fear of being seen as weak or feminine
- • Isolation due to shame
The Consequences of Underdiagnosis
- • Men enter treatment later in illness (when more severe)
- • Higher mortality rates (due to delayed treatment)
- • Longer duration of untreated illness
- • More severe medical complications at diagnosis
- • Greater shame and isolation
- • Missed opportunities for early intervention
Cultural and Societal Factors
Understanding the cultural context is essential:
Masculinity and Body Ideals
The male body ideal has become increasingly unattainable:
- • 1970s-80s: Lean and fit (runner's body)
- • 1990s-2000s: Muscular and defined (bodybuilder aesthetic)
- • 2010s-present: Extremely muscular AND lean (superhero physique)
- → Often requires steroids, dehydration, professional lighting, photoshop
This ideal is:
- • Impossible for most men to achieve naturally
- • Digitally altered and chemically enhanced
- • Requires full-time dedication (job, genetics, resources)
- • Creates widespread body dissatisfaction in men
Fitness and Wellness Culture
- • "No days off" mentality
- • Protein and supplement obsession
- • Body fat percentage tracking
- • Before/after transformations
- • Fitness influencers promoting unsustainable lifestyles
- • Gym culture often toxic and competitive
See our Exercise Addiction page for more on fitness culture.
Diet Culture for Men
Rebranded as "performance," "optimization," or "lifestyle":
- • Keto, paleo, carnivore diets marketed to men
- • Intermittent fasting as "biohacking"
- • Macro tracking as scientific nutrition
- • "Clean bulking" and "cutting" cycles
- • Bodybuilding diets normalized
- • Supplements and protein powders essential
Social Media Impact
- • Instagram and TikTok fitness influencers
- • Constant comparison to edited, enhanced bodies
- • Algorithm pushing fitness content
- • Steroid use often undisclosed
- • "Natty or not" debates creating pressure
- • Progress photo culture
LGBTQ+ Considerations
- • Gay and bisexual men at significantly higher risk for eating disorders
- • Body ideals within LGBTQ+ communities
- • Discrimination and minority stress
- • Intersection of masculinity norms and sexual identity
Treatment Approach at Beyond Eating Recovery
We provide specialized, gender-affirming treatment that addresses men's unique experiences with eating disorders while recognizing that the core healing principles apply across all genders.
Anne's 6-Step Treatment Process (Adapted for Men)
1. Establish Safety and Medical Stabilization
- • Comprehensive medical evaluation (cardiac, hormonal, bone health)
- • Treatment of acute medical issues
- • Testosterone and hormonal assessment
- • Nutritional rehabilitation
- • If using steroids or supplements: safe discontinuation planning
- • Exercise modification or temporary cessation if needed
- • Mental health stabilization (suicide risk assessment)
2. Challenge Food Rules, Body Ideals, and Fitness Culture
- • Identifying rigid food and exercise rules
- • Examining cultural messages about male bodies
- • Challenging unrealistic male body ideals
- • Critical analysis of fitness culture and toxic masculinity
- • Understanding "biohacking" and "optimization" as diet culture
- • Deconstructing supplement industry marketing
- • Exploring masculinity beyond physical appearance
- • Permission-based eating vs. rule-based eating
3. Explore Emotional Underpinnings and Masculinity
- • Understanding emotions driving disordered eating
- • Addressing masculinity norms and their impact
- • Building emotional awareness and vocabulary
- • Exploring vulnerability and connection needs
- • Processing shame around "having a woman's problem"
- • Understanding control needs
- • Trauma processing if relevant
- • Identity work: who are you beyond your body?
4. Address Co-Occurring Conditions
- • Treatment for depression and anxiety
- • OCD or body dysmorphic disorder treatment
- • Substance use addressing (including steroids)
- • Exercise addiction treatment
- • Trauma-informed therapy
5. Heal Body Image and Build Body Respect
- • Challenging body dysmorphia and distortion
- • Addressing muscle dysmorphia specifically
- • Body neutrality and respect practices
- • Understanding weight set point and body diversity
- • Grieving unattainable body ideals
- • Reducing body checking behaviors
6. Build Sustainable Recovery and Authentic Masculinity
- • Relapse prevention planning
- • Redefining masculinity on your terms
- • Building identity beyond appearance
- • Flexible, joyful relationship with movement
- • Creating meaningful life beyond body focus
- • Reconnecting with values and purpose
Gender-Affirming Approach
- • Recognition that men's experiences are valid and unique
- • Addressing masculine socialization and its impact
- • Creating space to explore masculinity and body image
- • No assumption that experiences mirror women's experiences
- • Validation of male-specific presentations (muscle dysmorphia, etc.)
Treatment Settings
- • Outpatient therapy (weekly or more frequent)
- • Men's group therapy (if available) for shared experience
- • LGBTQIA+ group available: Thursdays 6-7:15pm, $40/session
- • Dietitian support (Stephanie Okumura, MS, RDN)
- • Telehealth throughout Oregon and Washington
- • Intensive outpatient if needed
When to Seek Help
Seek Help If You:
- • Have rigid rules about eating or exercise
- • Exercise compulsively or can't take rest days
- • Are preoccupied with muscle size or body composition
- • Use supplements, steroids, or other substances to change body
- • Restrict food or have compensatory behaviors
- • Feel distressed about eating or body
- • Notice physical symptoms (fatigue, injuries, low libido)
- • Experience depression, anxiety, or mood swings
- • Avoid social situations due to food or body concerns
- • Recognize patterns interfering with life quality
Seek Immediate Help If:
- Suicidal thoughts or self-harm urges
- Chest pain or irregular heartbeat
- Severe weakness or fainting
- Unable to function in daily life
- Dangerous steroid or substance use
You Deserve Help Even If:
- • You're not as thin as stereotypical anorexia images
- • You're in a larger body
- • You're "just" focused on muscle, not thinness
- • You think eating disorders only affect women
- • You feel shame about having this struggle
- • You haven't been diagnosed
- • You're still functioning in some areas
Breaking the Silence
The hardest part is often admitting you need help. Masculinity norms make vulnerability difficult. Asking for help is strength, not weakness.
Contact Beyond Eating Recovery at 360-726-4141 to schedule a consultation. We provide specialized, gender-affirming treatment for men with eating disorders throughout Oregon and Washington.
For Loved Ones: Supporting a Man with an Eating Disorder
If someone you care about is struggling:
Do:
- • Take concerns seriously (don't dismiss because he's male)
- • Express care and worry (focus on behaviors and well-being)
- • Validate that men get eating disorders (normalize it)
- • Support seeking professional help
- • Be patient with the process
- • Learn about eating disorders in men
- • Challenge masculine stereotypes that prevent help-seeking
- • Celebrate non-appearance qualities
Don't:
- • Dismiss concerns because "eating disorders are for women"
- • Say "just eat more" or "just stop working out so much"
- • Comment on his body (including compliments)
- • Praise "dedication" or "discipline" that's actually compulsion
- • Engage in diet/fitness talk or body comparison
- • Make jokes about eating disorders or masculinity
- • Pressure him to be "manly" and handle it alone
What to Say
- • "I've noticed you seem stressed about eating/working out. I'm worried."
- • "Eating disorders can affect anyone, including men. Your struggle is valid."
- • "It takes strength to ask for help. I support you getting treatment."
- • "You're valuable beyond your body and what you achieve."
What NOT to Say
- • "Men don't get eating disorders." (false and harmful)
- • "You look fine!" (dismissive)
- • "Be a man and deal with it." (reinforces toxic masculinity)
- • "That's a girl thing." (stigmatizing and inaccurate)
- • "You're too big/muscular to have anorexia." (misconception)
Related Resources
Internal Links
External Resources
Recommended Reading
- • "Making Weight: Healing Men's Conflicts with Food, Weight, Shape & Appearance" by Arnold Andersen, Leigh Cohn, and Thomas Holbrook
- • "The Adonis Complex: The Secret Crisis of Male Body Obsession" by Harrison Pope, Katharine Phillips, Roberto Olivardia
- • "If Your Hunger Could Talk" by Anne Cuthbert
- • "The Body Keeps the Score" by Bessel van der Kolk (trauma)