Eating Disorders in Boys and Men: A Gender-Critical Narrative Review on Recognition, Stigma, and Treatment
Abstract
In this narrative review, I highlight diversity-related developments in eating disorder (ED) research, situate my own program of work on adult men within the broader literature on boys and men, and focus on risk factors, symptoms, diagnosis, and treatment in boys and men. I build on recent reviews on gender in EDs but adopt a gender-critical perspective that asks why males remain comparatively invisible in epidemiology, diagnosis, and services despite their substantial burden of illness. EDs in males span the full diagnostic spectrum and often present with muscularity-oriented body dissatisfaction, compulsive exercise, and performance-enhancing substance use that are poorly captured by traditional, thinness-focused tools. Internalized stigma regarding the construction of EDs as "women's disorders" and traditional masculinity norms create gender-specific barriers to recognition and help-seeking in males. Minority stress (i.e., stress related to discrimination, stigma, or social rejection among sexual and gender minorities) can further shape the manifestation and maintenance of EDs in sexual and gender minority males. Given the emerging evidence for distinct male phenotypes and pathways into care, there is a high need for gender-sensitive diagnostics, treatment settings, and health policies that make EDs in males more visible, more intelligible, and more treatable across developmental stages.
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