Bulimia Nervosa in Men: Top Ten Facts

Bulimia Nervosa in Men

Bulimia nervosa in men is a rare occurrence, and the stigma surrounding male bulimia often makes it difficult for men struggling with the disease to be honest about what is going on. The shame that comes with the admittance of bulimia nervosa is what makes the disease stay a secret, which can lead to serious health complications.

Bulimia nervosa in men can come in the form of laxative abuse, self-induced vomiting, compulsive exercise, diet pill abuse or periods of bingeing followed by periods of starving. These abnormal eating habits need to be treated quickly, before serious complications arise, but many men struggling with this disease hesitate to come forward. Here are ten facts that are known about bulimia in men.

1. Symptoms of Male Bulimia

Symptoms of male bulimia include binge eating, which is categorized as the rapid intake of large quantities of food in a short period of time. What differentiates bulimia from compulsive overeating is that the sufferers will compensate for the binge by "purging" the food in an unhealthy way. Purging can be done by excessive exercise, laxative abuse, self-induced vomiting, abuse of ipecac, diet pill abuse or by the abuse of diuretics. When a person with bulimia is in "binge mode" they feel out of control and incapable of stopping their eating (which is usually done in secret).

2. Prevalence

Of all patients with bulimia nervosa, only 5% to 15% are male cases. This number may be higher, but because men struggling with bulimia nervosa feel so much shame surrounding the disease, they don’t come foreward, and so the statistics are probably not a true reflection of incidence and prevalence.

3. Causes

It is difficult to generalize the causes of bulimia nervosa in men, but there are certainly several factors that can be catalysts in the progression of the disease. Many men who struggle with bulimia have a history of trauma. PTSD (post traumatic stress disorder) can fuel eating disorder behaviors.

Another factor that can aid in the development of bulimia is genetics. Science is currently trying to find the exact role that genetics play in the onset of an eating disorder, but for now all that is known is that there is some sort of genetic link.

4. Factors that Increase Chances of Bulimia Nervosa

Male wrestlers are 7 to 10 times more likely to develop bulimia nervosa than the average male. The pressure that is placed on male wrestlers to make weight and stay in their weight range is enough to trigger bulimic tendencies and ultimately lead to the development of an eating disorder. Other athletes with similar pressures include jockeys and runners.

Another group of men who are highly susceptible to bulimia nervosa are homosexuals. Since low self-esteem and a lack of self-worth contribute to the development of bulimia, men who are unsure about their sexuality, or discriminated against because of it, are prone to develop bulimic tendencies.

5. Weight before Onset

Typically, men who develop bulimia nervosa are overweight before the onset of the disorder. This is very different from women, who just "feel" fat, but are usually within the normal weight range. Diagnosis of an eating disorder in overweight men is very difficult, due to the accepted opinion that men just like to eat. So no suspicion stems from seeing a guy over-indulge, the way it does when a woman does the same thing. Not all men with bulimia nervosa are overweight however, and the longer the disease has been present, the harder it is to pin a certain weight range to men who are struggling. Some men can be severely overweight, while some can be severely emaciated.

6. Common Co-Occurring Problems

Often, when doctors diagnose bulimia nervosa in men, it becomes apparent that the sufferer also has a problem with alcohol or drug addiction. Although the co-occurrence of bulimia and addiction is found in both men and women, it is at a higher rate in men with bulimia. In addition to the bulimia, the male may also suffer from a psychiatric mental illness such as depression, post traumatic stress disorder, an anxiety disorder or obsessive compulsive disorder.

7. Medical Complications of Male Bulimia

The medical complications of male bulimia include tachycardia, bradycardia, low blood-pressure, diabetes, electrolyte imbalances, heart arrhythmias, constipation, diarrhea, heart burn, acid reflux, GERD, stomach ulcers, prolapsed rectum, malnutrition, dehydration, osteopenia, osteoporosis, blood vessel damage, cancer of the mouth, cancer of the esophagus, torn esophagus, heart attack and death.

8. Putting Together a Treatment Team

To treat bulimia nervosa in men, a treatment team should be designed to oversee care. There are several components to an effective treatment team. The first component is making sure someone is monitoring eating, either an RD (registered dietician) or LN (licensed nutritionist) would be the best option for this. A therapist is also important, to address the underlying issues that are fueling the eating disorder. A psychiatrist should be on the treatment team if medication management is necessary, and a consult can assess the patient for co-occurring disorders. Another necessary element of the treatment team is an RN (registered nurse), preferably one who is trained in eating disorders who can monitor the patient’s health during treatment.

9. Effective Therapies

There are several therapies that have been studied and shown to increase the chance of recovery from bulimia nervosa. Three of them are ACT (acceptance commitment therapy), CBT (cognitive behavior therapy) and DBT (dialectical behavior therapy). In all three therapies, the patient is taught better ways to cope with his emotions and deal with life on life’s terms. Various strategies are taught that can teach the person that he is not powerless over the way he feels, and just because he feels a certain way, that doesn’t make it reality. All three therapies have proven to be effective in the treatment of bulimia in men.

10. Treatment Types

There are many forms of treatment available for male bulimia. Often the man will struggle with body dysmorphia, which must be addressed while the eating is being restored to a sense of normalcy. Residential treatment centers are set up in some countries which are designed to focus on those who cannot recover in the outside world, and need long-term treatment to heal.

Eating disorder units provide short stays and are meant to stabilize someone who is in medical danger. Outpatient treatment can help people who are not too far progressed in their disease, and it will usually consist of group therapy, and one or two supervised meals. A doctor who is trained in eating disorders can assess the male and decide which level of treatment would be appropriate if necessary.


Bulimia Statistics Accessed October 10, 2010

Doc Shop Accessed October 10, 2010