How Boys are Uniquely Susceptible to Bulimia Nervosa

Males with Eating Disorders

The topic of boys and bulimia and disordered eating in general isn’t talked about enough, even in the eating disorder realm. These disorders will impact at least 10 million men in their lives. Yet, research is rarely focused on this population [1].

This is especially unfortunate for boys and male adolescents, as there are certain factors placing them at risk.


The pressure placed on young women and girls is commonly discussed. However, the burden to fulfill a certain image happens to boys, too.

Our culture’s view of what is considered “masculine” is limited and skewed in many ways, including what a “man” should look like. Children and adolescents are particularly susceptible to these messages, wanting to appear attractive and “fit in” so that they avoid negativity and bullying.

How sad is that?

Two guys discussing boys and bulimiaOur country’s youth are receiving the message that, if they don’t look like they are “supposed to,” they will be hurt, emotionally, and possibly, physically. The “ideal” male body that boys see is, similar to the female ideal, not representative of the average American male body.

Boys often feel that they need to “bulk up” while still appearing lean and achieving an impossibly chiseled figure. This can particularly put them at risk for BN behaviors because they may turn to bingeing and purging in an effort to achieve this impossible ideal.

This is further perpetuated if the boy is engaged in sports.

Unspoken & Unseen

There are a few reasons boys engaging in bulimic symptoms might either be misdiagnosed or underrepresented.

To begin, eating disorders are primarily thought to be “female” disorders, making people more vigilant for disordered body image or eating patterns with women and girls.

Many minimize the body image concerns that boys have, unfairly treating them as if they are less severe or dangerous than those in girls.

Not only that, our culture emphasizes that to be “masculine” is not to show weakness or express emotions, sending the message to boys that, even if they wanted to discuss their self-view or body image, there is something wrong, or “not manly,” about them if they do.

These errors also occur in the diagnosis of these disorders, as medical professionals are not perfect and may have gender biases impacting their consideration of a boy displaying disordered eating symptoms.

Even the tests and questionnaires that are evidence-based are often found to be biased towards women and girls.

One test explains why that is problematic by stating, “Males score lower than females even in clinical settings, highlighting that these measures may not capture some aspects of ED psychopathology relevant for males. For instance, males may be vulnerable to using steroids as part of their ED, which are not captured by traditional measures [2].”

Because of these challenges, many bulimic symptoms in boys and men are either overlooked or not reported, leading to the average age of BN diagnoses in men not occurring until their late 20’s [3].

What Can You Do?

Guy dealing with mental health in mirrorSo many of the unique risk factors experienced by boys involve misinformation and misunderstanding of the fact that boys are just as vulnerable as girls to feeling insecure and inadequate.

The best way to support boys and bulimia and reducing their risk factors is to open your eyes and ears to seeing them, hearing them, and understanding that adolescence is a tumultuous time for boys and girls. A time when parental support, non-judgment, and openness is important.

Allow your boys to be emotional, let them know it is okay to discuss their feelings and challenges, that it is okay to have a different body than others, that food should nourish your body and soul and be enjoyed, and that they are special just as they are.


[1] Unknown (2018). Eating disorders in men and boys. National Eating Disorders Association. Retrieved from

[2] Zayas, L. V. et al. (2018). Gender differences in eating disorder psychopathology across DSM-5 severity categories of anorexia nervosa and bulimia nervosa. International Journal of Eating Disorders, 51, 1098-1102.

[3] Pertschuk, M. (2019). Boys and bulimia. Eating Disorder Hope. Retrieved from

Image of Margot Rittenhouse.About the Author: 

Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published July 5, 2019, on
Reviewed & Approved on July 5, 2019, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.