Improving Understanding, Recognition and Treatment for Men With Anorexia Nervosa

Abstract

Aims/Background Anorexia Nervosa (AN) in males is often overlooked due to the traditional perception of eating disorders as female concerns. Despite this, there has been an increased focus on male presentations. Research evidence, including concerns from people with lived experience, highlights specific risks and unmet clinical needs as a result of delayed help-seeking, inaccessible services, and treatment that does not account for men's needs. Methods Published research and personal narrative from an author with lived experience are combined to assess (1) existing evidence and gaps in knowledge and treatment for males with AN, and (2) solutions which may address challenges across research, policy, and clinical practice. Results There is an increased prevalence of AN amongst males, with most recent data from National Health Service (NHS) England showing a faster increase in hospitalisations amongst males compared with females. However, the quantity and quality of prevalence data and research into the drivers of this trend are severely lacking. The exclusion of males from clinical research has hindered efforts to assess the efficacy of current AN treatments, despite emerging evidence for males-specific symptoms and health impacts across biopsychosocial domains. These include more frequent use of excessive exercise, feelings of emasculation, neurodivergence, and specific physiological risks occurring at higher weights than females. These factors combine with under-resourced treatment provision which often feels exclusionary to males to create an increased risk of death and significant barriers to recovery. Conclusion Evidenced solutions for providing more timely recognition and effective treatment for males with AN are limited, emphasising the importance of further research. Present-day clinical practice needs to ensure the safe medical management of males with AN, taking an integrated approach to treatment that accounts for co-occurring conditions and minority status identities. Being more responsive to the needs of males with AN and removing the barriers to effective care can be aided by projects that collaborate with men with lived experience.

Keywords: Anorexia Nervosa; Avoidant Restrictive Food Intake Disorder (ARFID); eating disorders; gastroparesis; male.