Bulimia in Men

Bulimia nervosa is a severe, life-threatening disorder characterized by recurrent episodes of binge eating followed by self-induced vomiting or other purging methods (e.g., laxatives, diuretics, excessive exercise, fasting) to prevent weight gain. An individual struggling with bulimia is intensely afraid of gaining weight and exhibits persistent dissatisfaction with his body and appearance, as well as a significant distortion in the perception of the size or shape of his body.

Although bulimia has been erroneously referred to as a “women’s disease,” it is the same psychiatric disorder, regardless of gender. Men who have bulimia need not feel stigmatized based on their sex. Amongst both genders, bulimia usually develops in a person’s teens or twenties. However, onset can occur at any age. Athletes, such as wrestlers, gymnasts, and jockeys, are at particular high risk. Treatment for males is similar to that for females, with perhaps added emphasis on father-son relationships, strength training, and all-male support groups when feasible.

Behavioral Characteristics:

  • Recurrent episodes of binge eating: eating an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
  • A sense of lack of control over eating during binge episodes
  • Recurrent purging or compensatory behavior to prevent weight gain: secretive self-induced vomiting, misuse of laxatives, diuretics, or fasting, compulsive exercise (possibly including excessive running, body building, or weight lifting)
  • Hoarding of food, hiding food and eating in secret
  • Frequently weighing self
  • Preoccupation with food
  • Focus on certain body parts; e.g., buttocks, thighs, stomach
  • Disgust with body size or shape
  • Distortion of body size; i.e., feels fat even though he may be thin

Emotional and Mental Characteristics:

  • Intense fear of becoming fat or gaining weight
  • Performance and appearance oriented
  • Works hard to please others
  • Depression
  • Social isolation
  • Possible conflict over gender identity or sexual orientation
  • Strong need to be in control
  • Difficulty expressing feelings
  • Feelings of worthlessness — uses weight, appearance, and achievement as measures of worth
  • Rigid, inflexible “all or nothing” thinking

Physical Characteristics:

  • Weight fluctuations
  • Loss of dental enamel due to self-induced vomiting
  • Edema (fluid retention or bloating)
  • Constipation
  • Swollen salivary glands
  • Cardiac arrhythmia due to electrolyte imbalances
  • Esophageal tears, gastric rupture
  • Lack of energy, fatigue


Compiled by Tom Shiltz, MS, CADC III of Rogers Memorial Hospital, and updated by Leigh Cohn of Gürze Books in 2006. (Source: DSM-IV, American Psychiatric Association, 1994).

Permission granted for reprint by NEDA (www.NationalEatingDisorders.org).