Boys can have anorexia, too

July 10, 2009

If a practitioner sees an underweight adolescent female, she might be suspected to have anorexia nervosa. But what if that teenage patient is male?

If a practitioner sees an underweight adolescent female, she might be suspected to have anorexia nervosa. But what if that teenage patient is male?

This is a woefully opportune time to discuss male anorexia: There is widespread speculation that Michael Jackson’s death was partly due to years of staying unhealthily underweight. Up to 15% of all people with anorexia nervosa or bulimia are male, and not all do it to make weight for the wrestling team. Some have the same psychiatric illness their “ano” sisters do, with unhealthy body images and warped growth due to malnutrition. They have the same potential for damage to the bones, kidney, heart, and liver, even death.

There has been speculation recently that anorexia and autism come from the same genetic predisposition for rigid thinking and an inability to change one’s mind or actions easily. About ten times as male males as females are diagnosed with an autistic spectrum disorder: the numbers are similar, but with reversed genders, for anorexia nervosa.

But what’s paramount in treating eating disorders is putting pounds back on the frame, increasing the BMI to a healthier number. The physical wellness may have to come before the mental wellness. Ask the right questions, establish a diagnosis, determine the severity -- and don’t exclude boys.