Prevalence of Eating Disorders By Group

Women

Women are considered to be the population most impacted by eating disorders, with studies indicating women have higher rates of Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder than men (.9%, 1.6%, and .5% versus .3%, .8%, and .1%, respectively [1]. Many argue that this is the case because societal expectations on women’s appearance are more stringent than the expectations placed upon men.

While this does not mean that men do not struggle with social pressures to appear a certain way, there does seem to be more money spent on beauty advertising directed toward women as well as more frequency and accepted social dialogue centering on women’s physical bodies and appearance than men’s. Regardless of the reasons, research makes it clear that women are more impacted by eating disorder beliefs and behaviors than any other population.

Men

While more women struggle with eating disorders than men, a frightening 1 million men affected is no small impact [2]. This number may not even properly convey the severity of eating disorders impact on men due to underreporting. Men are less likely to report their eating disorders because they experience increased pressure to hide their emotional selves and are often stigmatized for openly discussing feelings or struggles.

This also leads to men struggling with increased undiagnosed or untreated depression, making them more vulnerable to eating disorders as well.

The pressure to appear “strong” is not only limited to emotions, as men face expectations of having muscular body types that can trigger disordered eating and exercising.

Eating disorder presentations can also differ in men. For example, men tend to steer away from “traditional” bulimia nervosa behaviors of purging via vomiting or laxatives and tend to instead purge via excessive exercise [2]. Additionally, men that identify as gay or bisexual are 10 times more likely to develop disordered eating than straight men [2].

Children/Adolescents

Children specifically are more susceptible to eating disorder diagnoses of Avoidant and Restrictive Food Intake Disorder (ARFID), which is characterized by restrictive behaviors but not a fixation on body image, weight, or size. Children may engage in these behaviors to avoid certain foods they do not like, due to discomfort with textures, or avoidance of feeling sick. ARFID is more than “picky eating,” however, as the child’s health will be compromised due to their restrictive tendencies.

Adolescents may be one of the most concerning populations at-risk for eating disorder behaviors, as 2.7% of adolescents that struggle with disordered eating will struggle for their lifetime [1]. Adolescents are uniquely vulnerable to eating disorders due to the transitional changes they are experiencing mentally and physically. As their bodies change through puberty and development, teens may struggle with negative body image, increased emotion dysregulation, and social pressure to attain a certain appearance, all of which make them more at-risk for eating disorder behaviors.

For both children and adolescents, family beliefs and discussions on self view, body image, weight, shape, size, and appearance are an important factor in resilience against eating disorders or increased risk of development.

Young Adults/College Students

As teens transition from high school to young adulthood, eating disorder diagnoses increase [1]. Young adults are going through formative changes of identity exploration, living on their own for the first time, continued developmental body changes, social upheaval, and consideration of their future. All of this can lead to increased mental health issues and eating disorder behaviors may occur as a maladaptive coping skill or attempt to alter the changing body.

A survey taken by the American College Health Association found that “3% of females and 0.4% of males reported ever receiving a diagnosis of anorexia; 2% of females and 0.2% of males reported a previous diagnosis of bulimia; and 4% of females and 1% of males reported vomiting or taking laxatives to lose weight in the previous 30 days [3].” College students may also be more likely to engage in binge eating behaviors due to increased stress, adjusting to living on their own, or an inconsistent daily living schedule.

Adults

Eating disorders are not solely disorders experienced by the young, as research indicates .6% of adults will struggle with anorexia nervosa in their lifetime, .3% with bulimia nervosa, and 1.2% with Binge Eating Disorder [1]. Many adults may have struggled with these disorders their entire lives consistently while others may have entered a period of recovery only to have the disorder return later in life.

Life stressors such as death of a loved one, a child moving out, divorce/separation, loss of a job, and many more can trigger an individual to utilize the maladaptive coping skills of eating disorders. The aging process can also lead adults to development of dangerous behaviors in an effort to preserve youth.

Athletes

The pressure for athletes to perform leads them to be at an increased risk for eating disorders, with approximately 13.5% of them struggling [4]. This is specifically true for those in “aesthetic sports,” that is, those sports where appearance is considered as part of scoring. For women, the sports with highest eating disorder risk are dance, gymnastics, and figure skating. For men, these are wrestling, equestrianism, and bodybuilding.

Identifying eating disorder behaviors among athletes is difficult, as many of the behaviors viewed as “warning signs” are glorified in the athletic world. Some behaviors to look out for, regardless of the sport or athlete, include fixation on body size, weight, shape, or appearance, continuing to perform despite injury, obsessing over what one consumes, training long and arduous hours outside of practice, insufficient nutritional intake on par with energy output, declining or skipping meals, possessing diuretics or laxatives, leaving mid-meal or after meal to use the restroom, and/or hiding food, just to name a few.

Models/Fashion Industry

The fashion and beauty industry is viewed by many to be the “belly of the beast” when it comes to diet culture and disordered eating and exercising beliefs. Participants in this culture, such as models, are no less victims of the industry than consumers. These individuals experience the same pressure to conform to beauty standards and their professional success hinges on fulfilling these expectations.

A 2017 study learned that over 62% of models surveyed had been asked to lose weight or change their shape or size, 54% had been told that they would not book future jobs if they did not lose weight, and 21% were told by their agency that they would no longer represent them if they did not lose weight [5]. As study designers specified, this creates a situation of coercion where eating disorders become an occupational hazard of the modeling industry [6]. This is deeply concerning, particularly as more individuals than ever can become models for brands due to the burgeoning social media “influencer” market.

Resources

1. Unknown (2017). Eating disorders. National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/statistics/eating-disorders#part_155057.
2. Strother, E., Lemberg, R., Stanford, S. C., & Turberville, D. (2012). Eating Disorders in Men: Under diagnosed, Undertreated, and Misunderstood. Eating Disorders, 20(5), 346–355. doi:10.1080/10640266.2012.715512.
3. Eisenberg, D. et al. (2011). Eating disorder symptoms among college students: prevalence, persistence, correlates, and treatment seeking. Journal of American College Health, 59:8.
4. Ghoch, M. E., et al. (2013). Eating disorders, physical fitness, and sport performance: a systematic review. Nutrients, 5:12.
5. Rodgers, R. F., et al. (2017). Results of a strategic science study to inform policies targeting extreme thinness standards in the fashion industry. International Journal of Eating Disorders, 50:3.
6. Yotka, S. (2017). How Sara Ziff and more than 40 other models are leading the charge against eating disorders. Vogue Magazine. Retrieved from https://www.vogue.com/article/model-alliance-eating-disorder-study.