June 2, 2022 – Anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant or restrictive food intake disorder are life-threatening psychiatric disorders that are generally difficult to treat. The lifetime prevalence of eating disorders such as anorexia nervosa and binge-eating disorder is 8.4 percent for women and 2.2 percent for men around the world. These data reflect diagnostic criteria based on clinical presentation in women and, therefore, most likely underestimate the prevalence in men. Women experience societal pressures that encourage and reward them for being thin; in contrast, men are encouraged to become large and muscular.
These pressures often lead women to engage in purging after meals and excessive use of laxatives and diuretics to lose water weight. Women are exposed to higher rates of bullying, shame, and pressure to be thin. Men are more likely to exercise excessively and consume excessive amounts of dietary protein supplements that can damage the kidneys. Men often report being hesitant to seek help for their addiction to exercise or their pursuit of a perfect physique. For these reasons, eating disorders have a long history of being female disorders. The unique genetic risks for females:
Studies have identified some genetic risk factors across sexes. For example, female relatives of men with anorexia nervosa have an increased risk of developing the same eating disorder. Twin studies, including same- and opposite-sex twins, report that about 50 percent of the genetic risk for eating disorders was shared. Most interesting, the females of male-female twin sets had a consistently higher genetic risk than the males of developing an eating disorder. Hormonal maturation is important given that the risk for females in these studies was undetectable until after puberty. In addition, having anorexia nervosa and carrying a large percentage of body fat are more genetically correlated in females than in males.
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