More than one in five boys and men between ages 15 to 35 met criteria for a probable eating disorder in a recent study of Canadian and American males, according to research.

Researchers from multiple institutions, led by Kyle T. Ganson, PhD, of the University of Toronto, analyzed data from 1,553 boys and men. Using established diagnostic algorithms based on DSM-5 criteria, they found 21.3% of participants met criteria for any probable eating disorder.

"There is a continued need to identify the prevalence and sociodemographic correlates of eating disorders, particularly among the under-researched group of boys and men, to inform prevention and intervention efforts," wrote Ganson and colleagues in Eating Behaviors.

Bulimia nervosa showed the highest prevalence at 5.8%, while anorexia nervosa was the least common at 0.34%. Other identified conditions included binge-eating disorder (3.25%), atypical anorexia nervosa (2.85%), and subthreshold bulimia nervosa (2.07%).

Multivariable logistic regression analysis revealed sexual minority status and higher BMI as significant predictors of eating disorders. Gay men had 2.28 times higher odds and bisexual men had 2.22 times higher odds of meeting criteria for any probable eating disorder compared with heterosexual peers. Every unit increase in BMI was associated with 18% higher odds of meeting eating disorder criteria.

"These findings underscore the need for continued targeted prevention and intervention programming for sexual minority boys and men and those in larger bodies," the study authors noted.

Interestingly, they found no significant differences in prevalence across age groups, gender identity, race/ethnicity, or education levels, which suggested that eating disorders may present similarly across these demographic categories.

The researchers highlighted that eating disorders have typically been misunderstood as "female disorders," which has contributed to inadequate attention to male presentations. They noted that standard diagnostic criteria may not fully capture male-specific presentations that focus on muscularity rather than thinness.

"The assessment of eating disorders among boys and men should include a focus on muscularity concerns, drive for muscularity, muscularity-oriented eating behaviors, and use of appearance- and performance-enhancing drugs and substances," the authors stated.

The authors declared no competing interests.