A local expert is warning that eating disorders among men are far more common than most people realize—and far more likely to go unnoticed. Brian Pollack, a licensed clinical social worker and certified eating disorders specialist at Hilltop Behavioral Health in Summit, New Jersey, says the condition is “highly underreported” among men, who often hide their struggles out of shame.
The topic drew national attention recently after actor Sylvester Stallone, 80, told The New York Times he developed bulimia while preparing for his role in the 1982 film “Rambo,” describing an “obsession” with his eating habits that spiraled out of control. “It became an obsession. Really bad. It got to the point where I became bulimic,” Stallone said.
Bulimia nervosa involves cycles of binge eating followed by purging—vomiting, misuse of laxatives or diuretics, fasting or excessive exercise—according to the National Institute of Mental Health. The National Association of Anorexia Nervosa and Associated Disorders estimates that about 30 million Americans will experience an eating disorder in their lifetime, and roughly a third of them are male.
Pollack, who specializes in treating men with eating disorders at his Summit practice but has not treated Stallone, says the male version of the disorder often looks different from what people expect.
“Guys with eating disorders just present differently — for some men, it’s about musculature … they continue to build muscle because they are afraid that they are weak, they want their muscles to align. We also see people who want to be so lean and pencil-thin that they don’t eat whatsoever.”
Pollack compares the pressure boys and young men face today to the beauty standards that weighed on women in earlier decades. “We’re seeing this extreme need for perfection and musculature — and that is leading to bulimia right now,” he said. “It’s particularly in our adolescent boys, who are consuming a lot of information about the ideal of masculinity in the eyes of society at large.”
Control, shame and secrecy
Because masculinity norms discourage men from expressing vulnerability, Pollack says bulimia often becomes a stand-in for control. “Bulimia, especially, is about control,” he said. “And what is it that men want? They want to be in control on a superficial level.” Binging creates a feeling of losing control over food, he explained, and purging becomes a way of reclaiming it.
Pollack also pointed to a trend called “looksmaxxing,” in which young men pursue an idealized appearance through extreme measures, including cosmetic procedures to alter their jawlines. “It’s getting very scary out there, actually,” he said.
Because the binging and purging usually happen in private, families and friends often don’t see the warning signs. “They’re hidden,” Pollack said. “People are ashamed of them at times.”
Warning signs to watch for
Pollack said loved ones should pay attention to:
- A sudden increase in purchases of supplements like creatine or performance-enhancing substances such as human growth hormone
- Compulsive exercise routines lasting multiple hours a day
- Rigid, obsessive eating patterns, including strict keto diets, excessive protein intake, or refusal to eat anything but
