Men with eating disorders? Not the first thought we have when we think about an eating disorder. Typically, we think of young, thin women. But this week, during eating disorders awareness week, be mindful of the fact that around 10 million men will also suffer from an eating disorder in their life. And because eating disorders are most often associated with girls and women, there is a stigma for males to admit to the problem. But thanks to celebrities like Eminem, Dennis Quaid, Robert Pattinson, Aaron Carter, and Bam Margera, more men are talking about their struggles.

Men have body image issues just like women do.  When they compare themselves to supermodels, action figures and video avatars, they come up short. This body  dissatisfaction can give way to pressure wanting big muscles and a work out body with a six pack. To attain this goal, unhealthy behaviors with food and weight loss products can begin.

When men are involved in athletics, the body focus can really push them to the extreme. Purging by exercise is a way to get rid of unwanted calories. And behaviors like restrictive dieting, extreme exercise regimes and/or anabolic steroid abuse are common. A common subtype of clinical eating disorders is muscle dysmorphia, a type of body dysmorphic disorder that involves obsession with being more muscular.

The failure to live up to cultural views of masculinity and being strong physically can lead some down a dangerous path of food restricting or bingeing and purging. One group of men with eating disorders who is especially vulnerable is gay men.

Both men and women with eating disorders struggle with feeling out of control in parts of their life. Food becomes the object of struggle and is used to gain a false sense of control. When you think you have to have a perfect body to fit in or be successful, food takes on a new meaning. It becomes the object of obsession and control.

From a medical perspective, males with anorexia may have low testosterone levels and vitamin D. This means they have a high risk of osteopenia and osteoporosis and may need testosterone supplements. Psychologically, lower self-esteem, perfectionist, weight/body related teasing or bullying can all play in a role in the development of an eating disorder. And males who have high rates of substance use, depression and anxiety are also at risk.