About 365,000 Australian men are living with an eating disorder, yet they're four times more likely to go undiagnosed than women and less likely to seek help — a gap that highlights significant deficiencies in the nation's mental health infrastructure. On average, just under 2,500 men have been diagnosed each year since 2012, according to the Butterfly Foundation.
Alec White-Cheshire was first diagnosed with anorexia at 10 years old. He's lived with the illness for almost two decades. "I have 20 years of living with it," he said. "I developed as a child with an illness, which has now become entwined into who I am. And that's the hardest part to come to terms with. You want to feel like this never existed or that you'll never have these thoughts again. But I think the harsh reality is there are certain things you've learned over the years … which will be there forever."
The Recognition Problem
White-Cheshire said he feels annoyed rather than sad about his diagnosis. "When I was 10, [the perception of eating disorders] was quite bad," he said. "[Now] there are differences. Don't get me wrong, there's a lot of companies and charities and things like that which are doing incredible work. But in local communities, it's still very much lacking understanding. Being male, I've experienced dismissiveness. People still just don't really understand the impact that any sort of eating disorder has on somebody … it just still seems to be portrayed as more of a choice rather than the illness it is."
Jackson Rose, a counsellor and supervisor for the Butterfly Foundation's helpline, said boys aged 16 and under are increasingly reaching out to support services. Men make up 33 per cent of eating disorder diagnoses. But they make up less than 1 per cent of the empirical research on eating disorders and eating disorder treatment. "We see a lot more early intervention around female presentations of eating disorders … but we don't really have as much of that on the male side," Rose said.
Body image dissatisfaction in men has tripled over the last 25 years, rising from 15 per cent to 45 per cent, according to the Australian Psychological Society. According to the Butterfly Foundation's most recent BodyKind Youth Survey, published last year, 84 per cent of boys aged 12 to 18 reported a desire to be more muscular. Boys aged 15 to 17 showed the highest prevalence of body dissatisfaction in males, with 48 per cent of those in the 12 to 18 age bracket saying they never or rarely speak positively about their body.
Cultural Pressures and Athletic Environments
Rose said one of the biggest drivers of disordered eating helpline workers hear about is pressure from influencers "pushing an ideal around masculinity." "It's very tied into looking a certain way, having that very muscular physique," he said. "That's also being transferred into a lot of other areas, we're seeing it in television, in movies … that masculinity is presented a certain way."
Former AFL player Brock McLean played 157 games over his 11-year career with the Melbourne Demons and Carlton Blues. In private, he was struggling with bulimia nervosa. "It was back in 2010 when I developed an eating disorder, based on what the coaches were asking me to do," he said. "I was spending so much time on the sidelines due to an injury, I was desperate to get back and play and I was willing to do anything for it. That included compromising my physical health and mental health. Eventually, it just took hold of me and I struggled with it for a good five or six years."
InsideOut, an eating disorder research institute, says the line between healthy and unhealthy behaviours can become blurred for athletes. A study of Olympic athletes in 2019 found up to 19 per cent of male athletes experienced some kind of disorder. Rose said sports environments can leave men feeling they have to perform "ideals of masculinity." "I personally have spoken to some young men who are involved in sports and will often change eating habits," he said. "[Things like] very strict regimented eating styles, the clean and cut eating and bulking and cutting and cheat meals, all these kind of words people use are often covers for patterns of disordered eating."
Infrastructure Shortfalls
Rose said stigma remains a frustrating hurdle, but the infrastructure gap is equally concerning. "People don't think about it, but eating disorder programs in Australia are primarily female," he said. "If you're a male … and you have to go into an inpatient or outpatient program, 90-plus per cent of the people who you will go into that program with will be female. So there's no dedicated male eating disorder programs in Australia. We really need to … make males feel safe to come forward in the eating disorder space [to] get them back to the lives and the futures they deserve."
Eating disorders are one of Australia's deadliest mental illnesses. As many as a third of those diagnosed will attempt suicide, according a 2023 study published in scientific journal Molecular Psychiatry. Despite this, a recent Butterfly Foundation Community Insights Report revealed nine in 10 people were not confident spotting the signs of an eating disorder. Rose said preventative programs aimed at males and educating parents are needed.
McLean, now recovered and raising two children with his partner Stephanie, said admitting he needed help changed everything. "Getting on top of my issues [meant] accepting myself for who I was and finding I could stop blaming myself for things that were outside of my control," he said. "I was a human being and I was prone to mistakes and I wasn't perfect. Men struggle to talk about our emotions. We struggle to talk about our feelings. There's still this ingrained toxic culture that talking about our issues or our struggles or our mental health somehow emasculates us. But I've learned from experience that in fact, it's the total opposite. It's a huge sign of strength."
White-Cheshire said he now considers himself stable in his recovery, but knows anorexia is a manipulative disease. "There's a difference [from] being in a current state of watching everything you do and feeling like, 'Oh my God, is this the illness taking effect?'" he said. "The illness is very clever in being able to manipulate you into doing certain things and doing new things you may not have before. You have to be aware to be able to spot them before they become like a new habit that causes more distress again." He hopes sharing his story will let other men know they can ask for help despite the mental and social pressure to hide. "The hardest part really is that for so long you've been dismissed, and that's really hard to get over," he said. "Even once you get to the point where maybe someone is willing to listen or give the right support, it's still hard to break that barrier mentally. Because you're still not very sure whether that person's genuine. [But] you're not alone. No matter how much you feel like that right now, you can get to a point you will feel content and you will actually have your life back. And you can see it right now that we'll be there for you."
Why This Matters:
The absence of dedicated male eating disorder programs in Australia represents a significant market failure in mental health service delivery. With 365,000 men affected and eating disorders ranking among the nation's deadliest mental illnesses, the current infrastructure — designed primarily for female patients — fails to meet demand or serve a third of the diagnosed population. Men constitute 33 per cent of diagnoses but less than 1 per cent of research, creating an evidence gap that prevents effective treatment development. The economic and human costs are substantial: as many as a third of those diagnosed will attempt suicide. Body image dissatisfaction in men has tripled over 25 years, yet nine in 10 Australians can't spot the signs. The solution requires targeted investment in male-specific programs, expanded research funding, and preventative education — interventions that would address a growing public health crisis while respecting individual circumstances and reducing long-term fiscal burdens on the healthcare system.