Eating Disorders in Adolescent and Young Adult Males: Presenting Characteristics

Data on the clinical characteristics of adolescent males with eating disorders are limited. The purpose of this study was to describe the demographic characteristics, presenting vital signs, laboratory results, and relevant risk factors for eating disorders among males presenting to an outpatient adolescent and young adult medicine practice.

Retrospective chart review of male eating disorder patients aged of 11-25 years presenting to the University of California, San Francisco Adolescent and Young Adult Eating Disorder Program between June 1, 2011, and November 1, 2014. Charts were reviewed for demographic and clinical characteristics and risk factors for eating disorders.

Thirty-three patients were included; mean age was 16 years. Patients presented with mean heart rate was 58.7 bpm, and orthostatic heart rate change was 22 bpm, with 51.5% meeting Society for Adolescent Health and Medicine hospital admission criteria. Mean percent of median body mass index was 88%. Of patients with available laboratory data, 33.3% were anemic, 23.8% leukopenic, 19.0% thrombocytopenic, and 10.0% neutropenic. Half had a history of a psychiatric disorder; 41.5% had a history of overweight or obesity, and 12.1% had a family history of an eating disorder. The DSM-IV-TR and DSM-5 diagnostic criteria were retrospectively applied to patients, with an increase in diagnosis of anorexia nervosa from 36.4% to 48.5%. Diagnoses of Eating Disorder Not Otherwise Specified, now Other Specified Feeding or Eating Disorder in DSM-5, decreased from 62.6% to 45.5%.

Male patients with eating disorders presented with significant abnormalities; patients were bradycardic and orthostatic; and more than half met Society for Adolescent Health and Medicine admission criteria. Patients with available laboratory data demonstrated significant abnormalities consistent with malnutrition. Given that eating disorders are less likely to be detected in males, it is important to recognize early signs of malnutrition, particularly in those who present within the normal body mass index range for age.