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This article presents an integrative overview of existing research on anorexia nervosa (AN) in adolescent males. AN is commonly thought of as a female disorder. Even though as much as 25% of the clinical population is male, research on AN in males is limited. Additionally, most conceptualizations of male AN emphasize a single etiological factor and, therefore, produce treatments that fail to address it as a global phenomenon. In contrast, an integrative understanding that incorporates research on the familial, biological, cultural, and psychodynamic elements involved in male AN encourages treatment that comprehensively addresses the disorder.

The pro-anorexia community has emerged as a powerful cultural movement that takes an at least partially positive attitude toward anorexia nervosa and other eating disorders. A systematic review of the literature on pro-ana forums focused specifically on females with eating disorders. However, epidemiological data suggest that as much as 25% of the eating disorders population is male. In our review of pro-anorexia web sites, we found a substantial number of participants were male. We conducted a qualitative content analysis of male participation in pro-ana forums in an effort to learn more about male participation in these forums. In this article, we present the results of this analysis, highlighting themes of social support, community appreciation, and ambivalence, as well as themes that appear to be particular to the male experience of eating disorders, such as alienation and teasing.

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The “hungry self” is a self- and body-state (Petrucelli, 2015) characterized by profound need and accompanying frustrated rage that develops because of childhood maltreatment, which is prominent in patients with binge eating disorder (BED). In these patients, this part of the self is sadistically subjugated to a greater or lesser extent by another part of the self, developed through a powerful identification with an abusive parental figure. Binge eating episodes are a channel through which to express these otherwise subjugated affects which remain more-or-less dissociated from the patient’s conscious mind in her day-to-day life. Central to the treatment of BED is the facilitation of the outward expression, in the transference, of aggression, as this supports the patient’s efforts to break free of the experience of emotional subjugation and can, over time, facilitate her capacity to express these important affects in new relational contexts.