Eating disorder in males children and adolescents: a case series
R. Arias Hidalgo, C. Canga EspinaIntroduction
Eating disorders (ED) are psychiatric diseases associated with significant morbidity and mortality with a greater prevalence in the female gender. This has led to the presence of little literature on eating disorders in men, so that there is limited understanding and non-specific orientation of the disorder in this population. We present a series of five clinical cases of ED diagnosis in male children who attended our Child and Adolescent Psychiatry Unit during the last years.
Objectives
Descriptive study.
Methods
Case 1:
15-year-old male developed restriction and purging after peer comments, leading to severe malnutrition (BMI 14.5), depression, and bradycardia. Improved with hospitalization, enteral nutrition, pharmacotherapy, and family therapy; body image concerns and excessive exercise persisted.
Case 2:
12-year-old boy with anxiety and obsessive-compulsive traits presented with restriction, excessive exercise, and muscularity concerns (BMI 15.3). Treated with sertraline, psychotherapy, and nutrition; gradual improvement, though low BMI and muscle-focused goals persisted.
Case 3:
14-year-old male with ADHD developed selective eating and weight loss (BMI 17.3) without body image concerns. Sertraline and nutritional counseling led to weight recovery and social/academic improvement over 16 months.
Case 4:
9-year-old boy developed restriction and excessive exercise after peer comments and maternal illness (BMI 15.3), with bradycardia and hypoglycemia. Recovered with pharmacotherapy, psychotherapy, and intensive follow-up after relapse; fear of weight gain remained.
Case 5:
11-year-old boy with body dissatisfaction and paternal modeling developed restriction and exercise, severe malnutrition (BMI 13.4), depression, and suicidal thoughts. Required two hospitalizations with enteral nutrition, pharmacotherapy, and exposure-based feeding therapy; gradual improvement achieved.
Results
These cases highlight the variability of eating disorder presentations in male children and adolescents, including restrictive eating, selective intake, and muscularity-focused concerns. Early warning signs such as compulsive exercise, growth stagnation, and psychosocial distress may precede classical symptoms. Family involvement and gender-sensitive approaches are essential for early detection, tailored intervention, and improved outcomes.
Image 1: Long description.