Eating Disorders in Men: Specialist Therapy in London

If you are a man struggling with your relationship with food, eating, or your body, you may already know how difficult it is to find a therapist who actually understands male presentations. Most of what is written about eating disorders was written about women, by clinicians who treated primarily women, using frameworks developed from female populations. The result is that men with eating disorders frequently find themselves in clinical settings where their specific presentation is unfamiliar, misread, or missed entirely.

This practice is different. Dr Jacquet holds a Doctorate of Professional Studies and is the only person in Europe to have received a doctorate specifically on male eating disorders. His 25 years of clinical work includes extensive specialist practice in this area. If you are a man with an eating disorder, you will be working with a clinician for whom your presentation is not a variant of the standard picture but the primary subject of dedicated professional and academic work.

How eating disorders present in men

The clinical picture in men differs from the female presentation in ways that matter for recognition and treatment. Where the female presentation of anorexia and bulimia has typically been organised around a drive toward thinness, male presentations are more often organised around a drive toward leanness combined with muscularity — the goal is not to be thinner but to have a different, more muscular body composition. This is sometimes called muscle dysmorphia, and it can co-exist with restriction, compulsive exercise, and supplement and steroid use in ways that are clinically significant but that do not match the classic anorexia picture.

Binge eating disorder is the most common eating disorder in men, though it is perhaps the least recognised in this population. It involves recurrent episodes of eating large amounts of food in a short time, usually in private, with a sense of loss of control and subsequent shame. Unlike bulimia, there is typically no compensatory purging. The shame and secrecy that accompany binge eating in men are often significant barriers to help-seeking.

Bulimia in men presents with the same binge-purge cycle as in women, though it is less common than in female populations. Men are less likely to disclose, and less likely to be asked about the presentation by health professionals, producing the long delays between onset and treatment that characterise male eating disorder trajectories.

The psychological context

Male eating disorders, like their female counterparts, are not primarily about food. They are psychological conditions in which the relationship with food and the body carries the weight of other psychological material: the need for control in a life that feels chaotic or inadequate, the management of anxiety through dietary restriction or compulsive exercise, the use of the body as a site of self-punishment, or the expression through eating behaviour of trauma, loss, or a deeply hostile relationship with the self.

In professional men — a group disproportionately represented in the practice’s male eating disorder caseload — the eating disorder frequently runs parallel to high professional functioning. From the outside, everything looks fine. Internally, the relationship with food and the body has become something that consumes a significant proportion of daily mental energy, generating a private suffering that coexists with apparent competence and success.

Why men do not get help

The barriers are multiple. Most men do not apply the concept of eating disorder to their own experience — the image of who has eating disorders does not include them, and so the recognition comes late or not at all. When it does come, the shame of having a condition understood to be a female problem compounds the primary shame of the disorder. Health professionals are less likely to ask men about eating, and less likely to recognise the presentation when it is present. And male culture, more broadly, maintains norms around self-sufficiency that make seeking help for any psychological difficulty more difficult.

None of these barriers are insurmountable, and recovery from eating disorders is absolutely possible for men. The first step is working with a clinician who genuinely understands the male presentation.

Treatment at the practice

Treatment integrates psychotherapy as the primary modality with nutritional support, EMDR where there is a trauma component, and art therapy where verbal approaches are limited. The pacing is calibrated to the individual — some presentations require a more intensive initial phase; others are well suited to weekly outpatient psychotherapy from the start. Medical monitoring is arranged for presentations where physical health requires it.

All work is conducted with complete confidentiality. Many male clients choose the Harley Street location for its discretion. Online therapy is available for those who prefer not to attend in person or who are based outside London.

Frequently asked questions

Are you sure men get eating disorders?

Yes. Current research estimates that approximately one in three people with an eating disorder is male, though significant under-reporting makes this likely an underestimate. Anorexia, bulimia, and binge eating disorder all occur in men, as do presentations that do not fit neatly into these categories.

Will I be understood here?

Yes. The principal clinician has a doctorate specifically on male eating disorders and 25 years of clinical experience in this area. Your presentation will not be approached as an unusual variant of the female picture.

Do I have to come to London?

No. All services are available online via secure video. Many clients work entirely online; it is a fully effective clinical modality for eating disorder treatment.

What if I am not sure whether what I have counts as an eating disorder?

An initial consultation is the appropriate place to explore that question. If your relationship with food, eating, or your body is causing you significant distress or affecting your life, that is sufficient reason to seek a consultation. You do not need to be certain of a diagnosis before making contact.

Further reading: why eating disorders in men are so difficult to recognise.