More than one million Australians are currently living with an eating disorder (Deloitte Access Economics, 2012.) and one third of these are male (Mitchison and Mond., 2015).

Research shows that males account for 20-30% of people with anorexia and bulimia, and up to two thirds of those with binge eating disorder and avoidant/restrictive food intake disorder.

These statistics may come as a surprise to many, as eating disorders are often stereotypically associated with white females. However, researchers widely acknowledge that eating disorders among males are substantially under-reported. This under-recognition is partly due to differences in how eating disorders present across sex, which can obscure early warning signs in males (Murray et al., 2017). For example, males are more likely to binge on savoury or protein-rich foods and are often motivated not by a desire to be thinner, but by aspirations to become stronger, fitter, faster, or healthier. Under-reporting may also be influenced by traditional ideals of masculinity that emphasise self-reliance and discourage help-seeking, alongside the normalisation of male body ideals within society, which can make emerging concerns more difficult to identify.

A common misconception is that eating disorders are defined by undernourishment or being visibly underweight. In reality, eating disorders are complex mental health conditions characterised by disturbances in eating behaviours, thoughts, and emotions. Individuals can experience significant eating disorder symptoms across the weight spectrum, including those who appear to be at a healthy weight or in larger or athletic bodies.

For parents, this creates a difficult challenge. How do you know when your child's interest in health, fitness, or sport is simply part of growing up and when it signals something more concerning?

Looksmaxxing

Changing body composition and increasing social comparison can leave many boys feeling uncertain about whether they "measure up”. Boys are increasingly exposed to messages that suggest success, popularity, and confidence are synonymous with a taller and muscular physique.

A growing trend of constant appearance monitoring and the pursuit of countless solutions to improve perceived attractiveness is now commonly known as “looksmaxxing.”.

This trend encourages intensive ranking systems based on “pseudo-scientific hierarchies”, such as facial symmetry, jawline definition, and lean body mass. This has then led to the proliferation of grooming tactics to ‘fix’ perceived aesthetic deficiencies for social advantage. These tactics range from cheek biting, dieting, and supplements to the more extreme TikTok trends of ‘bone smashing’ (the act of using a hammer to repeatedly hit cheekbones and jaws to create micro fractures in an attempt to reshape facial features), surgery, and the use of peptides and steroids.

Needless to say, experts have warned against these extreme forms of self-harm, stating the technique fails to deliver the appearance benefits claimed with significant risks. “You only have to look at a UFC fighter or a boxer's face to see how repeated trauma can lead to unfavourable scar tissue, possible nerve damage and likely permanent disfigurement.” – Dr Diana Kennedy, a plastic and reconstructive surgeon at Mater Private Hospital Brisbane.

Looksmaxxing communities often exploit young men's fears and insecurities, using pseudoscientific claims to legitimise their advice. A simple Google search reveals numerous websites dedicated to packaging these ideas in aspirational and normalised language. For example, a title tag on one of the first Looksmaxxing websites reads, “Get brutally honest, AI-driven analysis of your appearance with personalised recommendations to level up your looks.”. It would be naïve to expect individuals, particularly impressionable young males who are trying to find their purpose and role in society, to disregard their appearance entirely when societal messages consistently emphasise its importance. Most alarming, should be the advances in technology that now allow us to digitally alter our appearance to resemble increasingly artificial ideals, further fuelling society’s pursuit of 'perfection'.

This trend has been largely reinforced by the assumption that body ideals have evolved through natural selection (e.g., women are attracted to chisel jawlines, height etc), and are positioned as universal, fixed, and unmodifiable. Dr Scott Griffiths, one of Australia's foremost researchers in body image and eating disorders, has cautioned against accepting these beliefs as simply the “natural order of things.” Emphasising the crucial difference between describing the way things are and prescribing the way things ought to be. For example, evolutionary arguments were once used to justify racist ideologies, a position that is now widely intolerable and considered extremely radical.

By questioning and reshaping societal assumptions about appearance, Dr Griffiths believes we can significantly reduce the burden of body image concerns and eating disorders. However, significant and systemic work is required to address these entrenched attitudes.

When Healthy Becomes Harmful: The Continuum of Disordered Eating

Many children and adolescents go through phases of selective eating, changing food preferences, or increased interest in nutrition. For neurodivergent children, particularly those with Autism Spectrum Disorder (ASD) or Attention-Deficit/Hyperactivity Disorder (ADHD), food preferences may be influenced by sensory sensitivities to taste, texture, smell, temperature or appearance. These preferences can be longstanding, predictable and manageable, and may not interfere with growth (if not avoiding whole food groups), health or participation in everyday life.

However, for others body ideal pressures can lead to excessive exercise, restrictive eating, compulsive calorie counting or body checking, or an unhealthy reliance on supplements and protein products.

Social media trends are not wholly to blame. Eating disorders arise from a complex interplay of biological, psychological, developmental, and sociocultural factors, including direct or perceived pressure to change appearance, mental and physical health conditions, identity-related challenges, and participation in environments that place a strong emphasis on weight, shape, or appearance.

Research shows boys involved in sports emphasising leanness, endurance, aesthetics or weight categories, including gymnastics, swimming, distance running, cycling, wrestling, rowing and martial arts may face increased risk. Equally, boys involved in bodybuilding, contact sports such as rugby, or strength training may develop an intense drive for muscularity, believing they are never muscular enough despite appearing fit and healthy.

Unlike the stereotypical image of an eating disorder, these boys may not lose significant weight initially. Instead, they become increasingly preoccupied with food timing, calorie intake, protein consumption, supplements and training routines. Parents may receive praise from others about their child's "discipline" long before anyone recognises that anxiety (not health) is driving these behaviours.

Healthy eating and regular physical activity are important parts of development however problems arise when flexibility disappears. Meals may become increasingly restrictive, favourite foods are suddenly labelled "bad," social events involving food are avoided or exercise becomes non-negotiable even when they are injured, exhausted or unwell.

“I’m tracking my macros”.

Muscularity-oriented disordered eating can be particularly difficult to identify because many of its behaviours are often normalised within athletic and fitness cultures. As a result, the physical consequences may become apparent before the underlying disordered eating patterns are recognised. One example is Relative Energy Deficiency in Sport (RED-S), a condition that occurs when energy expenditure consistently exceeds energy intake. Symptoms can include recurrent illness, fatigue, mood disturbances, impaired recovery, and delayed growth and development.

Weights

Because these patterns can be easily mistaken for healthy lifestyle choices or athletic commitment, it can be helpful to move beyond asking, “Is my son eating healthily?” and instead ask:

- Can he eat flexibly?

- Can he enjoy a birthday party without anxiety?

- Does missing one training session create significant distress?

- Is food becoming a source of guilt rather than enjoyment?

- Has exercise become something he has to do rather than wants to do?

-

The NEDC provides a full list of symptoms to look out for, provided in the resources section. Here are some of the main signs to look out for:

- Sudden weight loss, gain, or fluctuation

- Signs of vomiting, prolonged time spent in the bathroom, damaged teeth, or swollen cheeks

- Bloating, constipation, or increased food intolerance.

- Stomach pains

- Preoccupation with food groups, or activities with food

- Distorted body image

- Anxiety or irritability around mealtimes

- Rigid thoughts about food being ‘good’ or ‘bad’.

- Compulsive or excessive exercise

- Dieting behaviour

- Rituals around food, food preparation and eating

- Changes in food preferences

- Social withdrawal

- Avoidance of activities requiring exposure of the body such as wearing long-sleeved t-shirts to the beach, or avoiding swimming.

Remember that eating disorders can occur in children and adolescents of any body size. A young person who appears to be at a healthy weight may still be medically unwell or experiencing significant psychological distress.

The Protein Fad

Protein is having its moment. Supermarket shelves are now packed with everything from protein ice cream, protein bars, protein packed cereal to protein cheese. Restaurants and drink chains are also jumping on the bandwagon with protein bowls and protein smoothies reflecting a growing appetite for protein-rich foods.

Protein supplement brands are targeting the parent community with protein shakes for children marketed as healthy nutritional alternatives. Together, protein supplements have flooded the market and at first glance this may seem fairly innocent.

However, protein deficiency is very uncommon amongst children and adolescents and therefore protein supplements are usually unnecessary (Australian Bureau of Statistics, 2026). According to the 2015-2020 Dietary Guidelines for Americans, the recommended daily protein for children are as follows;

Recommended daily protein in grams by age group

1-3 years = 13g

4-8 years = 19g

9-13 years = 34g

14-18 years = 52g

Yet, data indicates adolescents are consuming more than they need.

Screenshot 2026-07-25 at 3.17.51 pm

Source: 2015-2020dietaryguidelinesforAmericans

While protein is an important part of a healthy diet, young boys are using it as a quick way to ‘bulk’. Experts warn that consuming excessive amounts can have adverse health effects, including dehydration and organ stress. Liquifying foods also has behavioural, physiological, and social consequences. Fullness signals are weakened, energy crashes and irritability are more likely, social connection over mealtimes is bypassed, and healthy eating habits, enjoyment, and perceptions of food are disrupted. Furthermore, many supplements are poorly regulated, with ingredients and dosages not always clearly disclosed on product labels. For example, Clean Label Project reported 47% of protein supplement products exceeded the US federal state regulatory standard for safety for toxic metals. Finding flavoured protein and plant-based products at higher risk.

The general advice from medical professionals is to focus on real food first.

If your doctor clears your child for a supplement, it is recommended to use those specifically formulated for children with minimal ingredients, good manufacturing practices, and balanced formulas - https://lotusmedicalcentre.com.au/blog/is-it-safe-to-give-a-child-protein-powder/

What Parents Can Do: Practical Conversations and Home Strategies

Early support is always preferable to waiting until eating difficulties become severe. Consider discussing your concerns with your child's general practitioner or paediatrician.

Discovering that your child may be struggling with food, body image or exercise can feel overwhelming. Parents often wonder whether they have caused the problem or worry that saying the wrong thing will make matters worse. The good news is that recovery is possible, and parents play a key role as agents in their recovery.

The goal is not to become your child's therapist, but to provide a safe, supportive environment where concerns can be identified and addressed without shame or blame.

For neurodivergent children, the goal is not to create a "perfect" eater or eliminate all food preferences. For boys with ADHD, they are more at risk of developing an eating disorder, and will require closer monitoring.

Start with Curiosity, Not Criticism

If you notice changes in your son's eating habits, exercise routines or attitude towards his body, begin the conversation from a place of curiosity. Rather than focusing on food or weight, talk about the behaviours you have observed and how they might be affecting his wellbeing. Remember that many boys do not recognise they have an eating disorder. They may genuinely believe they are simply trying to become healthier, fitter or better at their sport.

Listen More Than You Speak

Resist the urge to immediately solve the problem. Give your child the opportunity to talk without interruption. Validate their emotions, even if you disagree with their beliefs. Validation does not mean agreeing with distorted thoughts about food or body image. It simply communicates that you understand your child's emotional experience and are there to support them.

Avoid Conversations Focused on Weight

Parents naturally worry about weight loss or poor growth, but focusing on numbers can unintentionally reinforce the eating disorder. Instead of commenting on appearance, focus on health, energy, mood, relationships and participation in everyday life.

Similarly, avoid praising weight loss, muscle gain or restrictive eating, even if these changes initially appear healthy.

Challenge Diet Culture at Home

Children learn powerful messages about food and bodies from the adults around them. Consider the language used within your family. Instead, model a balanced relationship with food by talking about nourishment, enjoyment, variety and flexibility. Children benefit from seeing adults eat a wide range of foods without guilt or rigid rules.

Support Regular Meals

One of the most effective ways to interrupt disordered eating is to re-establish consistent eating patterns.

Aim for:

  • regular meals and snacks throughout the day;
  • eating together as a family whenever possible;
  • reducing distractions during meals; and
  • creating a calm, predictable mealtime environment.

Avoid negotiating around every bite of food. If meals regularly become a battleground, seek professional advice early rather than allowing conflict to escalate.

Look Beyond Food

Food is often the visible symptom rather than the underlying problem.

Ask yourself:

  • Is my child feeling anxious?
  • Are they under pressure academically or in sport?
  • Have friendships changed?
  • Are they spending increasing amounts of time comparing themselves online?
  • Has something happened that has affected their confidence?

Supporting emotional wellbeing is just as important as addressing eating behaviours.

Be Mindful of Social Media

Many boys are exposed to unrealistic images of muscular physiques, fitness influencers and nutrition advice through social media, gaming platforms and online communities. Encourage a diverse online feed that includes positive role models, varied body types and interests beyond appearance and fitness.

Maintain Interests Beyond Sport

Sport can be a wonderful source of confidence and belonging. However, when self-worth becomes dependent on performance or physique, psychological wellbeing becomes more vulnerable.

Encourage your child to maintain friendships, hobbies and interests outside sport. Identifying positive traits outside of sport skills helps broaden sources of identity that helps build resilience if injury, illness or performance setbacks occur.

Don't Wait for the Problem to Become Severe

One of the biggest misconceptions about eating disorders is that someone must be significantly underweight before help is needed.

In reality, early intervention leads to better outcomes.

Seek professional advice if you notice persistent changes in eating, increasing rigidity around food or exercise, significant distress, weight changes, declining growth, social withdrawal or concerns about body image. You do not need to be certain that your child has an eating disorder before asking for help.

Remember: Recovery Is Possible

Eating disorders are serious illnesses, but they are also highly treatable, particularly when identified early. Parents are not expected to manage an eating disorder on their own. Working collaboratively with your general practitioner, paediatrician, psychologist and dietitian can help your child regain not only physical health but also confidence, flexibility and enjoyment of life.

When to Refer and Where to Seek Help

One of the most common misconceptions about eating disorders is that a young person has to be "very sick" before they need professional help. In reality, eating disorders are easier to treat when they are recognised early. Waiting for significant weight loss or obvious physical symptoms can allow the illness to become more entrenched, making recovery more difficult.

Parents know their child better than anyone. If you have noticed persistent changes in eating habits, exercise patterns, mood or body image, trust your instincts and seek advice. You do not need to wait until you are certain that your child has an eating disorder.

When Is Urgent Medical Assessment Needed?

Some symptoms require immediate medical review, either through your GP on the same day or presentation to the nearest Emergency Department. Seek urgent medical attention if your child experiences:

  • Fainting or collapse.
  • Chest pain, palpitations or an unusually slow heart rate.
  • Severe dehydration.
  • Rapid or significant weight loss.
  • Refusal to eat or drink for prolonged periods.
  • Repeated vomiting.
  • Confusion, marked weakness or inability to carry out normal daily activities.
  • Thoughts of self-harm or suicide.

These symptoms may indicate serious medical complications associated with malnutrition or another underlying condition and should not be ignored.

Who Can Help?

Your General Practitioner (GP) is usually the first point of contact. They can assess your child's physical health, monitor growth and vital signs, organise blood tests if needed, and coordinate referrals to other health professionals.

A paediatrician may be involved when there are concerns about growth, puberty, complex medical issues or the need for specialist assessment.

A psychologist or mental health clinician experienced in treating eating disorders can assess the psychological factors maintaining the illness and provide evidence-based therapies. Family-Based Treatment (FBT) is considered the first-line psychological treatment for most children and adolescents with anorexia nervosa and is also adapted for other eating disorders where appropriate.

An Accredited Practising Dietitian (APD) with experience in paediatric eating disorders can help restore nutritional adequacy, support normal growth and development, and guide families in rebuilding flexible, balanced eating patterns. For children with ARFID, dietitians often work closely with psychologists, occupational therapists and speech pathologists to address nutritional concerns alongside sensory or feeding challenges.

A Final Message for Parents

Perhaps the most important thing to remember is that eating disorders are not a phase, a lifestyle choice or a lack of willpower. They are complex mental illnesses that affect both physical and psychological health. Equally important is the knowledge that recovery is possible.

The earlier concerns are recognised, the sooner effective treatment can begin. If something about your child's relationship with food, exercise or body image doesn't feel right, it is always appropriate to ask questions and seek professional advice. It is far better to discover that your concerns were unnecessary than to miss an opportunity for early intervention.

By responding with curiosity rather than criticism, seeking support early and working alongside experienced health professionals, parents can play a powerful role in helping their child return to a healthy relationship with food, movement and themselves.

Trusted Australian Resources

Parents do not have to navigate this journey alone. The following organisations provide reliable, evidence-based information and support:

Neurodiversity and disordered eating

Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterised by restricted food intake that is not driven by concerns about body weight or shape. Instead, children and adolescents with ARFID may avoid foods because of sensory sensitivities, a fear of choking or vomiting, or a lack of interest in eating.

ARFID is more common in neurodivergent children, particularly those with autism, although most autistic children with selective eating do not have ARFID.

A child with sensory-based food preferences may continue to grow well, meet their nutritional needs through a limited but adequate range of foods, and participate comfortably in family and social activities. They may happily eat the same foods each day without significant distress, and their preferences remain relatively stable over time.

By contrast, ARFID becomes a clinical concern when food avoidance results in one or more of the following:

  • poor growth or unexpected weight loss;
  • nutritional deficiencies (such as iron, vitamin or protein deficiencies);
  • dependence on nutritional supplements or enteral feeding;
  • significant anxiety or distress around eating;
  • increasing restriction rather than gradual expansion of accepted foods;
  • avoidance that limits school attendance, camps, sleepovers, holidays or family activities; or
  • marked interference with social, emotional or family functioning.

Importantly, a diagnosis of ARFID does not require a child to be underweight. Some children maintain a healthy weight while still experiencing significant nutritional deficiencies, psychological distress or functional impairment.

For neurodivergent children with ARFID, the goal is not to create a "perfect" eater or eliminate all food preferences. Many autistic individuals will continue to have lifelong sensory preferences, and this is entirely appropriate. Instead, treatment aims to ensure that eating is nutritionally adequate, medically safe and does not significantly limit a child's health, independence

References

Australian Bureau of Statistics. (2026). Usualnutrientintakes,2023. https://www.abs.gov.au/statistics/health/food-and-nutrition/usual-nutrient-intakes/latest-release

Brown, T. A., Griffiths, S., & Murray, S. B. (2018). Eating disorders in males. In L. K. Anderson, S. B. Murray, & W. H. Kaye (Eds.), Clinical handbook of complex and atypical eating disorders (pp. 309–326). Oxford University Press.

Clean Label Project. (2025, January 9). Nearlyhalfoftop-sellingproteinpowdersexceedsafetythresholdsforheavymetalcontamination. https://cleanlabelproject.org/protein-study/

Deloitte Access Economics. Paying the price: the economic and social impact of eating disorders in Australia. Australia: Deloitte Access Economics; 2012.

Mater. (2026). Materdoctorswarnofdangersofbone-smashingtrend. https://www.mater.org.au/about-us/news/mater-news/2026/april/mater-doctors-warn-of-dangers-of-bone-smashing-trend

Mitchison D, Mond J. Epidemiology of eating disorders, eating disordered behaviour, and body image disturbance in males: a narrative review. J Eat Disord. 2015;3(1):1-9.

Murray SB, Nagata JM, Griffiths S, Calzo JP, Brown TA, Mitchison D, Blashill AJ, Mond JM. The enigma of male eating disorders: A critical review and synthesis. Clin Psychol Rev. 2017 Nov;57:1-11. doi: 10.1016/j.cpr.2017.08.001. Epub 2017 Aug 2. PMID: 28800416.

Perth Sports Medicine. (n.d.). Relativeenergydeficiencyinsport(RED-S). https://www.perthsportsmedicine.com.au/relative-energy-deficiency-in-sport-perth-claremont-cockburn-wa.html

Ricciardelli, R., & Nicholls, E. (2026). Fromgymtojawline:Whatlooksmaxxingsaysaboutmodernmasculinity. TheConversation. https://theconversation.com/from-gym-to-jawline-what-looksmaxxing-says-about-modern-masculinity-277130

U.S. Department of Health and Human Services, & U.S. Department of Agriculture. (2015). 2015-2020dietaryguidelinesforAmericans (8th ed.). https://odphp.health.gov/sites/default/files/2019-09/2015-2020_Dietary_Guidelines.pdf

Villa, F. M., Crippa, A., Rosi, E., Nobile, M., Brambilla, P., & Delvecchio, G. (2023). ADHD and eating disorders in childhood and adolescence: An updated minireview. JournalofAffectiveDisorders,321, 265-271. https://doi.org/10.1016/j.jad.2022.10.016