EPV604
Eating disorder in males children and adolescents: a case series
R. Arias Hidalgo 1,*, C. Canga Espina 2
1Hospital Puerta de Hierro, Madrid, 2Clinica Universidad de Navarra, Pamplona, Spain
Introduction: 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.
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Conclusions: Eating disorders in males are underdiagnosed, but incidence is rising; pediatricians need training for early detection.
Most common EDs: Binge Eating Disorder, Bulimia, and Anorexia; anxiety is the most frequent comorbidity.
Males often aim to reduce fat and increase muscle; gender-sensitive diagnostic tools are required.
Early warning signs: compulsive or altered exercise patterns; purging behaviors are less common.
Boys lack clear biological markers (e.g., amenorrhea); growth stagnation is a critical red flag.
Further research is needed to develop male-specific diagnostic tools and treatment approaches.
Disclosure of Interest: None Declared