The Ones We Don't See: Hidden Eating Disorders in Men, BIPOC Communities, and Older Adults
By Jen Bennethum, LCSW, Mental Health Trauma Therapist
This is the third post in our Eating Disorders Week series, focusing on groups whose struggles are often overlooked. Eating disorders can be serious and sometimes life‑threatening. If you or someone you care about is struggling, please consult a qualified healthcare professional for assessment and support; this post is informational and not a substitute for clinical care.
“I thought I was just trying to get fit. I didn’t realize my habits were a problem until I felt sick and alone.” — a lived‑experience reflection from anonymous contributor.
Why these eating disorders stay hidden
Many people picture an eating disorder as a young, thin, white woman, and that image makes it easy to miss other stories. When we expect a certain look, age, or gender, we overlook the ways disordered eating shows up across different lives. Stereotypes shape what family, friends, and clinicians notice, so men, people from BIPOC communities, and older adults can go years without being seen or offered help. This gap matters because delayed recognition often means delayed care and worse health outcomes. The National Eating Disorders Association notes that about one in three people with an eating disorder is male, and men are less likely to be diagnosed or to seek treatment.
How eating disorders often look in men
Men may not say they want to be “thin.” Many describe pressure to be more muscular, lean, or athletic, and that can lead to extreme dieting, compulsive exercise, or use of supplements and steroids to change body shape. Because public messages and many screening tools were built around female experiences, men’s concerns are sometimes dismissed as fitness goals or stress responses rather than signs of an eating disorder. Raising awareness about different language and behaviors helps open the door to care and reduces shame.
Cultural context and barriers in BIPOC communities
Culture, family expectations, and historical experiences shape how people relate to food and body image. In many BIPOC communities, eating problems may be hidden by cultural norms or interpreted through other lenses such as stress, grief, or medical issues. Structural barriers like limited access to culturally competent providers, diagnostic bias, and mistrust of healthcare systems make it harder for people of color to get accurate diagnoses and effective treatment. Clinical reviews emphasize the need for culturally responsive care that recognizes different body ideals and the impact of discrimination on eating behaviors.
Why older adults are often missed
When someone in midlife or later loses weight or changes eating habits, the first thought is often a medical cause rather than an eating disorder. Weight loss in older adults can trigger medical testing while the emotional or behavioral drivers go unasked. People can develop restrictive eating, bingeing, or purging later in life for reasons such as grief, loss of routine, or resurfacing body image concerns. Research and advocacy groups report that eating disorders occur in midlife and beyond and are frequently overlooked by families and clinicians who assume these problems belong to younger people.
The role of trauma, stigma, and diagnostic bias
Across these groups, trauma and stigma often shape how eating problems begin and persist. Trauma can change appetite, emotional regulation, and coping strategies, and food can become a way to manage overwhelming feelings. Stigma about mental health, gender expectations, or cultural norms can silence people and make it harder to ask for help. Diagnostic tools and clinical training that assume a narrow patient profile reinforce blind spots. Trauma‑informed, nonjudgmental approaches help people feel safe enough to share what’s really happening.
What recognition looks like in everyday care
Recognition starts with open, nonjudgmental questions about how food fits into someone’s life and how they feel about their body and routines. For men, that might mean asking about exercise patterns, supplement use, or pressure to be muscular. For people from BIPOC communities, it means asking in ways that respect cultural values and acknowledge stressors like discrimination. For older adults, it means considering an eating disorder when weight or appetite changes appear without a clear medical cause. Primary care, sports medicine, and geriatric settings are important places to screen because they often see people who wouldn’t go to a specialty clinic. The American Psychiatric Association recommends routine screening as part of initial psychiatric evaluations to reduce missed cases.
Treatment that fits the person
Effective care is tailored, respectful, and evidence‑based. Psychotherapies that address thoughts and behaviors around food and body image are central, and trauma‑focused therapies can be essential when past harm shapes current eating patterns. Some people benefit from therapies that specifically target traumatic memories and their emotional impact; EMDR can be part of a broader, individualized plan when trauma is a maintaining factor. Coordinating mental health care with medical monitoring is especially important for older adults, who may face more physical risks. Cultural humility, gender‑affirming practices, and family or community involvement improve engagement and recovery.
This post links to our EMDR service page so readers can learn more about this intervention if they want help. It also links to the earlier posts in this series: Part One: Recognizing Early Signs and Part Two: When Food and Trauma Intersect.
Resources and credible reading
National Eating Disorders Association offers accessible pages on eating disorders in men and on eating disorders in midlife and beyond. The National Institute of Mental Health provides an overview of eating disorders and treatment. For clinical and cultural guidance, see reviews on culturally responsive care and clinical overviews of disordered eating in older adults.
Moving forward and conclusion
Seeing the people we’ve overlooked means changing how we talk, screen, and offer care so that men, BIPOC clients, and older adults feel safe naming their struggles. Practical steps include using plain, inclusive language in intake conversations, offering trauma‑informed and culturally responsive options, and making clear pathways to help like EMDR so feel free to reach out to us at Integrate Therapy and Wellness Collective at our Contact page to schedule an intake with us in Lancaster County. Recovery looks different for everyone, and when clinicians, families, and communities listen without judgment, more people get timely support and better outcomes. What one small change could your clinic or community make this month to help someone who’s been invisible feel seen?
