Days after Sylvester Stallone revealed his own history with bulimia, experts are highlighting a growing but often overlooked rise in eating disorders among men.
The Academy Award-nominated actor, 80, revealed during an interview with The New York Times that he developed an “obsession” with eating habits while prepping for his role in the 1982 movie “Rambo.”
Stallone said he took pains to appear more “animalistic,” drawing inspiration from jaguars and cats. “It became an obsession. Really bad. It got to the point where I became bulimic,” he said during the interview.
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Bulimia nervosa is an eating disorder marked by episodes of binge-eating — consuming a large amount of food while feeling a loss of control — followed by purging behaviors such as vomiting, excessive use of laxatives or diuretics, fasting or excessive exercise, according to the National Institute of Mental Health (NIMH).
Brian Pollack, a licensed clinical social worker and certified eating disorders specialist at Hilltop Behavioral Health in Summit, New Jersey, specializes in treating males who struggle with eating disorders, which he said is “highly underreported.”
According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), about 30 million Americans experience an eating disorder during their lifetime, and roughly one-third are male.
“Guys with eating disorders just present differently — for some men, it’s about musculature … they continue to build muscle because they are afraid that they are weak, they want their muscles to align,” Pollack told Fox News Digital. “We also see people who want to be so lean and pencil-thin that they don’t eat whatsoever.”
The expert, who has not treated Stallone, compared today’s body-image pressures on boys and men with the beauty ideals many girls and women faced during earlier decades.
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“We’re seeing this extreme need for perfection and musculature — and that is leading to bulimia right now,” he told Fox News Digital. “It’s particularly in our adolescent boys, who are consuming a lot of information about the ideal of masculinity in the eyes of society at large.”
Societal expectations of masculinity can make it harder for men to identify and express feelings of vulnerability or distress, according to Pollack.
“Bulimia, especially, is about control,” he said. “And what is it that men want? They want to be in control on a superficial level.”
With binging, there is a loss of control over food — and purging is a way to get back in control, Pollack noted.
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The increase in bulimia and other eating disorders among men may also be driven by a desire to emulate celebrities.
“There’s a big trend right now called ‘looksmaxxing,’ where boys are harming themselves in pursuit of an ideal appearance, including undergoing cosmetic procedures to alter their jawlines,” Pollack said. “It’s getting very scary out there, actually.”
For many men, it may not be easy for others to recognize that they are struggling with bulimia or other eating disorders, as the binging and purging behaviors are usually done in secret, Pollack said.
“They’re hidden,” he said. “People are ashamed of them at times.”
One red flag, he said, is if a loved one begins purchasing increasing amounts of supplements, such as creatine, or performance-enhancing substances such as human growth hormone.
People with eating disorders may exhibit compulsive behaviors around both exercise and eating, including working out for multiple hours every day and carefully calculating every aspect of their diet.
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Some men become fixated on restrictive eating patterns, Pollack said, including following strict ketogenic diets, consuming excessive amounts of protein or eating only foods they consider “clean,” such as organic, whole-food or non-GMO products.
In some cases, the obsession becomes so extreme that men may avoid eating foods prepared elsewhere or outside their strict standards.
Pollack said some people may have “cheat days” where they visit fast-food restaurants and eat as much as they can, in an attempt to satisfy an “intense urge” stoked by restriction. “They binge, and we often see people hiding in the bathroom within 45 minutes after meals.”
Another warning sign is escalating use of laxatives or diuretics, with some people taking increasingly large amounts because smaller doses no longer produce the desired effect of feeling “emptied” or “in control.”
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Pollack emphasized that bulimia and other disorders are experienced among men at all ages, from middle school and high school through college and adulthood.
“This is real, and men are afraid to talk about it,” he said. “There’s a real issue.”
The expert said men often don’t have the vocabulary to talk about emotional distress, making eating disorders harder to identify.
Instead, Pollack recommended asking questions about body goals — such as whether someone is trying to “sculpt your body” or “make sure that you have a six-pack” — and whether those pursuits are helping them avoid confronting difficult emotions.
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Bulimia is known to have life-threatening health impacts. “Just on a baseline level, with someone who purges, we see electrolyte imbalances, along with kidney and liver damage,” Pollack said.
The expert shared that he has seen people go into cardiac arrest because prolonged malnutrition and repeated purging had severely damaged their hearts.
Bulimia patients may face expensive dental work, he added, due to severe erosion of their tooth enamel.
Esophagus issues, such as acid reflux and GERD, may also develop due to purging.
Long-term medical issues can range from treating heartburn with over-the-counter medication to facing life-threatening issues, Pollack said.
“It’s a very serious scenario.”
