Brian Pollack, LCSW, CEDS-C
Brian is the Founder and Clinical Director of Hilltop Behavioral Health, a boutique eating disorder specialty practice in Summit, NJ. He is one of the few male master’s-level Certified Eating Disorder Specialists in the country, with expertise in FBT, male clients, athletes, and muscle dysmorphia. He hosts the Minding Men podcast and serves as an adjunct professor at Yeshiva University.
Learn more about Brian →He orders three Big Macs at 2 a.m. He eats fast, half the bag gone before the regret even lands. Then he carries the rest outside so he won’t finish it. Then he makes himself sick anyway, because the food is already inside him and that isn’t good enough. Then, still hungry, he goes looking for something else to eat.
This isn’t a scene from a script. It’s how Riverdale actor KJ Apa described a night during the pandemic, when he was quarantining in Vancouver and trying to get lean before returning to a show where his character spent half his screen time shirtless. He told the story on the Wildmen podcast, not as a confession exactly, but as something closer to a memory he was finally ready to say out loud.
We hear versions of this story often. Not the McDonald’s, not the podcast, but the shape of it: a man who is disciplined everywhere else in his life and completely at war with himself around food.
When “Getting in Shape” Turns Into a Secret Battle
A client we’ll call Dan came to us after his girlfriend noticed something was off. Not that he’d lost weight. That he’d started declining dinner invitations. That he was tracking his macros with the intensity of a spreadsheet audit. That when he finally did eat something outside his plan, he’d disappear into the bathroom afterward.
Dan didn’t think of himself as someone with an eating disorder. He thought of himself as someone who took fitness seriously. That’s often where this starts: not with a diagnosis, but with a story a man tells himself about discipline, control, and what it means to be a man who has it together.
He wasn’t lying to us. He was lying to himself, the way a lot of men do, because the alternative felt like admitting weakness.
Eating Disorders in Men: A Pattern Hollywood Just Made Visible
Apa isn’t the first public figure to describe something like this. Ed Sheeran has spoken about his own struggle with bulimia. Elton John has talked about a lifelong fight with food addiction. Singer Noah Kahan recently opened up about body image struggles that shaped much of his life. Each disclosure chips away at a stereotype that still does damage: the idea that eating disorders are a women’s issue.
They aren’t. Roughly one in three people struggling with an eating disorder is male, according to the National Eating Disorders Association (NEDA). That number tends to surprise people, mostly because men rarely get asked the question in the first place.
Brian Pollack, LCSW, CEDS-C, a certified eating disorder specialist, was one of the clinicians Yahoo turned to for this story. His read on it matches what shows up consistently in clinical work with men: they often present differently than women do, hide symptoms longer, and rarely get asked the question that would surface the problem in the first place. Eating disorders in men are a serious, treatable condition, but one that gets missed because clinicians, families, and men themselves aren’t always looking for it.
Why Muscle Dysmorphia and “Bro Culture” Fuel Silent Struggles
Women are frequently pushed toward thinness. Men face a different, but just as punishing, standard: lean, muscular, and always in control. Muscle dysmorphia, the persistent belief that you’re not big or lean enough even when you objectively are, is one of the fastest-growing patterns clinicians are seeing in men, and it often goes unnamed until it has already reshaped someone’s whole life.
Add in “bro culture,” the gym-bro ethos that frames extreme discipline as strength and any deviation from the plan as failure, and you get a group of men who are praised for the exact behaviors that are quietly destroying them. Skipping dinner with friends to protect a training block doesn’t read as a warning sign to most people. It reads as commitment.
That’s the trap. When you’re that obsessed with how your body looks, you start to lose the ability to connect with the people around you. Social isolation creeps in. The gym or the kitchen becomes the whole world. And when the plan doesn’t deliver the body a man was promised, because genetics don’t bend to willpower, the response is often to push harder rather than to question the plan itself. It’s part of why eating disorder treatment for men increasingly has to address body image and exercise compulsions right alongside food, rather than treating them as separate problems.
Some men escalate their restriction, their protein intake, and their exercise volume to a degree that starts to look less like fitness and more like a compulsion: rigid rules, intrusive checking, and a conviction that just one more adjustment will finally make it work. That rigidity can start to resemble obsessive-compulsive patterns layered on top of the eating disorder itself, which is part of why treatment has to look at the whole picture rather than just the food. Not every body is built for a six-pack, and that mismatch between expectation and biology is its own kind of injury.
How Eating Disorders in Men Show Up, and Why They’re Missed
Compared to women, men are more likely to struggle with bulimia and binge eating than with restrictive anorexia. That distinction matters clinically, because it changes what the warning signs look like. It’s rarely visible weight loss. It’s more often a private cycle: overeating in secret, purging through vomiting, laxatives, or compulsive exercise, and a level of shame that keeps the whole pattern hidden from the people closest to him.
Apa’s account, difficult as it is to read, maps onto that cycle almost exactly: the binge, the immediate regret, the purge, the hunger that follows because the body still needs what it just lost. It’s not a one-off bad night. It’s a loop, and loops like that don’t resolve on their own.
Getting Help: What We Tell Every Man Who Walks Through Our Door
The hardest part of recovery usually isn’t the treatment plan. It’s the moment before it, when a man has to admit there’s a problem at all, especially in a culture that rewards the exact discipline that’s hurting him. If someone in your life has raised a concern about your eating, your body image, or your exercise habits, that’s worth sitting with instead of dismissing.
From there, a primary care doctor is often a reasonable first stop, but honesty matters more than almost anything else in that conversation. Shame has a way of shrinking the story men tell their doctors, which makes it harder to get the right help. If a doctor brushes off real concerns, it’s worth getting a second opinion. Eating disorders carry real physical risk, including cardiac complications, and deserve to be taken seriously the first time, not the third.
If you’re a man in New Jersey wondering whether what you’re doing with food, exercise, or your body in the mirror has crossed a line, that question deserves a real answer, not shame or dismissal. Specialized eating disorder treatment in New Jersey exists for exactly this, built around integrated therapy and dietitian care rather than a one-size-fits-all approach.
For more on KJ Apa’s story and the broader research on men and disordered eating, read the full Yahoo Health feature, which includes additional insight from our founder and other eating disorder specialists.
If you recognize any part of this in yourself or someone you love, don’t wait for it to get worse before reaching out. Contact our team to talk through what you’re experiencing and what support could look like.
