Noah Kahan and the Struggle He Finally Named: Body Dysmorphia in Men

He performs for twenty thousand people. The crowd sings every word back to him. It is, by any measure, the best night of his professional life. Then he opens Instagram to see how the show landed, sees a photo of himself on stage, and the first thought that arrives is not pride. It is disgust at his own body.

That moment, captured in Noah Kahan’s Netflix documentary Out of Body, is the one our team has not stopped thinking about. Two of Hilltop’s clinicians, Maggie Lefavor, RD, LDN, CEDS and Jessica Coviello, unpacked the film on a recent episode of their Nourish and Empower podcast, embedded above. What follows is not a recap. It is what that moment, and the fifteen years of silence behind it, tells us about a problem we treat every week in Summit, New Jersey.

Body Dysmorphia in Men Hides in Plain Sight

Kahan says he struggled silently for fifteen years. Fifteen years of a “shame section” in his closet. Fifteen years of a restrict and binge pattern he never named out loud. Fifteen years in which the whole world watched him, and nobody saw it.

That timeline is not unusual. It is typical.

Here is what we see clinically: men do not usually walk in saying “I have body dysmorphia.” They come in describing stress. Irritability. A gym schedule that has quietly become non-negotiable. Meals skipped out of guilt, then eaten in secret volume later. A photo untagged, a beach trip declined, a shirt kept on. Each behavior has a reasonable-sounding explanation. Together, they are a disorder wearing a disguise.

The research backs up what the consulting room shows. According to the National Eating Disorders Association, about one in three people struggling with an eating disorder is male, and subclinical disordered eating behaviors, including bingeing, purging, and fasting for weight loss, are nearly as common in men as in women. One study of college men found that more than 80 percent reported body dissatisfaction. Eighty percent. And yet most men have never once heard another man describe the experience in plain language.

And every one of those numbers is an undercount. Prevalence data only captures the men willing to answer the question honestly, and the defining feature of this condition in men is that they do not answer the question at all. For every man who reports dissatisfaction on a survey, there is another doing push-ups in the dark, deleting photos of himself, and telling no one.

That is why Kahan’s disclosure matters. Not because a celebrity said it, but because a man said it, shirtless, mid-workout, on camera, in the exact posture the shame usually demands he hide.

The Restrict and Binge Cycle Nobody Names

One detail in the documentary deserves more attention than it got: Kahan describes bingeing when stressed and not eating at all out of guilt. Restrict, then binge. Guilt, then restriction again.

If you recognize that loop, understand what it actually is. It is not a willpower problem. It is not “letting yourself go” followed by “getting back on track.” It is a physiological and psychological cycle in which restriction itself drives the binge. The body, deprived, eventually overrides the rules. The mind interprets the override as failure. The failure justifies harsher restriction. The cycle tightens.

In men, this loop often hides inside socially rewarded behavior. Cutting and bulking. Clean eating. Training through exhaustion. The culture applauds the restriction half of the cycle and shames the binge half, which is precisely why men keep the second half secret. Kahan kept it secret while playing Madison Square Garden.

Where does someone even begin with a pattern like this? Often with the skill his own story circles: accepting what is true before trying to change it. We wrote recently about radical acceptance in eating disorder recovery, and Kahan models it almost word for word when he talks about letting his father be who he is, and letting his own struggle be what it is, so he can finally work on it.

Why Body Dysmorphia in Men Goes Untreated

Kahan said he never discussed it because he did not know what his place in the world was with this issue. Sit with that phrase. He did not doubt that he was suffering. He doubted that he was allowed to be.

This is the core clinical barrier with men, and it is why generalist care so often misses them. Screening tools were historically written around female presentations. Awareness campaigns rarely show a male face. A man who compulsively exercises, obsesses over his chest and arms rather than his waist, and cycles between restriction and bingeing may never once think the words “eating disorder,” and neither may his doctor.

Hilltop Behavioral Health built a dedicated program around this exact gap. Our eating disorder treatment for men exists because men do not need a softened version of standard care. They need care that recognizes muscle-focused dysmorphia, the pull toward leanness and size at the same time, the shame of holding a “female” diagnosis, and the fifteen-year silence that usually precedes the first phone call. Our founder, Brian Pollack, LCSW, CEDS-C, is one of a small number of master’s-level clinicians in the country holding the CEDS-C credential, and male body image has been a clinical focus of this practice from the beginning, including through his Minding Men podcast. If you are looking for male eating disorder treatment NJ specifically, that page describes how we approach it.

The Instagram Moment Is the Whole Illness

Go back to that post-show scroll. It matters because it demonstrates something families and partners consistently misunderstand: achievement does not treat this.

He sold out the arena he once tweeted he would never play. A fan told him his music carried her through cancer treatment. None of it held. Within minutes, the evaluating mind found the photo, found the body, and rendered the verdict it always renders.

If you love someone with body dysmorphia, stop waiting for the promotion, the wedding, the race time, or the weight goal to fix it. External wins are inadmissible evidence in the court this disorder runs. That is not pessimism. It is the reason treatment works and accomplishment does not: therapy targets the judge, not the verdict.

There Is No Finish Line, Only a First Step

The most clinically honest line in the film is Kahan’s closing realization: there is no single event that fixes everything. There is waking up every day and trying.

We would add one thing to that. Trying alone, in silence, for fifteen years is what he already did. Trying with structured, specialized support is a different activity entirely. He describes standing at the edge of the diving board, knowing the only move left is to jump. For most of the men we work with, the jump is one unglamorous act: saying it out loud to someone trained to hear it.

Hilltop Behavioral Health provides eating disorder treatment in New Jersey with a team that treats body dysmorphia, disordered eating, and the anxiety and perfectionism underneath them, in men and in everyone else who was told this was not their struggle to claim.

If any part of this sounded like your inner monologue, or like someone you love, reach out to us. One conversation is enough to start. Prefer to talk it through? Call us at (973) 637-0572.

References

1. National Eating Disorders Association. Eating Disorders in Men and Boys. https://www.nationaleatingdisorders.org/eating-disorders-in-men-and-boys/
2. Male body dissatisfaction and eating disorder symptomatology: moderating variables among men. PubMed, PMID: 23988683. https://pubmed.ncbi.nlm.nih.gov/23988683/