Background: To examine the epidemiology of anorexia nervosa in men, we screened Finnish male twins born in 1975-79.
Methods and findings: Men (N = 2122) from FinnTwin16 birth cohorts were screened for lifetime eating disorders by a questionnaire. The screen positives (N = 18), their male co-twins (N = 10) and those with lifetime minimum BMI< or =17.5 (N = 21) were administered the Structured Clinical Interview for DSM-IV anorexia nervosa. The incidence rate of anorexia nervosa for the presumed peak age of risk (10-24y) was 15.7 per 100,000 person-years; its lifetime prevalence was 0.24%. All probands had recovered from eating disorders, but suffered from substantial psychiatric comorbidity, which also manifested in their co-twins. Additionally, male co-twins displayed significant dissatisfaction with body musculature, a male-specific feature of body dysmorphic disorder.
Conclusions: Anorexia nervosa in males in the community is more common, transient and accompanied by more substantial comorbidity than previously thought.