Toronto, ON — A new binational study of 259 outpatient psychotherapists across Canada and the United States highlights significant gaps in clinician knowledge, confidence, and formal training related to treating eating disorders and muscle dysmorphia among boys and men, conditions that are rising sharply but remain widely misunderstood.
Led by Kyle T. Ganson, PhD, MSW, of the University of Toronto’s Factor-Inwentash Faculty of Social Work, the research is the first of its kind to examine outpatient mental health providers’ preparedness to treat this underserved group. The study found that most psychotherapists lack adequate training and report low confidence in identifying and treating these conditions, despite regularly seeing boys and men who present with eating disorder symptoms.
Overall, clinicians reported low levels of knowledge and confidence regarding both eating disorders and muscle dysmorphia in boys and men. More than one-quarter of providers said they had no knowledge of eating disorders in this population, and nearly half reported no knowledge of muscle dysmorphia, an even more concerning finding given its growing recognition in the community.
“Boys and men with eating disorders are often hiding in plain sight,” said Dr. Ganson. “Many clinicians simply haven’t been trained to recognize the unique ways these issues show up in male clients.”
Formal training was uncommon. Only a small minority of psychotherapists received any training specific to boys and men with eating disorders during their undergraduate or graduate programs, and just a quarter received such training afterward. Yet among those who received training, most reported that it improved their clinical work, suggesting that even limited educational interventions can meaningfully enhance therapists' preparedness.
Despite this, the effectiveness ratings for these trainings were modest. Providers consistently rated training on muscularity-oriented concerns, such as bulking and cutting, or excessive exercise behaviors, among the least effective components. According to Dr. Ganson, this gap has real consequences: “Clinicians are telling us they want more tools. They’re seeing boys and men in their practice but don’t feel equipped to address the muscularity-focused concerns that are often central to these cases.”
When asked about their training needs, clinicians identified several priority areas: understanding and assessing boys’ and men’s unique risk factors and symptom presentations, learning how to tailor treatment to male-specific experiences, and better addressing stigma, shame, and barriers to care. Surprisingly, fewer clinicians expressed a need for training on building rapport or fostering treatment engagement, even though boys and men are known to seek help less often and drop out of treatment more frequently.
“This is a critical moment for the field,” Dr. Ganson noted. “Our findings show that clinicians want more specialized training, and that such training is urgently needed to ensure boys and men receive competent and affirming care.”
To help meet this need, the University of Toronto’s Factor-Inwentash Faculty of Social Work offers a graduate-level Eating Disorders Assessment and Treatment course taught by Dr. Ganson. The course equips emerging social workers with gender‑responsive assessment strategies, skills for addressing muscularity‑oriented concerns (including muscle dysmorphia), and evidence‑informed psychotherapy approaches tailored to boys and men, while remaining inclusive of diverse genders and intersectional identities.
“We designed the course to close the training gap we’re seeing in the field,” said Dr. Ganson. “Students leave with practical tools, including how to assess muscularity-focused symptoms, how to adapt treatment language and strategies for boys and men, and how to address stigma and barriers, so they can deliver competent, affirming care right away.”
Contrary to persistent stereotypes, eating disorders are affecting boys and men at increasing rates. Hospitalizations and community prevalence data show sharp rises across North America and internationally. Muscle dysmorphia, a disorder marked by a preoccupation with muscularity, is also increasingly recognized among adolescent boys and young men.
These conditions often present differently in males, frequently centered on muscularity and leanness rather than thinness, yet most clinical training still reflects female-centric symptom patterns. As a result, boys and men are at heightened risk of underdiagnosis, misdiagnosis, and delayed treatment.
Because outpatient psychotherapists are often the first point of contact for individuals with eating disorders, the study authors emphasize that improving training at this level is critical.
The findings point to several opportunities to strengthen care, including:
Integrating gender-sensitive approaches into assessment and treatment
Expanding training on muscularity-oriented behaviors
Enhancing understanding of stigma and gender norms that affect help‑seeking
Tailoring psychotherapy models to male-specific body image concerns
Improving clinicians’ ability to recognize muscle dysmorphia in practice
Together, these steps can help ensure boys and men receive competent, informed, and equitable mental health care.
Eating Disorders
Exploring outpatient psychotherapists’ knowledge, confidence, and training on eating disorders and muscle dysmorphia among boys and men
30-Mar-2026