Sylvester Stallone's disclosure that he developed bulimia while training for his breakout role in the 1982 film «Rambo» has renewed attention to a problem that experts say remains largely invisible: eating disorders among men. The Academy Award-nominated actor, 80, told The New York Times that his pursuit of an «animalistic» physique, inspired by jaguars and cats, turned into an «obsession» that became «really bad.»
«It got to the point where I became bulimic,» Stallone said. His account, delivered decades after the fact, has given new visibility to a condition that clinicians say is far more common among men than public perception suggests.
Bulimia nervosa is characterized by episodes of binge-eating, during which a person consumes a large amount of food while feeling a loss of control, followed by purging behaviors such as vomiting, excessive laxative or diuretic use, fasting, or compulsive exercise, according to the National Institute of Mental Health.
Brian Pollack, a licensed clinical social worker and certified eating disorders specialist at Hilltop Behavioral Health in Summit, New Jersey, treats men with eating disorders and describes the problem as «highly underreported.» According to the National Association of Anorexia Nervosa and Associated Disorders, roughly 30 million Americans experience an eating disorder at some point in their lives, and about one-third of them are male.
Pollack said men often present differently from women. «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,» he said. Others pursue extreme leanness, restricting food to the point of near-starvation.
The clinician compared today's pressures on boys and men to the beauty ideals that girls and women faced in earlier decades. «We're seeing this extreme need for perfection and musculature — and that is leading to bulimia right now,» he said, pointing especially to adolescent boys who absorb constant messaging about masculinity.
Pollack noted that bulimia is often rooted in a need for control. Binge-eating represents a loss of control over food, while purging restores a sense of it. Because those behaviors are typically performed in secret, family members and friends may miss the signs entirely. «They're hidden,» he said. «People are ashamed of them at times.»
Several warning signs can indicate a problem. One is a growing reliance on supplements such as creatine or performance-enhancing substances like human growth hormone. Another is compulsive behavior around exercise and eating, including multi-hour daily workouts and meticulous calculation of every dietary detail. Some men adopt rigid restrictive diets — strict ketogenic plans, excessive protein intake, or eating only foods deemed «clean» — and may avoid meals prepared outside their own standards.
Pollack also described «cheat days» in which people visit fast-food restaurants and eat as much as possible to satisfy urges intensified by restriction. «They binge, and we often see people hiding in the bathroom within 45 minutes after meals,» he said. Escalating use of laxatives or diuretics is another red flag, with some users taking larger doses as smaller ones stop producing the desired feeling of being «emptied» or «in control.»
Pollack said eating disorders affect men across the lifespan, 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.»
He suggested that men often lack the vocabulary to describe emotional distress, which makes eating disorders harder to detect. Instead of asking directly about food, he recommended asking about body goals — 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 difficult emotions.
The health consequences can be severe. «Just on a baseline level, with someone who purges, we see electrolyte imbalances, along with kidney and liver damage,» Pollack said. He added that he has seen patients go into cardiac arrest after prolonged malnutrition and repeated purging severely damaged their hearts.
Pollack also pointed to a broader cultural trend he called «looksmaxxing,» in which boys harm themselves in pursuit of an ideal appearance, including undergoing cosmetic procedures to alter their jawlines. «It's getting very scary out there, actually,» he said.
Stallone's disclosure, made during an interview with The New York Times, has been widely discussed as a rare moment of candor from a male star known for his physique. Experts say such openness matters because stigma and silence remain among the biggest barriers to men seeking treatment.