The Hidden Challenge: Male Eating Disorders in the Middle East: A Systematic Review of Prevalence and Cultural Factors

Middle Eastern males face unique eating disorder (ED) risks due to cultural transitions from traditional masculine ideals that emphasized functional strength to Western aesthetic standards. Male EDs in Middle Eastern populations constitute an emerging public health concern that has received limited systematic research attention, despite increasing clinical recognition. This systematic review synthesized available epidemiological data on ED prevalence among Middle Eastern males to examine regional patterns and associated risk factors. We conducted a systematic review following PRISMA guidelines by searching PubMed, Scopus, and Google Scholar databases for studies published between 2000 and 2023 that examined EDs in males aged 15 years and above across Middle Eastern countries. Thirteen studies encompassing 5236 male participants from 11 countries met the inclusion criteria. ED prevalence demonstrated substantial variation from 2.2% to 81.4% depending on population and assessment methodology, with Gulf Cooperation Council countries showing consistently higher rates. Age-stratified analysis revealed the highest rates among adolescents aged 15–18 years (mean: 35.0%) compared to adults over 25 years (mean: 2.1%), with university students showing intermediate levels (mean: 29.0%). Muscle dysmorphia emerged as particularly prevalent among bodybuilders (5.7–81.4%), while university students showed rates of 9.7–49.1%. Depression, body dissatisfaction, and cultural transition stress were consistently identified as correlates across multiple populations. These findings underscore late adolescence as a critical risk period and highlight the urgent need for culturally adapted diagnostic tools, healthcare provider training, and region-specific prevention strategies.