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Eating disorders in men

It's easy to forget that eating disorders are not exclusive to females. Males are also affected, and although fewer men than women are diagnosed and treated for eating disorders, according to the largest UK eating disorder charity organisation, B-EAT the number of men with eating disorders is on the rise.

Prevalence of male eating disorders

According to B-EAT, approximately 10% of people with eating disorders are men. The fact that this number is on the increase highlights the importance of raising awareness of eating disorders in men. In 2000, B-EAT published the results of a review of specialist healthcare provision in the UK, that indicate that gender and sexual orientation are significant factors in the prevalence of male eating disorders. For example, approximately 20% of men with eating disorders identify as gay.

Triggers for eating disorders in men

While in our society there is generally less cultural pressure on men to be slim, men are still susceptible to the notion of an ideal body type which is enforced by the media. Covert and overt societal messages that inform us about the ideal body size, shape, and weight are targeted towards both men and women, and men can also be inclined to internalise these ideals.

On a daily basis, we are all exposed to billboards of male models using their bodies to sell everything from designer underwear to perfume. The message seems to be, ‘if you look like this, you’ll be attractive, worthy, and in control’. Such messages are highly suggestive and while we are able to intellectually distance ourselves from them, such messages work on a subliminal level that renders our conscious mind powerless.

However, holding the media and internal messages to blame does not suffice in explaining the aetiology of eating disorders. Although media influences are unquestionably a contributing factor for many sufferers, and remain triggering for most people in recovery, the disorder usually develops in men, in response to a specific trigger. These triggers may include peer pressure and a desire to avoid bullying or teasing for being overweight since childhood. Studies also indicate that certain athletic activities appear to put males at risk for developing eating disorders. Therefore, body builders, runners, swimmers, gymnasts, and dancers are at greater risk, primarily because of the weight restrictions necessitated by their sports.

The clinical presentation of eating disorders is similar for men and women, and more information on the signs and symptoms of anorexia, bulimia and binge eating disorder (BED) can be found on our website. It is believed that a large number of men suffer in silence, as coming forward and speaking about an eating disorder, wrongly believed by many to be a disorder exclusive to women, can be daunting.

In cases where GPs fail to recognise symptoms and make prompt referrals to eating disorder specialists, the disorder can increase in severity, making treatment more difficult. Rarely does a person suffering from an eating disorder tick all the boxes and fall neatly into one category. Regardless, because eating disorders can make the sufferer blind to the severity of their problem, the sufferer is often not able to make the decision to seek treatment without the care and support of loved ones.

Eating disorders do affect men and women

Eating disorders are perceived to affect women and only women. This is a huge misconception, as eating disorders do affect men and there are men who are struggling with eating disorders. It is about time to recognise that men, just as well as women, have concerns over their weight, body, shape and appearance.

Men with eating disorders may be reluctant to admit to having an eating disorder, which is stereotypically perceived to be ‘a female disease’ or ‘girls’ problems’. Being a man with an eating disorder can be perceived to be ‘less masculine’ and ‘flawed’. Men with eating disorders may feel stigmatised and ashamed of having a stereotypically perceived ‘female disorder’. The perceived stigma of being a man with an eating disorder makes it more difficult for a man to admit to having an eating disorder and reach out for help. Men with eating disorders have long been suffering in silence, in what has been named an ‘invisible struggle’.

Men with eating disorders may also be overlooked by mental health professionals. Studies have found that they are less likely to diagnose a man with an eating disorder or refer them to specialised eating disorders services (SLaM Media Release, 2010). Personal accounts of men with eating disorders frequently include stories of how health professionals failed to recognised their eating disorder and were instructed to either ‘just eat’, ‘go on a diet’ or ‘they are depressed’. John Morgan, a psychiatrist who specialises in eating disorders, argues that men are "less likely to recognise their eating disorder, are more likely to be misdiagnosed with other mental health problems, are less likely to receive treatment and are less likely to be referred to specialist eating disorder services" (2009).

Statistics show that eating disorders are most common in women but they are also present in men. The National Institute for Health and Care Excellence (NICE) reported that 1.6 million people in the UK are affected by an eating disorder, of which 11% are male. Research studies suggest that 10 to 20% of cases of anorexia nervosa and bulimia nervosa are men and up to 40% of cases of BED are men (Muise et al 2003). It is also believed that the actual numbers of men with eating disorders may be higher than the ones reported, due to the fact that men are reluctant in seeking help for their eating disorder, they might not recognise or admit that they suffer from a ‘female disease’ and also, health professionals might not readily recognise eating disorder symptoms in men.

Increase in awareness of male eating disorders

Overall, there is a general rise in the numbers of men who are suffering from eating disorders. However, it is questionable whether this is because there are more incidents of men suffering with eating disorders in more recent years, or whether it's because of an increase in awareness in this area. Either way, there is a rise in the awareness of eating disorders in men, as more men are coming forward in admitting to struggling with an eating disorder, seeking help for an eating disorder and sharing their experiences. Also, the media is increasingly addressing men’s problems with eating disorders. Examples include, ‘Binge eating among men steps out of the shadows’ (New York Times, 2012); ‘The secret world of male anorexia’ (The Guardian, 2012); and ‘Rise in men suffering from eating disorders’ (BBC News, 2011). 

The ideal body image differs between men and women, in what has been termed as ‘thinness vs masculinity’, where women strive to achieve a thin body image ideal and men strive to achieve a muscular body image ideal. The issue of masculinity is very prominent to ‘muscle dysmorphia’, where the individual is highly preoccupied with gaining muscularity without gaining fat. It is also come to be known as ‘bigorexia’ or ‘reverse anorexia’, a condition which is more common in men than in women.

Even though eating disorders are well researched, this is mainly research conducted on women and not men. Recently, there has been a shift as more research studies are published on the issue of men and eating disorders and this issue is receiving wider media coverage.

More research and awareness is needed in the area of men and eating disorders, for mental health professionals to be better able to provide specifically tailored treatments for the needs of men with eating disorders. With raising awareness, more men will feel better understood and better able to speak up about their own struggles and experiences. This can help them to seek treatment for their eating disorder and finally put an end to what has long been and hopefully will no longer be an ‘invisible struggle’.

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