Male Eating Disorders
Eating
Disorders are illnesses that are generally believed to affect women rather
than men, and have mostly been investigated within the female population.
To a large extent this is because of the apparent prevalence of eating
disorders in women. On closer inspection however gender distributions
of eating disorders show about 10 per cent of people with anorexia and
bulimia are men. To date the evidence suggests that the gender bias of
physicians means that diagnosing either bulimia or anorexia in men is
less likely, despite identical behavior. Men are more likely to be diagnosed
as suffering from depression with associated appetite changes than to
receive a primary diagnosis of an eating disorder.
The lack of visibility of anorexia or bulimia in the male population means
a number of things - men do not discuss eating disorders, they tend not
to share the information with other men because the subject is a female
issue, men's beauty has to do with body mass, muscle bulge and definition,
not weight loss. This male population, socially defined as powerful and
masculine, results in men not seeking help because of their reluctance
to admit to the problem.
Gender
and sexual orientation are significant factors when considering male eating
disorders - approximately 10% of people with eating disorders are men
and approximately 20% of men with eating disorders identify as gay, which
is double the proportion of gay men in the population. There are a few
occupations in which the demand for low body weights can lead to anorexia
or bulimia; among them are horse racing, modelling, dancing, distance
running and driving.
In part, the hidden problem of eating disorders in men is cultural. Women
tend to discuss emotions and psychological problems more than men. Anorexia
and bulimia are perceived as a woman's problem. Discussion of weight issues,
weight control, linking thinness with beauty are common features in women's
magazines, as are eating disorders. Young women can therefore adopt the
same behaviour without it being seen to be too socially unacceptable.
How Eating Disorders Develop In Men:
There is less cultural pressure on men to be slim although the 'sixpack' shape and image may be important. The onset of an eating disorder in men usually has a specific trigger. These include:-
- Avoiding childhood bullying/teasing for being overweight
- Bodybuilding/exercise
- Specific occupations including athletics, dance, horse racing etc
A number of men with personal experience of eating disorders were interviewed in the course of preparing the report and some of their comments appear below.
The majority of the men reported that their eating disorders had started in their school years when they were overweight and called names. Several reported being severely overweight in their younger years, for a variety of reasons to do with low self esteem, crises at home, and difficulties with coming to terms with their situation. For example, one man was 10 stone at 10 years and was put on a 'diet' by the school. This led to him eating on his own and being teased. However, some older men had experienced episodes of eating disorders throughout their lives, associated with loss of a partner, illness of a parent, a relationship breakdown, change of job, stresses of achieving higher university or work qualifications etc.
The particular pressures in the gay male community to have the 'body beautiful' and 'to be slim in order to get a partner' was mentioned by the gay men interviewed. Some gay men talked about the conflicts they had experienced when younger. It was felt to be a bigger problem in the gay male community than has previously been acknowledged. One man reported that his partner had helped him a lot. Men also experienced particular difficulty discussing their illness with their peers. One young man commented 'It is more difficult to come forward, you cannot admit to your feelings in a macho culture; people think you are weak and you fear that you are going to lose respect from your friends.'
The men were asked about their experiences of treatment and care and identified the following issues as being particularly important: Access to sympathetic professionals who did not moralise, who knew about eating disorders and who could provide specialist help.
Whilst some of the men interviewed had received a very prompt response from their GP, the general lack of recognition of the problem or the severity of it, by the GP and the consequent time it took to get specialist help, was a difficulty experienced by many people. GPs were seen as crucial, both because they often dealt with men on an ongoing basis and because they had the power to make appropriate referrals as well as to issue medical certificates.
Chat with others who might be going through similar experiences and who could offer support and advice in our Forums.
It
is clear that the general lack of recognition of eating disorders in men
makes it more difficult for them to access specialist eating disorder
services. Their problems are less likely to be recognised and diagnosed
by professionals, including GPs and psychiatrists, and therefore their
illness may be well established before treatment is offered.
Men find it hard to acknowledge they have an eating disorder and then
to seek help. For example, weight loss is more likely to be attributed
to physical causes rather than to psychological ones.
However, please remember that if you are experiencing problems with weight
control you are not alone. Get help by contacting your family doctor,
a psychologist, mental health center or a doctor who specialises in eating
disorders. You can also visit our Forums
to chat to others who might be going through a similar experience and
be able to offer you with support and advice.