Men and eating disorders

A collection of links

NEW ORLEANS -- Eating disorders in men are much more prominent than is generally appreciated, Dr. Arnold Andersen said at the annual meeting of the American Psychiatric Association.

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The pressure of maintaining a proper body image--to which men are as subject as women--is an important trigger in initiating and sustaining eating disorders. In men, altering body shape--to be thinner, more muscular, and to increase the chest-waist ratio--is likely to be the concern that drives abnormal eating behavior. Weight manipulation appears to be only a means to achieve the ideal shape.

The prevalence of full-blown eating disorders, however, is substantially greater in women than men: 4:1 for anorexia, and 11.4:1 for bulimia nervosa. Partial syndromes--for example, chronic concern about diet and weight maintenance--are more evenly divided: 1.5:1 for anorexia and 1.8:1 for bulimia, Dr. Anderson said.

That the prevalence of eating disorders among homosexual men is about fourfold higher compared with heterosexual men is believed to reflect possible social influence.

Other groups subjected to an unusual degree of pressure, such as high school wrestlers, also are greatly overrepresented, he commented.

Among the factors that make eating disorders difficult to detect in men are clinician ignorance and patient shame. The association of these disorders with homosexuality and women drives many men to conceal any symptoms of the disorder that they may have as well as any associated distress. Binge eating disorder in particular is often overlooked because of the embarrassment and ignorance surrounding reverse anorexia," Dr. Andersen said.

"We're not asking the right questions" to detect pathology in men, he said. Patients who make any of the statements listed below, may be affected or at risk:

* "I want to be taller."

* "I'm too thin."

* "I want more muscle."

* "I want to gain weight as muscle, not fat."

Most tests applied to eating disorders are skewed toward women and are based on characteristically female presentations and body image distortions.

There are gender-specific obstacles to treatment, too. Many programs have a bias against men, and the larger ones typically refuse to accept them, Dr. Andersen said.- from here

Same old story, males are victim of othering, science is not taking them serious.

February 6, 2004 (AXcess News) Philadelphia - The Renfrew Center released the results of a study on eating disorders Friday which outlined those research findings. The Center, based in Philadelphia, specializes in the treatment of eating disorders, including anorexia, bulimia, binge eating disorder and related mental health issues.

Traditionally, eating disorders were thought to have only been associated with young, privileged, white women. However, today anorexia, bulimia and compulsive overeating are not discriminating - they are affecting people of all ages, gender and ethnic backgrounds.- from here

Eating disorders
, such as anorexia, binge-eating, and bulimia, are characterized by an individual displaying extreme behaviors and attitudes about their weight and food issues.

Many feel that eating disorders are common in young girls who have developed these issues through their pubescent years. This, however, is incorrect thinking.

The fact is eating disorders do not discriminate and can be developed by both males and females, as well as those of all ages and races. According to the National Institute of Mental Health
, approximately 5-15% of individuals that have been diagnosed with an eating disorder and approximately 35% of those diagnosed with binge-eating disorder are male. - from here

And another one that adds some facts here and there

Research into male eating disorders
A large US study of adolescents reported in 1995 does show that significant numbers of young males experiencing problem weight control behavior.

2%-3% of males diet all the time or more than ten times a year

5%-14% of males deliberately vomit after eating

12%-21% had a history of binge eating

A study published in the April 2001 American Journal of Psychiatry found many psychological similarities between men and women with eating disorders, with both groups experiencing similar symptoms.

Doctors fail to recognize male eating disorders
To date the evidence suggests that the gender bias of clinicians mean that diagnosing either bulimia or anorexia in men is less likely despite identical behavior. Men are more likely to be diagnosed as suffering depression with associated appetite changes than receive a primary diagnosis of an eating disorder. - from here

Here is an approach I really liked (and I really would like to see a similar approach when it comes to DV). From a website about eating disorders.

Okay, so we all want to hear how Calvin Klein is the culprit and that the emaciated waif look has caused women to tale-spin into the world of Eating Disorders. While the images of child-like women has obviously contributed to an increased obsession to be thin, and we can't deny the media influence on eating disorders, there's a lot more to it than that. With approximately six billion people in the world, and a mere ten million of them suffering with some type of disordered eating (.18% of the overall population -- less than a ¼ of 1%), the media obviously doesn't cause everyone to develop Anorexia, Bulimia or Compulsive Overeating. (Current statistics indicated that approximately one in every one hundred teenage girls may develop an Eating Disorder).

It is a lot more complex than blaming the media.
The media most certainly contributes to dieting and size discrimination
but Eating Disorders are NOT Diets!

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While all of these images, advertisements, and messages may be counterproductive to a good self-image, and society's overall acceptance of each person's different size and shape, they are NOT the reason so many men and women develop an Eating Disorder. These images may not help, and for those already open to the possibility of negative coping mechanisms and/or mental illness, the media may play a small contributing role -- but ultimately, if a young man or woman's life situation, environment, and/or genetics leave them open to an Eating Disorder (or alcoholism, drug abuse, depression, OCD, etc.), they will still end up in the same place regardless of television or magazines. Ultimately it's important to know that Anorexia, Bulimia and Compulsive Overeating are NOT about weight and food. Rather they are complex disorders where each sufferer is plagued with low self-esteem, an inability to cope with their own emotions and stress, and many underlying issues that have lead them to their disordered eating. - from here

"This Child" can be anyone from someone with Compulsive Overeating to Anorexia or Bulimic. It can be your husband or wife, your sister or brother, your son or daughter, your lover or friend, a parent or grandparent, an aunt or uncle, a niece, a nephew, a cousin. They might be male or female, any age, and come from any race or religious background. It is me, it is you or it is someone you love or know.

To have an Eating Disorder is to have a disease of the self-esteem, and to have a broken coping mechanism. Eating Disorders are about being addicted to a behavior that makes it easy to temporarily forget problems and feelings of depression and self hate, stress and anxiety, guilt and pressure. Just like alcohol is a symptom of alcoholism, food is a symptom of Anorexia, Bulimia or Compulsive Overeating. The real issues are hidden away in each sufferers heart and mind. - from here

People with Eating Disorders are only "young, white and female".

ANYONE can suffer from Anorexia or Bulimia. Regardless of previously held beliefs, it is not only young, middle-class white teenagers or college students who can suffer. African-American, Hispanic, Asian, or white, women or men, rich to poor, from their teen years well into their fifties, there are sufferers from every age-bracket, class and culture. Don't rely on the "written statistics" - they are based on reports made to government agencies and if a country, state, or province doesn't require that doctors report the cases, the statistics will not be accurate. Keep in mind as well, the more shame a sufferer feels, the less likely that they will come forward and say they have an Eating Disorder... so if we keep perpetuating the idea that only "young white women" suffer, less and less of them that don't fit this ideal will not come forward, be acknowledged, and get the help they deserve.

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Doctors should know. If the doctor says there's nothing to worry about, then there isn't.

Doctors do not know everything. Unfortunately, in most places, unless a doctor has taken additional courses in Eating Disorder training or has specialized in the field, they know very little about them. A great number of doctors are not aware of all the warning signs or will begin testing for other possible physical problems because of the stigma society has attached to Eating Disorders. A lot of times, doctors wait for the patient to say "hey doc, I have an Eating Disorder" and considering the low-self esteem and nature of the illness, more often than not this is unlikely to happen early on. Also, the human body learns to adapt to starvation and malnutrition, so unless blood tests are specifically geared towards Eating Disorders, average blood tests of a physical will show little detrimental information. I cannot stress enough how important it is to find a way to tell your doctor you have an Eating Disorder... and I will add if any doctor ever treats your poorly or ignores your plea for help, find another doctor!

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An Eating Disorder is a woman's illness.

Absolutely Not. Only recently has the media begun to address the "hidden population" of men with Eating Disorders. Many men suffer but because of the old wive's tale that Eating Disorders were just illnesses of woman, the men suffering have feared telling of their problems, or even facing it themselves. It is calculated that 1 in 10 Eating Disorders currently are men, and expected that the number is much higher. - from here

According to Arnold Andersen and the research he did for his book Males with Eating Disorders, while women who develop Eating Disorders feel fat before the onset of their disordered eating behaviors, typically they are near average weight. Men are more typically overweight medically before the development of the disorder. In addition, men who are binge eaters or compulsive overeaters may go undiagnosed more than women because of society's willingness to accept an overeating and/or overweight man more-so than an overeating or overweight woman.

Though it is more common for homosexual men to suffer from Eating Disorders such as Anorexia and Bulimia (because of the tendency in the male gay community to place a high level of importance on success and appearance), there are still many heterosexual men out there who suffer. This contributes back into the shameful feelings a heterosexual male sufferer has -- he may be afraid that people will think he is gay -- or that a homosexual and heterosexual male can feel -- that the illness is considered to be a "female's problem". I have often received e-mail from men who are suffering in silence because of these two issues.

In addition, there may often be shrouds of secrecy because of the lack of therapy groups and treatment centers offering groups specifically designed for men. They may feel very alone at the thought of having to sit in a group of women, to be part of a program designed for women, and even at the prospect that a treatment facility will turn them down because of their sex.

Men who participate in low-weight oriented sports such as jockeys, wrestlers and runners are at an increased risk of developing an Eating Disorder such as Anorexia or Bulimia. The pressure to succeed, to be the best, to be competitive and to win at all costs, combined with any non-athletic pressures in their lives (relationship issues, family problems, abuse, etc.) can help to contribute the onset of their disordered eating.

It is not uncommon for men suffering with an Eating Disorder to also suffer with alcoholism and/or drug abuse simultaneously (though many women also suffer both disordered eating and substance abuse problems combined). This may be due to the addictive nature of their psychological health combined with the strong images put out by society of men's overindulgence in alcohol. In addition, men suffering with Anorexia and Bulimia seem to have more sexual anxiety. There may also be a link between ADHD, Attention Deficit and Hyperactivity Disorder, with male sufferers of Anorexia and Bulimia and self-injury. More research needs to be done in this area. For all those who suffer, men and women, there are many possible co-existing psychological illnesses that can be present, including depression, anxiety, post-traumatic stress disorder, self-injury behavior and substance abuse, obsessive compulsive disorder, and borderline personality disorder and multiple personality syndrome.

The most important thing, overall, to remember is that most of the underlying psychological factors that lead to an Eating Disorder are the same for both men and women. Low self-esteem, a need to be accepted, depression, anxiety or other existing psychological illness, and an inability to cope with emotions and personal issues. All of the physical dangers and complications associated with being the sufferer of an Eating Disorder are the same. A great number of the causes are the same or very similar (family problems, relationship issues, alcoholic/addictive parent, abuse, societal pressure). Most of all, all people with eating disorders deserve to find recovery and the happiness and self-love on the other side. - from here

The one in 10 seems to be the number when it comes to eating disorders. It seems though there could be more:

The number of men with symptoms of eating disorders has doubled in past decade. New research out of the University of Toronto shows that 1 of every 6 people who qualified for a full or partial diagnosis of anorexia was male - substantially more than the 1 in 10 usually reported. Largely under recognized and underreported in men and boys, males are more likely to blame unnatural weight loss on physical rather than psychological problems. In addition, it remains taboo in our society for men to care about how they look, so there is a greater motivation to keep body image obsessions a secret.

The issues of eating disorders for men are for the most part, similar to those of women who suffer from the same disease.

* Men suffer from with self-esteem and perfectionism.
* They seek to gain control of their lives by controlling their bodies.
* They often suffer from depression, anxiety, alcohol or drug abuse or other psychiatric conditions as well.
* Most have distorted image of body, seeing obesity where others see skin and bones.
* They are at risk to suffer cardiac irregularities, electrolyte imbalances that could lead to death, and osteoporosis, to name a few physical side effects.
* Hormone (testosterone) levels plummet and sexual desire vanishes. - from here

Another one about the similarities between men and women.

Eating disorders are more common in men than was previously thought, yet men are not as likely to seek treatment for eating disorders, according to a study published in the April 2001 American Journal of Psychiatry. The researchers found many psychological similarities between men and women with eating disorders, with both groups experiencing similar symptoms.

The authors compared 62 men who met all or most of the Diagnostic and Statistical Manual of Mental Disorders criteria for eating disorders with 212 women who had similar eating disorders, and 3,769 men who had no eating disorders who had a wide variety of medical histories.

"Men are generally very similar to women in terms of comparing psychopathology," said lead author D. Blake Woodside, M.D., of the Department of Psychiatry at Toronto Hospital. "The illnesses are much more equivalent in prevalence than was previously thought. We have to think about why men wouldn't come for treatment."

One possible explanation is that men are reluctant to come for help because they feel eating disorders fall under the category of "woman's diseases." This is linked to the second possible reason, which is that men may not recognize the symptoms because it doesn't occur to them to do so, because eating disorders have long been assumed to plague women only.

"Men with symptoms should get help, as women do. This is where public education comes in," Woodside said, adding that public education efforts should do more to identify and treat men with eating disorders.

Woodside also said that the differences that are observed between men with eating disorders and men in the general population could result from side effects of the disorders.

["Comparisons of Men with Full or Partial Eating Disorders, Men Without Eating Disorders, and Women with Eating Disorders in the Community," by D. Blake Woodside, M.D., et al., p. 570, American Journal of Psychiatry, April 2001.]- from here

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