Eating disorders

Males with eating disorders

By Abigail H. Natenshon, MA, LCSW, GCFP

Eating disorders were once thought to be women's diseases. No longer. The number of men with symptoms of eating disorders has doubled in past decade. 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 under-reported 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.

Twenty percent of men with eating disorders are reported to be homosexual. Despite controversy on the topic of gays with eating disorders, there has, in fact, been no proven relationship between homosexuality and eating disorders. Gays may simply be over-represented among men seeking help because they are more willing to identify themselves, and because their culture puts a premium on physical appearance.

Men are no more immune to the compelling forces of the media than women have been. Men and boys feel pressured to conform to the lean and chiseled body image stereotypes of Hollywood and Madison Ave; where women and girls strive to achieve thinness, men and boys look for well-developed muscles, sleek abs, sculptured pectorals. Since the 1970s, three times as many men have become dissatisfied with their overall appearance. One study shows that close to half of men between the ages of 50 and 59 were dissatisfied with their overall appearance, as compared with 41 and 48 percent for younger age groups. Related body image conditions include:

• BDD, body dysmorphic disorder (a severe preoccupation with an imagined or slight defect in appearance that can impair daily function and cause severe depression)
• steroid use
• muscle dysmorphia in which men and boys believe their muscles aren't large enough; these individuals spend inordinate amounts of time in the weight room

The onset of disease in males is typically triggered by a concern with bodybuilding and sport training, an indicator that schools and coaches can have a great deal of influence in determining how a child thinks about himself, his body and his priorities. They also play a significant role in prevention. In fact, one of the chief differences between male and female eating disorders is that disordered men are more likely than women to be involved in sports like biking, wrestling, of diving that require weight control. Other differences include that facts that the average age of onset for men (15–16) is slightly later than that for women (14–15). In addition, men may purge through self-induced vomiting (see bulimia nervosa) and exercise more readily than do women because dieting, as a device to manage weight, is not as socially acceptable for men.

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.

Might you or your child have a problem? It is important to understand that working out, or watching what you eat, are not in themselves pathological. A problem exists when an individual's concern about appearance interferes with his daily life function, creating serious stress, undermining social activities, schooling and "job status."

Observe yourself. Become aware of what you do and why. The following is a short quiz to help you consider whether or not you may have a problem.

• Do you worry about your appearance?
• Spend a lot of time on preening, grooming?
• Eat special foods just to improve appearance?
• Do you use behaviors around food and exercise to relieve or resolve anxiety, depression?
• Are behaviors around eating and exercise compulsive, inflexible?
• Does excessiveness or extremism show up in other life spheres as well?

Remember that eating disorders are a misuse of food to resolve emotional problems. If your eating or exercise behaviors diminish anxiety or depression, or if they double as pseudo-solutions to emotional problems even as they address issues of hunger and satety, it's time to seek out more effective ways to solve problems. Professional treatment for eating and exercise disorders generally involves anti-depressants and psychotherapy.

Does your child have a problem? Parents and coaches have a vital role to play in the lives of young boys with disorders or disorders in the making. If your child does not recognize a problem, can't respond to his condition as such, or is otherwise unwilling to do what he must to care for himself, it is up to you as a parent to:

• take charge
• know what you are looking at
• understand what eating disorders are
• talk to your child: discussing an existent problem won't make it worse, but through defining it as such, can make a solution possible
• get professional help

My book, When Your Child Has an Eating Disorder: A Step-by-Step Workbook for Parents and Other Caregivers (Jossey Bass Publishers), offers parents all they need to know to get their child the care he needs to recover fully and lastingly.

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Abigail H. Natenshon, MA, LCSW, GCFP
www.empoweredparents.com
www.empoweredkidZ.com
www.treatingeatingdisorders.com

A Family Approach to Healthy Eating,
Positive Body Image and the Prevention and Healing of Eating Disorders