In the past, men enjoyed a much broader range of “acceptable” body shapes and sizes than women. Societal messages implored women to be stick-thin in order to be sexy or desirable, while men could be tall and lanky or stout and plump without drawing much negative attention. Over the years, men have increasingly joined the ranks of people dissatisfied with how they look. Not coincidentally, male role models in magazines and on TV, even the action figures of their youth, have gotten leaner and more muscular.
Today, men are catching up with women in body dissatisfaction and disordered eating. Some are going to dangerous lengths to slim down, others spend hours in the gym bulking up and others find themselves drowning their emotions in food. In short, men are struggling with the same eating disorders that have for too long been categorized as “women’s diseases.”
An Invisible Problem Comes to Light
While men make up about 10 percent of patients with anorexia and bulimia, both sexes struggle almost equally with binge eating. According to the Binge Eating Disorder Association, 40 percent of the estimated 10 million Americans who binge eat are men. In a recent study of 46,351 men and women ages 18 to 65 published in The International Journal of Eating Disorders, roughly 11 percent of women and 7.5 percent of men struggled with binge eating.
Binge eating is defined as consuming large amounts of food within a two-hour period at least twice per week, combined with loss of control. Those struggling with this disorder often consume thousands of calories in one sitting, followed by an overwhelming sense of shame and self-loathing, which leads to further binging.
The causes and underlying mechanisms of binge eating are similar to other eating disorders. Binge eaters may suffer from low self-esteem, past trauma or weight-related bullying, or use food to numb emotions and cope with stress. The symptoms of binge eating disorder are similar in men and women, and include:
- Repeatedly eating large amounts of food in short periods of time, without purging
- Feeling out of control around food
- Eating in secret or hiding food
- Eating regardless of hunger and until uncomfortably full
- Eating to relieve difficult feelings
- Feeling shame, self-hatred, disgust or despair after overeating
- Frequently dieting or taking other measures to control weight and eating habits
Underrepresented but Highly Impacted
One factor that differentiates binge eating in men and women is that it is more likely to go unnoticed in men. Even if they are overweight or obese, as an estimated 70 percent of people with binge disorder are, eating more and carrying more weight are more socially acceptable for men than women.
Because eating disorders still carry a stigma, especially among men, the risks of binge eating are great. Heart disease, Type 2 diabetes and other weight-related health conditions are common, as are mental health issues such as depression and anxiety. Binge eating, like other eating disorders, can impact a man’s career, relationships and every area of his life.
Compounding the problem is the reality that many men do not seek treatment for fear of appearing weak, strange or like less of a man. Even when they do, there is no distinct listing for binge eating disorder in the current DSM, the diagnostic manual for mental health professionals (though it has been approved for inclusion in the next DSM). As such, therapists may not be experienced in diagnosing or treating binge eating disorder in men.
Although men may not reach out for help as often, treatment is equally effective for men as it is for women. Treatment for binge eating disorder typically includes cognitive-behavioral therapy, dialectical behavior therapy, nutritional counseling as well as other approaches. There are also support groups and eating disorder treatment programs, some of which have specialized tracks for men.
We Can’t Heal What We Don’t See
So why is it important to know that binge eating disorder is prevalent among men? A man who binge eats needs treatment and support just as a woman does. Until more health care providers understand the symptoms of binge eating disorder, screen for eating disorders in both men and women (particularly when working with obese patients, or individuals struggling with depression, anxiety and other mental illnesses), and recommend appropriate treatment options, men will continue to hide in the shadows – at great cost to themselves and their loved ones. With a growing body of research and expanding awareness, there’s no longer an excuse to overlook men who are so clearly in need of help to live longer, healthier lives.