When you think of anorexia nervosa, what comes to mind? If you’re like most people, you probably think of a teenage girl, obsessed with counting calories, struggling with perfectionism and dangerously thin from an often deadly psychological disorder.
But what about the men and boys with anorexia? In fact, as many as 25% of patients with anorexia are male! In spite of this, anorexia is typically thought of as an exclusively female disorder and the majority of research has focused on girls and women.
This wasn’t always true.
In 1689, Richard Morton published his magnum opus, A Treatise of Consumptions, which provides a rich description of a variety of diseases that waste the body. Although the London doctor was recognized at the time for his description of tuberculosis, Morton is now known as the first author to provide a medical description of anorexia nervosa.
Strikingly, one of the two cases he described is of a 16-year-old adolescent boy. For the boy's "nervous consumption" caused by "sadness and anxious cares," Morton tried a handful of remedies with limited success, eventually advising the boy to retire to the country and adopt a diet of milk and fresh air.
For many years, the existence of males with anorexia was widely recognized. In fact, the disorder would’ve been called “anorexia hysterica” except for the existence of male patients who couldn’t be labeled “hysterical” according to medical custom at that time.
Now things are different. When we think of anorexia, we think of women. As a result, males with anorexia inherit the idea that anorexia is a “woman’s problem.” In practice, males feel alienated by discussions of lost menstrual periods and women’s cultural issues. With this in mind, it’s crucial that both the lay public and medical professionals begin to understand anorexia as men and boys experience it.
Anorexia is a disorder that can be understood from many perspectives. To really unpack the male experience of anorexia, we have to consider each of them. In my next entry, I will talk about the relationship between male anorexia and the family.
Gull, W.W. (1874). Anorexia nervosa (Apepsia hysteria, anorexia hysterica). Transcript of the Clinical Society of London, 7, 22-28.
Hudson, J., Hiripi, E., Pope, H. & Kessler, R. (2007). The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biological Psychiatry, 61, 348–358.
Silverman, J. A. (1990). Anorexia nervosa in the male: Early historic cases. In A. E. Andersen (Ed.), Males with eating disorders (pp. 3-8). New York: Brunner/Mazel.