A recent report from Britain's National Health Service announced a 66 percent rise in hospital admissions for men with eating disorders over the last 10 years. This did not come as shocking news to me since for years now, experts in the field have been warning us about the rise in male eating disorders. Some estimate that as many as one quarter of eating disorder sufferers are male, but even that figure may be outdated by now.
The stigma toward female eating disorders is slowly lifting as we learn more about the genetic basis for these psychiatric disorders, causes that have nothing to do with lack of willpower, laziness or general moral failure. More people, including general practitioners, educators, coaches, and parents, realize that these are serious illness that can kill, and must be treated as such. Yet the male eating disorder is still largely taboo. Men and boys are more afraid to come forward, and thus far fewer men end up in treatment. That means they don't show up in hospitalization statistics. Happily, this latest report indicates things may be changing, at least in Britain.
All the factors that have been cited for this high incidence are true: men are judged on appearances as much as women today. A poor economy and increasing financial pressures make men (just as women) feel they have to look younger, fitter, to compete in the job market. Often the disorder starts with an effort to get fit, the exercising spirals out of control, becoming obsessive. Restricting food intake can quickly become pathological in a genetically susceptible individual and very soon, you have a full-blown eating disorder on your hands. Doctors don't look for male eating disorders as much as female eating disorders, and again, men aren't coming forward as much to seek treatment.
Part of the problem has been that men by nature (if I may make a completely broad generalization here) tend to be less comfortable discussing feelings of any sort: insecurity, anxiety, depression, loneliness, all of which are moods that can underlie and complicate an eating disorder. Often the defenses erected against those feelings preclude any recognition of them, which makes discussing them or seeking help for them impossible to do. I recall one (male) doctor who specialized in eating disorders among men talking about sitting in a room with a patient who was so completely in emotional pain yet struggled for insight as to how he ended up there.
Another memory that pops up is the story of the former lacrosse star-turned eating disorders advocate Patrick Bergstrom, whom I interviewed for this National Eating Disorders Association (NEDA) toolkit on athletes and eating disorders. It was hard to hear his devastating story of going from golden boy athlete who could do no wrong to the desperate young man who ate less than a meal a day, drank to excess, fainted periodically and couldn't hold a job. A month before his wedding day, Bergstrom found himself lying on the ground, crying out for help.
Two weeks later he was finally diagnosed with anorexia nervosa, and entered an eating disorders treatment center. In an account of his illness Bergstrom wrote, "I was also still in complete denial because of the shame and stigma put on those that suffer from eating disorders. I thought I was the only guy dealing with body image issues, depression, substance abuse, and an eating disorder. Since being in strong recovery, I have learned that so many males struggle with these exact issues and have very similar stories to mine." (For a fuller version of Patrick's story, click here.)
I hope that the recent headlines will encourage men and boys who are suffering in secret to seek treatment. A good place to start, for those who don't know where to turn, is the NEDA Information & Referral Helpline: (800) 931 2237.
Marcia Herrin and Nancy Matsumoto are co-authors of The Parent's Guide to Eating Disorders. Marcia is the author of Nutrition Counseling in the Treatment of Eating Disorders