3 Myths About Men and Eating Disorders

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By Nina Savelle-Rocklin, PsyD

1. Only teenage white girls get eating disorders
2. Male eating disorders are a new phenomenon
3. Only gay men struggle with their body image

All these statements are false.

The reality is, eating disorders impact people of all races, ages, and genders, regardless of sexual orientation. It is estimated that 10 million men suffer from a clinically diagnosable eating disorder.

The author Brian Cuban, who details his struggles with bulimia and body dysmorphia in a memoir, Shattered Image, says, “People tend to believe that men who suffer from eating disorders are not ‘real men’ as society defines us.”

Due to ongoing stereotypes about eating disorders, many men suffer in silence and do not get treatment, which suggests that the incidence of male eating disorders is likely higher than reported.

An Example

Even when men do seek help, the medical community may not recognize or consider an eating disorder diagnosis. Frank*, a grandfather in his 60's, had bulimia since childhood and finally summoned the courage to disclose to it his physician. He told his doctor, “I throw up every day.”

The doctor presumed it was a case of spontaneous vomiting and ordered several invasive medical procedures to isolate the problem. Frank was too mortified to explain that he was forcing himself to purge. He endured the tests rather than suffer the humiliation of further explanation.

It’s just as hard to be Ken as it is to be Barbie

There is increasing societal pressure on men to conform to an idealized masculine body type that is nearly impossible to achieve. Magazines depict muscular male models with six-pack abs and smooth skin, images that contribute to increased body dissatisfaction in all males, regardless of age or sexual orientation.

Up to 43 percent of men are dissatisfied with their bodies and a recent study showed that 18 percent of boys were highly critical of their bodies. Although not a direct cause, body dissatisfaction can lead to the development of eating disorders.

The psychoanalytic perspective on eating disorders posits that restricting, bingeing and purging, purging, and/or over-exercising, each represents a means of communicating something about a person’s inner conflicts and emotions.

Eating disorders are thus a maladaptive attempt to express or cope with untenable emotions and thoughts.

Boys don’t cry

Our culture sends men the message that active emotions such as anger are acceptable, but passive feelings such as sadness, loneliness, or fear, are not okay. In fact, the very existence of these emotions is often perceived as feminine or weak.

As Adam* told me, “I’m a dude. I don’t have feelings.”

Adam denied his loneliness and stuffed his sadness by eating. He was stuck in a vicious cycle of eating to fill the void in his life, getting upset about his weight, and then eating for comfort.

The cycle ended when he was able to express loneliness with words, and to respond to his needs differently, using comfort words instead of comfort food.

This yearning for comfort is one that many men deny, believing they should somehow be above such longings, or that the existence of any vulnerability undermines their masculinity.

Instead of expressing their emotional pain, some men eat until they’re in physical pain.

Instead of processing emotions that feel too big, others eat too much or tell themselves their bodies are too big.

Instead of processing hurt or disappointment towards others, they become disappointed in themselves, or decide that a perfect body will bring them a perfect life.

The behaviors of an eating disorder convert emotions, wishes, wants and needs into physical problems or sensations. Yet, one cannot resolve an emotional or psychological conflict by taking physical action.

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If uncomfortable thoughts or feelings are not identified and processed, eating disorders can develop as a means of coping.

Healing

Patients with eating disorders often consciously think they are trying to lose weight, or attain some physical ideal. Yet, whatever is going on with food is a symptom of an underlying problem, not the real problem - although of course it seems like “the” problem.

Frank learned to put words to his inchoate emotions and began talking about what was bothering him, instead of purging. When he used language to express his internal world, the bulimia stopped.

When Adam came to terms with emotions he had labeled as feminine and therefore forbidden, he stopped turning to food to express his longings and inner emptiness.

Identifying and working through the core conflicts and feelings that lead to the behaviors, rather than focusing on the behavior itself, or their bodies, is the key to true and lasting healing.

Warning signs specific to males

Although the media has coined a pithy phrase, “manorexia” referring to anorexia in males, the symptoms of all eating disorders are the same regardless of gender. There are, however, some warning signs that are specific to males:

• Preoccupation with body building, weight lifting or muscle toning
• Weight lifting when injured
• Lowered testosterone
• Anxiety/stress over missing workouts
• Muscular weakness
• Decreased interest in sex, or fears around sex
• Using anabolic steroids

If you or someone you know exhibits these signs, help is available. With treatment that addresses the underlying causes of eating disorders, they are treatable and curable.

*All names of patients have been changed to protect their privacy

About the author: Nina Savelle-Rocklin, Psy.D. is a Los Angeles-based psychoanalyst and recognized expert in weight, food and body image issues. Her book "Food for Thought: Perspectives on Eating Disorders" was recently published by Rowman & Littlefield. www.winthedietwar.com

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