A photo of a skinny white man's body as he pulls at his stomach skin with a speech bubble that says - Why Is There A Disparity In Male Eating Disorder Care?

Why Is There A Disparity In Male Eating Disorder Care?

I decided to write this article on male eating disorder care due to the difficulties I personally had with getting my GP, the specialists I’ve seen for my health issues, therapists, counsellors, and other health professionals to take my struggles with my eating disorder seriously. It seems health professionals either don’t believe men can have an eating disorder or they’re just not interested in supporting male sufferers.

 

 

At the time of researching and drafting this article, I’d just watched ‘Freddie Flintoff: Living With Bulimia‘ which reminded me of all the times I told my doctors, psychiatrists, counsellors, and therapists about my eating disorder and never getting support. The lack of support around my eating issues resulted in me developing reactive hypoglycaemia. So if you find yourself in a similar situation, don’t give up fighting for the care you need, as it can have a last impact on your physical health.

 

The ‘Freddie Flintoff: Living With Bulimia‘ documentary is still available on BBC iPlayer if you’d like to watch it, which you can do by clicking here.

 

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The Evidence

 

The cloud of shame surrounding men with eating disorders still exists, even though the visibility and access to resources are much better (Veritas Collaborative). Although I think it’s less the shame and more the difficulty of having such concerns taken seriously, that is the real problem for men with eating disorders.

 

When we think of eating disorders, we pretty much all start thinking of female sufferers, who do make up the larger share of people with eating disorders. However, according to Child Mind Insitute, it is estimated that 1/4 to 1/3 of eating disorder sufferers are male. Furthermore, Beat estimates the figure to be 25% of those with an eating disorder are men. However, it’s hard to say when it comes to men as they’re less likely to come forward for support (Beat).

 

One of the notable reasons why eating disorders in men has had an issue with recognition, according to Verywell Mind, is because prior to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), to meet the criteria for anorexia, you had to have a disruption to your menstrual cycle (amenorrhea). As a result, males were anatomically incapable of being diagnosed as anorexic.

 

Furthermore, according to an article by The Guardian in 2017, in the previous six years, male admittance to hospitals for eating disorders increased by 70%. This should be a wake-up call to health professionals everywhere to take male eating disorders seriously.

 

Societal conditioning has trained men to think that you need to be able to handle your problems yourself, at least from my generation and generations before me (I’m an 80s child), as well as society as a whole as well. Because of this, seeking mental health support is seen as a weakness due to this stigma, so it’s little wonder men don’t want to report suffering from a condition that is seen as being a female issue.

 

I hear a lot that men should just “man up”, and I’m guilty of saying the same myself in the past, but no more. Thus, this might well be a true reflection of what a lot of men feel, confusing those feelings and thoughts with facts (classic thinking error), but that doesn’t explain why health professionals also do it. I guess they’re still stuck in pre-DSM V thinking.

 

Eating disorders and male recognition as being sufferers, as well as societies acceptance of men needing support is likely linked to the outdated notion that men should be able to just suck it up and handle it. 

 

Another insight comes from Veritas Collaborative, who note that there seems to be a mistake with male sufferers of an eating disorder, which might also be true with some female sufferers. That mistake is that not all men with an eating disorder want to be skinny and fear being fat, some want to be lean and muscular. For me, I didn’t want to lose weight at all when I first started starving myself, I wanted to bulk up as I hated being skinny. Although it’s also very likely that I have BDD as well.

 

Just like women are feed a diet of skinny images and impossible body standards on beauty, men are bombarded with images of abs, pecks, and shredded muscular physique. Both media portrayals of beauty are damaging to the target audience.

 

A photo in black and white of a muscular white man posing in a gym to represent the disparity in male eating disorder care and is prevalent in the body building community to represent the article title - Why Is There A Disparity In Male Eating Disorder Care?

 

Male Eating Disorder Patients Study

 

I’m not the only male who has found their eating disorder concerns have been overlooked. A small qualitative interview study by Robinson, Mountford, and Sperlinger (2012) was done on eight male eating disorder patients, who provided some additional insights on the topic.

 

One of the studies participants commented on how you don’t see much in the media about male sufferers of eating disorders and how difficult it was to get their GP to understand their problem. Another participant talked about how people were surprised about their eating disorder because they’re “male.”

 

A common theme among the male participants of the study was the fear of judgement due to their eating disorder diagnosis. The participants also felt invisible due to having an eating disorder. They felt alone for having an eating disorder as if they were the only male with it.

 

It’s a shame that there are male sufferers who have had a similar experience to me. Because of this, some men won’t seek help precisely because they believe that people see eating disorder conditions as being female-only conditions (Medical News Today). If other men are having experiences like mine or like the participants from Robinson, Mountford, and Sperlinger‘s (2012) study, it’s no wonder they feel that way and why so many don’t reach out for support.

 

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My Eating Disorder Story

 

I’ve had issues with eating since childhood, starting out with me being a picky eater, which would result in me skipping eating if there wasn’t food I liked. One example of this was a school ski trip where I lost a stone in a week because I couldn’t find food I liked in the first week there on the trip. This picky eating also resulted in me being abused. Numerous times I force feed by adult chaperons and staff at my primary school, I actually hated bacon because of this for so long, and still can’t stand the sight, texture, taste, or smell of baked beans.

 

I then started starving myself in my early twenties even though I wanted to put weight on at the time. This habit of starvation is still with me to this day. For a decade or more, I never ate on a Friday because that was my day to go out, get drunk, and dance the night away. I had a high tolerance for alcohol, even when I don’t drink for months, and I needed to get drunk to overcome my anxiety disorders and control my psychotic episodes. Thus, I avoided eating to make it easier.

 

For most of my 20s, I only ate one piece of southern fried chicken and a small plate of chips each day. In my late 20s to early 30s, I mainly ate the same meal, with the occasional packet of £0.09 noodles to save money for my Friday night out. I was too poor to do both, socialise with people or eat. I could live without food, but I couldn’t live without socialising, it was literally the only way I was able to keep my suicidal ideation in check at the time.

 

I would later go on to start binge eating because I accidentally created this behaviour when I was trying to modify one that caused me to fall into despair when I didn’t go out at the weekend. This was the need to socialise to control my suicidal ideation. In short, I trained myself not to need to go out and get wasted at the weekend to cope with my life, by staying in and eating junk food. This behaviour modification worked in that I stopped needing to go out and getting wasted, thus stopping me from falling into suicidal despair when my friends let me down and I couldn’t go out. However, it left me with a binge eating habit which coupled up with my starvation to form a binge starvation cycle.

 

Recently, I literally told me CBT Therapist in September 2020, who was meant to be helping with my reactive hypoglycaemia, about having an eating disorder, and nothing. My course of CBT sessions was ended in our fourth session when they finally believed me that my reactive hypoglycaemia symptoms had nothing to do with my anxiety. They were ended even though I reported to them that I’d also had a suicidal breakdown the week before.

 

What does a guy need to do to do to be taken seriously if they have an eating disorder? Every health and mental health professional I’ve ever told over the course of 20 years has just ignored it, even though it caused me to develop a permanent health problem that has destroyed my quality of life. No wonder men don’t say anything.

 

Since getting my reactive hypoglycaemia diagnosis, I’ve tried going Keto to manage it, which started off successful but because impossible for me to maintain. It’s clear to me that I won’t be able to successfully maintain a new eating lifestyle without tackling my long convoluted issues with eating: my eating disorder. Thus, I decided to try again and get support, first reaching out to Beat. When I talked to Beat and documented my experience of using their web chat service, it was suggested that I may have bulimia.

 

Since talking to Beat and talking to my partner, I looked up what eating disorder services were available around me, finding a service that I then contacted. They informed me that I couldn’t self-refer, so I emailed my former CBT therapist and laid out my case for being referred to the eating disorders service, including a CC to the PALS team. The PALS team are the first port of call for a complaint about an NHS Trust, so I tagged them in to make sure they didn’t brush me off. As a result of this, I’m now getting a referral to the eating disorders service. It took twenty years, but I guess it’s better late than never.

 

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Possible Triggers For Eating An Disorder In Men

 

Eating disorders cover a whole host of issues, from Orthorexia which is linked to clean eating and dieting, to compulsive eating, Anorexia, and Bulimia. The following are some of the possible triggers for eating disorders in men: 

 

  • Being bullied or criticised for being overweight. This rings true for me, I was bullied for my appearance, of being black in a white space.
  • Comments from sports coaches.
  • Being in a sport that requires extreme weight control, such as having to meet a weight class in boxing.
  • Illness.
  • A breakdown of a relationship.
  • Not coping with stress and other pressures.
  • Changing career.
  • Problems at work.

 

The picture is split in two with the top image being of white man's muscular torso who's also holding two tubs of healthy food and the bottom image being of a white man's feet on a weighing scale. The two images are separated by the article title - Why Is There A Disparity In Male Eating Disorder Care?

 

Some Of The Big Problems For Male’s With Eating Disorders

 

Being skinny isn’t the only criteria

Simply put, if you’re a sufferer who doesn’t look emaciated, then you can’t have an eating disorder, you can’t be sick. This certainly seemed to be the case for me. I have a large ribcage that just makes me look naturally bigger than most. I’m also black, so I have some junk in my truck which further adds to the visual image of me not having an eating disorder.

 

However, the fact is most people with an eating disorder aren’t underweight (National Eating Disorders Association – NEDA), and that seems especially true for males. The reality is you can’t tell who has an eating disorder just by looking at them. This is something society needs to learn, but also health professionals as well.

 

The view that if you’re not skinny then you can’t have an eating disorder, is outdated, which might be why no one ever cared when I tried to get help for mine. Most my life I’ve been underweight for my height, but my weight always reminded stable. That is until the symptoms for my reactive hypoglycaemia started and I started putting on weight.

 

One of the subtle differences between male and female sufferers of eating disorders is that males are more likely to be focused on building and highlighting muscle than weight loss (NEDA). Thus, using skinniness as a criterion to judge if males are suffering from an eating disorder can be harmful.

 

Only daughters

Parents don’t need to worry about eating disorders if they have sons, due to the societies view on it being a “girl thing.” Wrong. As I said, yes females are more likely to suffer from an eating disorder, but that doesn’t mean male sufferers aren’t also an important concern.

 

Eating disorders can affect anyone, regardless of their gender or sex (NEDA). However, because too many health professionals and society as a whole haven’t got this memo yet, males with eating disorders tend to have more severe and entrenched conditions. I can certainly testify to that from my personal experience of 20 years of not getting support.

 

In fact, there’s also the myth that only white suburban girls get eating disorders. Not only do eating disorders not care about your age or gender identity, but they also don’t care about your ethnic group, culture, geographic location, socioeconomic group, etc. no ones immune to developing an eating disorder (University of Rochester Medical Center Rochester). In the same way that no one is immune to developing a mental health issue. It’s this misconception that leads to the underdiagnosis of men and people from minority groups. This revelation got me thinking, did they ignore me because I’m male, because I’m black, or because I’m a black male?

 

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Consequences

 

A quick question for you, what do you think the societal impact is of not addressing men’s mental health and making them feel like they shouldn’t seek help for an eating disorder?

 

Well, the continuation of the gross disparity is suicide, for one. The male suicide rate in the UK is 17.2 deaths per 100,000, whereas, for females, the rate is 5.4 deaths per 100,000 (Office for National Statistics) in 2018. Leaving men and boys to suffer in silence with their eating disorder and other mental health and health problems also affect the communities and families they’re from. Without support, suicide is one method men unduly pick, but so is substance abuse. There’s also the risk that they’ll take their frustrations out on their loved ones through domestic abuse. Furthermore, the University of Connecticut also suggested that there’s an economic burden of leaving men to suffer in silence and we all lose if we don’t tackle this issue.

 

As a side note, no matter the reason for domestic abuse, it’s no excuse to engage with it. Abuse is always a choice.

 

As always, leave your feedback in the comments section below. Also, feel free to share your experiences eating disorders and seeking support for your mental health as a male in the comments section below as well. If you want to stay up-to-date with my blog, then sign up for my newsletter below. Alternatively, get push notifications of new articles by clicking the red bell icon in the bottom left corner.

 

Lastly, if you’d like to support my blog, then you can make a donation of any size below as well. Until next time, Unwanted Life readers.

 

 

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References

 

Robinson, K., Mountford, V.A., & Sperlinger, D. (2012). Being Men with Eating Disorders: Perspectives of Male Eating Disorder Service-Users. Journal of Health Psychology, 18(2) 176–186. Retrieved from DOI: 10.1177/1359105312440298.

 

Support

 

Beat Eating Disorders

National Eating Disorders Association

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64 thoughts on “Why Is There A Disparity In Male Eating Disorder Care?

    • This is a subject, which surprisingly, being a person that has suffered with depression and anxiety for most of her adult life, knows virtually nothing about. Which I’m sad to confess. It presents itself in so many ways. It’s so trué that when à person thinks of eating disorders, a girl or woman comes straight to mind, which is so wrong. It’s so bad that you didn’t get any support for such a long time and it’s still a struggle. It really does, make me wonder why? Don’t they cover these subjects in medical school! Thank you for such an enlightening piece of writing.

  1. Thank you for sharing your story. How frustrating that must be to not be taken seriously! This past week’s episode of This American Life podcast was titled, “Secrets” and one of the segments dealt with eating disorder. One of the interviewees mentioned that it wasn’t something they feel comfortable sharing about, even to their closest friends and family, and in many ways our culture is more sympathetic to drug and alcohol addictions or whatnot. I thought that was interesting. Anyways, I wish you the best in your recovery.

    • I can certainly see why some people might find it difficult to talk to others about, it hasn’t been one of the areas of my mental health I’ve talked about with the people I know. Ive been a lot more open with my BPD and anxiety disorders than I have been about my eating disorder

  2. Thank you for sharing your experience and for speaking up about male disorders. I think males, as you said, are told from society to be strong and never show their problems, so loads of people will either keep them secret and suffer alone or act like they don’t exist. We should all be more open and supportive and not shame others. i am afraid that even my sister had a similar experience with her GP where she’s has not been believed for the last 7 years that she has asthma since she was a kid here in the UK. I am sure this post will help a lot of people to be more open about it!

    • Even though I know I have an eating disorder I still don’t see my starvation cycles as a problem, just my unhealthy junk food habit and binge eating. Eating disorders are so complex that you can acknowledge you have one while still denying it’s a problem

  3. It really does surprise me how many people forget that it’s always men that supper with eating disorders. I am glad you shared your story.

  4. Thank you for sharing your own experience with eating disorders and for shedding light on the fact that boys and men can and do suffer from body image and eating disorders too.

  5. Thank you for your thorough research that refutes common misconceptions regarding eating disorders. I also appreciate that you shared your personal experiences. It takes so much bravery to express your truth. I agree that there is a serious lack of care for and awareness of men’s eating disorders. Outdated, toxic gender stereotypes play a role in this. As you intelligently pointed out, society perpetuates this idea that only women suffer from eating disorders and poor body image. Men are also often told to bottle up their emotions, which is why men’s mental health advocacy is so important. I’m glad you received a referral to an eating disorder service, and I hope you receive the care you need and deserve.

    • Outdated gender roles and gender stereotypes are to blame for a lot of mental health and other issues, I can’t wait to those concepts are put in the trash bin of history

      Do you have a blog of your own?

      • This is Spring from My Shell again. Sorry for any confusion. I’m still trying to fix how my comments appear on other WordPress sites.

  6. The Freddy Flintoff documentary was so powerful and so important for raising awareness of male eating disorders. There is such a perception that EDs are just for teenage girls and that is so harmful. So well done for writing this post.

  7. Thank you, again, for sharing your own experiences and being so open about it all. I really admire you. I definitely think the stigma for ED to only ht young, teenage girls is a really dangerous. My young nephews do not suffer but they are aware of friends who go through things like this. And, they don’t reallt know where to turn!

    Scary!

    Rosie

  8. Interesting post! This is the first time I heard that men also have eating disorders. Before this I thought only us women have eating disorders. Thank you for sharing this information with me.

  9. Thank you for sharing this- and also for showing the places people can find the support they need. I think this is an important topic that doesn’t receive enough discussion and I’m glad you’ve drawn attention to it.

  10. One of my favorite posts from you so far without doubt! Love the way this embraces the societal pressures and thinking that does not only affect women. Nothing only ever includes one type of person or one gender. Things like eating disorders come about for many reasons and can manifest in anyone.
    Here is to the men reading this. Asking for help is another kind of strength. 🙂

  11. This post is everything for me! I always love the topics you write about. Thought provoking but so needed! It’s really sad to see the huge gap between the support men get from society and those around them when it comes to mental health issues. Men suffer and have distortions about how they look just as women. They experience the same emotional pain as women about how they feel their body should look based on life experiences they encounter. It’s really sad to see the lack of support there is for our men. Thanks for sharing you story.

  12. Well done on sharing your story and bringing this issue to light! Hopefully the more people that do this, the more others will realise this is a problem and men need help to! As a mother of a son and a daughter I worry about them both equally with how eating disorders could affect them as they get older, unfortunately it could be a problem for either of them!

  13. This is a post that definitely needed to be written. I have to say that since you shared this, I realize how I had never considered much about males having eating disorders. Which goes to show how we are all subject to things that may be considered “social norms” or even conditioned to ignore certain subjects. Thank you for shedding light on an important thing and now that you have enlightened me I will always be more aware of this as an issue. I hope that this post helps many and that the healthcare system can start taking this more seriously. Keep doing what you do!

  14. So glad to hear you’ve finally gotten the referral you need! Here is to follow-through and continued progress (on their part)! What you have been through sounds terribly difficult, but you are paving the way for young men following in your footsteps. So they don’t have to go through what you went through when they need help. Thank you for sharing and for continuing to be a positive impact for others. Be well.

    • Although the referral was made, there’s been no acknowledgement of them getting the referral or sorting of the initial assessment. I hope this doesn’t become something I have to chase up. I’m getting sick of having to always chase things up

  15. Well done for being so open and sharing your own experiences. Sadly there are a lot of preconceptions within health care around what certain groups of people can or cannot have. It must be difficult to question as well if you’re care is different because of your race. It’s sad that this stereotype of men not needing help exists, everyone needs help at some point in life and it shouldn’t be treated as a weakness. I also agree that they need to change how they view eating disorders from just being “skinny” because eating disorders can manifest in so many different ways! Really informative and personal post!

    • I actually saw on a programme the other day how there were still US medical doctors who thought black people don’t experience pain, how does anyone even have such ridiculous ideas? How do such nonsense ideas remain

  16. This is such an insightful article! You’ve provided some great information and I must say it’s too bad that society stereotypes health conditions into predominately male or female issues. Thanks for sharing your experience and good luck on your journey to wellness.

  17. Thank you for sharing your experiences in such a detailed article. I coordinate PSHE in a secondary school and find it so difficult to find good examples of men who have overcome eating disorders, but there are 100s of female examples. I totally agree that it’s an assumption that only women go through it and we need more men to speak out too.

  18. i commend you for being so honest and vulnerable in sharing your own story. i find it astonishing that it’s 2021 and society still attributes eating disorders to mostly females. your story as well as these other documentaries are shedding light more. thanks for sharing this, i’m sure this will resonate with many people.

  19. It’s so refreshing to see a blog post focussing on male eating disorders and their lack of proper care. Society sees ED’s as a female issue but they really aren’t – males can also develop them. Super interesting post and so important to raise awareness of.

  20. The failure to recognize male eating disorders is another example of the sexism in medical research. For example, the studies done on cardiovascular health and heart attacks only included male test subjects. For too long, women were not taken seriously when they presented with the signs and symptoms of a heart attack. For women, that meant many heart attacks were missed. It also meant women were denied recommended therapies, interventions and rehab opportunities.
    Good point about previous editions of the DSM, which listed amenorrhea (abnormal absence of menstruation) as one of the diagnostic criteria for an eating disorder. Another example of implicit bias in the medical field, which hopefully is behind us. If a medical professional harbors unrecognized implicit bias that men cannot have eating disorders, it’s time to find another health provider. I’m so glad you were able to do that!

    • Almost all medical research was done on white men, so not only is there a gender bias in treatment as a result, but there’s an ethnic one as well. Doctors are trained to look for signs like turning blue or yellow, which just can’t be seen in people with black and brown skin. Then there’s the myths around both women and ethnic groups in medicine that somehow still exist

  21. Thank you for sharing your story and highlighting the reality of men who suffer from eating disorders. We are not educated enough about it and this piece raises awareness on this problem. What surprises me the most is that health care professionals are not really aware of this problem in men and underestimate it. I am sure that your experience will help many people directly or indirectly. I wish you a lot of courage and perseverance in your journey to get better and improve your quality of life.

    Corinne

  22. I love how you shared your personal story. I personally don’t have any challenges regarding eating disorders and I don’t have male friends who do, but putting yourself out there has the power to inspire and help people who are going through the same thing. Very well done!

  23. You always bring out topics people rarely talk about and share your Opinion as well as Research Study. After reading your article I realised so many people in my family and friends suffer this disorder. Thanks for sharing an informative Post.

  24. Thanks for opening my eyes! I truly never thought of eating disorders and how it affects males. I suppose I am guilty too. Like I say you have opened my eyes.
    I found your post so interesting. Learning about all the ways that your outlook has been affected makes me think of all the people we might be overlooking.
    I trust that things go well for you. All the very best.

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