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 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 notes 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.
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.
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 didn’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.
Possible Triggers For An Eating 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.
- A breakdown of a relationship.
- Not coping with stress and other pressures.
- Changing career.
- Problems at work.
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. For most of my life, I’ve been underweight for my height, but my weight always reminded stable. That is until the symptoms of 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.
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?
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 in 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 always, leave your feedback in the comments section below. Also, feel free to share your experiences with 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 for new articles by clicking the red bell icon in the bottom right corner.
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Unwanted Life readers.
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 https://doi.org/10.1177/1359105312440298.