We tend to have a very narrow view of what eating disorders look like, and who they affect. That is, the assumption is that eating disorders only affect women. But this couldn’t be further from the truth.
According to one national survey, about 10 million men in the U.S. will have an eating disorder in their lifetime. Researchers of this 2015 review published in the Journal of Eating Disorders, concluded that “the prevalence of extreme weight control behaviors, such as extreme dietary restriction and purging, may be increasing more rapidly in males than females.”
Yet because of cultural perceptions, men are less likely to seek treatment. Which is terrible because eating disorders create a host of health consequences and are potentially life threatening. Anorexia, for instance, has the highest mortality rate of any psychiatric disorder. To shed light on eating disorders in men, I spoke with Tyler Wooten, M.D., the medical director at Eating Recovery Center.
If you’re struggling with an eating disorder, please seek help. And if you know someone who’s struggling, please share your concerns with them, and help them find a clinician or treatment center that specializes in eating disorders. Eating disorders are serious, stubborn illnesses. However, they’re also highly treatable, and you can completely recover.
Q: What are the biggest myths about eating disorders in men?
A: One of the biggest myths is that anorexia nervosa is a female disorder but it’s clearly not – it affects men all the time. Also, men are typically not looking to be thin in the same way girls are.
Q: How do eating disorders manifest in men? How are they different and similar to how they manifest in women?
A: In the straight male population, it is rare for them to want to be thin and skinny. Part of what goes into that is that girls with eating disorders feel overweight, but they have never actually been overweight, which leads them to the path of restricting. For men, more often than not, they have been overweight/chubby at some point – but not necessarily driven by a desire to be thin. Rather they want to be cut, thin, and strong.
The problem is that when they start to restrict, as that process gets going, they start to lose control and they don’t see they’re getting skinny, but rather see it as more and more muscle definition.
For the LGBTQ population, there was a study done that looked at the differences between the LGBTQ and straight population. Between the two there is a higher rate of eating disorders within the LGBTQ population, but lower in the straight male population. However, when you look at total numbers there are more straight men with eating disorders than there are in the LGBTQ community. For commonalities – one is typically temperament. Boys are genetically predisposed the same ways girls are. Also, binge eating disorder tends to be the same for men and women, as people are trying to feed a hunger that is really an emotionally-based hunger.
Q: What are the early warning signs of EDs in men to watch out for?
A: One of the hallmark things to look out for in men – or in women – is if someone distances themselves and starts disappearing even before they start disappearing physically. The important thing to note is, does your loved one seem to be vanishing/disappearing from your life?
Any kind of talk around dieting should also be a red flag. For example, when someone is hyper-focused, can’t eat right now, already eaten, cutting out certain food groups.
Q: Is treatment different in men?
A: Treatment can be a bit different in men, though the commonality is that if someone is underweight they need to restore their weight, and if they’re making poor food/nutrition choices they need to fix that.
The main difference is in the clinical approach, but this is often hard to narrow down. For a lot of males – especially straight men – it hits them that they’re too thin and they want to gain the weight back. Losing the weight was never their original, intended plan, so talking about weight gain tends to be easier than with women. Boys and young men tend to be motivated to gain the weight back, but a commonality between both males and females is that they don’t know what is “normal” for their weight. They just know that they’re feeling different.
Another thing that’s hard and different from women, is that it’s actually harder for males to gain the weight back as they’re often taller, so it complicates their refeeding and weight restoration process. It is rare for a girl to be 6’2”, but not for a guy, who then needs to gain 50 or 60lbs. Men can lose weight easier, but it’s harder for them to gain weight, and they often actually need a refeeding tube to be successful and take in the amount of calories they need.
Q: What do we know today about eating disorders in men that we didn’t know a decade or even a few years ago?
A: The most important thing to know is that men are catching up in the number of eating disorders in the general population as compared to girls. Over 20 years ago, for every 10 girls there was 1 guy, but now it’s 1 in 3. It’s a huge jump but what isn’t clear is, was this an error in reporting or are more men actually developing eating disorders? Today, however, it seems unanimous among dietitians and therapists that there are more males now with eating disorders.
Q: What would you like male readers who are struggling with disordered eating or eating disorders to know?
A: I would encourage people to break off their own gender biases and prejudices about their eating disorder. The longer someone has an eating disorder, the longer it will take to get over it.
Overall, eating disorders are not a female disorder – they are a human disorder. It is definitely something on the rise and exploding in the western population, and the longer people wait to get help, the worse it will get.
Q: Anything else you’d like readers to know about eating disorders in men?
A: Many of the treatment facilities that treat eating disorders are behind the time in terms of treating men, as a huge chunk of these facilities still only treat women. This is problematic for men as it narrows their ability to get help. And help and treatment are what’s needed for recovery. As we find at Eating Recovery Center, women and men being in treatment together actually mix and mingle well, and since it’s a psychological/mental illness, men being with women is generally not an issue with going through treatment.
For additional information about Eating Recovery Center, call 877-789-5758, email [email protected], or visit eatingrecoverycenter.com to speak with a Masters-level clinician. Stay tuned tomorrow for an interview with a male alum who talks about recovering from his eating disorder.