Eating disorders, such as compulsive overeating, binge eating, anorexia, bulimia, obesity, orthorexia & failed dieting affect people in every walk of life. There are millions of men and women suffering from chaotic eating disorders, perhaps harbouring persistent weight problems and obsessed with food and weight who need help to beat their symptoms.
Dieting, fasting, purging, laxative abuse, slimming pills and compulsive exercise cannot succeed because the underlying problems need to be treated first.
A good relationship with food and a healthy weight are central to your physical and emotional well-being. We can help sufferers and their carers.
It is very hard to know how many men suffer from an eating disorder at any one time. It is also hard to know what proportion of new cases is male. There are many reasons for this. Perhaps we are more sensitive to low weight in women. Women are more likely and from an early age to compare themselves to other women and confess their anxiety about weight and shape. Women talk about food and dieting and are more likely to overtly seek weight loss through dieting, while many men with eating problems hide their difficulties with excessive exercise, or going to the gym. Men are more likely to avoid seeking help, in case they are stigmatised as gay.
Anorexia nervosa 19 per 100,000
Bulimia nervosa 29 per 100,000
Binge eating disorder (full criteria) 2%
1 male incidence 1 new case /100k pa
1 male incidence 2 new cases
Gender distribution unknown but believed to be as high as 50%
Of note, studies of anorexia and bulimia indicate that in North America there are probably more males with bulimia than females with anorexia.
Males may account for approx 1-5% of patients with anorexia nervosa although prior to puberty the risk increases, and approx 50% of sufferers in children are boys. Males account for 5-10% of patients with Bulimia Nervosa. In actual numbers, bulimia is more common among males than anorexia and will occur in a greater ratio. In actual numbers this means that there are more men with bulimia than there are with anorexia.
Known risk factors for the development of eating disorders in men include dieting, a previous history of obesity, homosexuality and participation in a sport that emphasises thinness. Eating disorders have similar features in males as in females although there are some gender differences in aspects such as age of onset and pre-illness levels of real obesity. Males tend to develop eating disorders later than females with a later age at onset of bulimia, and higher levels of obesity before the illness occurs.
Men do worry about their appearance but:
They favour a fit healthy ideal with a v-shaped back rather than a skinny frame. For men there is a social penalty for being underweight.
They do not want to look slimmer than other males (as women strive to be thinner than other women).
They tend not to view themselves as fat unless they are fatter than most males around them (while women of all weights tend to feel fat as default).
They are concerned with their stomach, hair and genital size (while women are sensitive about their hips and thighs).
When the average male looks in a mirror they largely perceive an image which is fairly accurate in shape and size, while women see an image which is larger than they really are. In one survey of college students, 13% of males perceived themselves to be overweight compared to 11% who were actually overweight. A similar proportion of the females surveyed were actually overweight but 50% perceived themselves to be overweight.
Media images which are iconic for males are strong and muscled, or lean and sporty while for women they are pathologically thin with surgically enhanced breasts.
Men do not aspire to standardisation of sizes like the female “size zero” and are thus less exposed to comparison based on absolutes. Women tend to pick their “ideal shape” as much smaller than they are at any weight. With regard to ideal shape, men in studies reliably select the ideal shape that is bigger (more powerful) than they are.
So it would seem that although males and females share a culture in which there are strong pressures to attain an appearance which is aesthetically pleasurable and appropriate, there are still some differences in gendered receptivity to these pressures. However, males can and do get eating disorders too.
Triggers For Eating Problems In Males
- There are males with Anorexia Nervosa and Orthorexia – which is an addiction to healthy eating. They suffer from Bulimia Nervosa and compulsive overeating too. The presence of an eating disorder in a man can often be traced to a specific trigger:
- Being bullied or criticised for being overweight
- Comments from an athletic coach
- Being in a sport which requires extreme weight control
- Illness and loss at home
- A relationship breakdown
- Not coping with pressures, such as exams
- A career change
- Unbearable pressure at work.
ARE YOU A MALE WITH AN EATING DISORDER?
- Does eating play great significance in your life?
- Is someone else concerned about your weight even though you think you are OK?
- Do you ever make yourself sick to stop yourself from putting on weight?
- Have you lost more than one stone in the last 3 months?
- Do you feel that at times you are not in control of your eating?
- Do you feel unbearably anxious if you don’t exercise?