Eating Disorders in Men
Despite the existing stereotype that eating disorders are predominantly female, the National Eating Disorders Association (NEDA) suggests that approximately one in three people experiencing an eating disorder is male. Furthermore, it is thought that certain eating disordered behaviours, such as binge eating, are nearly as common among men as they are among women today. However, eating disorders in men have historically been underdiagnosed and unfortunately undertreated.
What might drive eating disorders in men?
Whilst eating disorders and their triggers can vary greatly from one individual to the next, it is thought that eating disorders in men are often underpinned by a drive for muscularity or by a depiction of “the muscular ideal”. This male body type ideal is somewhat praised today within the media. For instance, images of muscular men have grown ubiquitous on apps like TikTok and Instagram. This can place unrealistic expectations on those who identify as male to look a certain way, which can also increase body dissatisfaction – a major risk factor for developing an ED. This drive for muscularity can lead men to over-exercise due to the desire to “bulk up” or gain more muscle and lose fat. It can also lead to other rigid and problematic behaviours, such as restrictive dieting, in another attempt to control weight and bodily shape.
What might stop men from seeking help?
Whilst reaching out for help can understandably feel difficult across the sexes, the common misconception that eating disorders are primarily female might mean that help-seeking is even more difficult amongst men. Some men might feel ashamed to acknowledge that they are suffering from an eating disorder, and therefore keep it a secret, whilst others might lack the insight to even realise that they are. A reluctance to seek help might also be exacerbated by broader cultural conceptions of how men should relate to mental health struggles. For example, boys and men are generally taught by our current society that sharing emotions and/or vulnerability is uncharacteristic or even unsafe. It is, therefore, perhaps unsurprising that specialist eating disorder services are seeing and treating far fewer men than we know are likely to actually have an eating disorder diagnosis.
Why should we encourage men to seek help?
Sadly, eating disorders can have serious consequences, such as an increased risk of comorbid mental health difficulties, and they tragically have one of the highest mortality rates out of any mental health condition. Importantly, however, eating disorder treatment, such as CBT-E, has been shown to be successful in men. In addition, early intervention is an important driving factor for treatment success, stressing the importance for men to reach out as soon as they feel able to ask for the right support.
What can we do to help eating disorders in men?
Unfortunately, male experiences of eating disorders have historically been largely ignored in diagnosis and widely used screening tools. This has meant that men have been less likely to be diagnosed with an eating disorder as and when they have reached out for help. For example, as diagnostically defined in 1952, Anorexia Nervosa (AN) is characterised by a focus on thinness, an extreme fear of weight gain and being significantly underweight. Criteria for diagnosis also previously included the loss of one’s period – amenorrhea – something that cannot happen to most men.
Thankfully, in 2013, the DMS-V made some changes in order to address these issues. For instance, amenorrhea has been taken out of the DSM essential criteria for diagnosis of AN. On top of this, new diagnoses have been included in order to incorporate more male experiences. For example, Binge Eating Disorder was included as an individual condition, as this seemed to better capture some males’ experiences, in comparison to bulimia nervosa or AN.
Given these historic issues surrounding diagnosis, and the developments outlined above, it seems of utmost importance that specialist eating disorder practitioners and services educate themselves and those around them on the potentially differing experiences of eating disorders within men. By doing this, one hopes that men do not go underdiagnosed, and instead receive the recognition and treatment that they need and, unquestionably, deserve.
Here at The London Centre we encourage and welcome men into our clinic. If you are worried about yourself or someone else, here are a couple of pointers to help you take the first steps towards getting the help you need:
Consider talking to your closest friends or family members, or those that you can trust. Building up a support network will be invaluable whether or not you also ask for more specialist eating disorder support.
Visit online eating disorder support services, such as Beat https://www.beateatingdisorders.org.uk/, where you can find information and confidential and inclusive support forums for eating disorders in men.
Reach out to a specialist eating disorder service for a consultation or assessment that will explore what treatment might be best suited to your needs.
For more information or to book an appointment please contact us on info@thelondoncentre.co.uk or click here.