November is Men’s Health Awareness Month, and whilst it shouldn’t be relegated to a single month of the year, many take the opportunity to look at the male experience of mental health.
There are many reasons why mental health is an important topic when we look at the male experience. Notably, there is considerable evidence which tells us that boys are less likely to seek help for their mental health than teenage girls. Boys are more likely to feel a deep sense of shame (a powerful, ‘master’ emotion) for struggling or appearing ‘weak’ to their peers, and this shame prevents them from putting their hand up and admitting their difficulty.
Today we’re homing in on mental health and looking specifically at the male experience of eating disorders; the myths and misconceptions that create barriers to support, as well as the symptoms to look out for. If this is something you may be struggling with, we advise that you go gently and consider reaching out for support as soon as possible.
Men get eating disorders too
Over the last six years, hospitals have seen a 128% rise in the number of boys and young men being admitted for eating disorders. Studies suggest that 25% of people with eating disorders are male, however, it’s very hard to accurately assess diagnosis rates as they can be very isolating illnesses with a lot of shame and secrecy, meaning that many people suffer in silence.
Some studies from North America suggest that men are more likely to experience a Bulimia diagnosis, and other UK studies tell us that prior to puberty, the balance it more equal when it comes to boys and girls who are suffering from Anorexia.
The myths that persist
These statistics may surprise you – and if so, that’s understandable. There are many myths and misconceptions about eating disorders that create difficult barriers for men to overcome. Let’s explore a couple:
Myth 1: Eating disorders are female illnesses
Fact: Anyone, of any gender, sexuality, age or cultural background can suffer from eating disorders. Simply put, they do not discriminate.
Myth 2: There’s ‘one way’ to have an eating disorder, and often it means that you’re very underweight
Fact: There is no ‘one way’ to have a problem like an eating disorder. Every person’s experience will be unique to them – it will ‘look’ different and perhaps evolve over time.
The problem with myths such as these is that they can make diagnosis very challenging.
If we only understand women to struggle with eating disorders, we may overlook the symptoms in men. This is compounded if we only recognise Anorexia (or a restrictive illness) as an eating disorder – there are in fact many different diagnoses but even still, how they ‘show up’ will look different to each person.
The typical approach to diagnosing an eating disorder is to look at the Body Mass Index (BMI). If someone’s BMI is too low, they may ‘tick the box’ of an eating disorder diagnosis at their GP. However, when it comes to men this can be more complicated, as men’s BMIs tend to be higher than women’s, so an eating disorder diagnosis may be overlooked for something else.
In summary, if we don’t have a good understanding of men and eating disorders, we may not recognise the problem in ourselves or in others. Unfortunately, some people have even found that medical professionals have a very outdated understanding of eating disorders, which can complicate or delay a referral to specialist services. The most important thing is to educate yourself so you can spot the signs and support yourself or your friends.
What to look out for in men
So, if eating disorders are different for each person, does that mean it’s impossible to spot the signs? No. Despite the individuality of eating disorders, there are some similarities that can help us with diagnosing.
Much of the reason why so many men with eating disorders go unrecognised and undiagnosed is because the way the illness can manifest can look very different to the typical experience. Many of the subtle symptoms may go overlooked, especially if they reflect characteristics of modern life that are in fact celebrated.
For instance, over-exercising at the gym or eating ‘clean’ may on the outside look like a healthy lifestyle, when in fact someone is pushing themselves to the extreme to the compromise of other areas of their life, such as relationships, work or their own self-care. A regimented lifestyle may look like admirable ‘discipline’ to others, when in fact the individual is bound by routine and ritual in an unhealthy and damaging way.
The Diagnostic and Statistical Manual (DSM-5), used in the US for diagnosing mental health conditions, has coined the term “Bigorexia” as a body dysmorphic disorder that “triggers a preoccupation with the idea that your body is too small or not muscular enough”. According to Healthline, the symptoms for Bigorexia are:
- Spending hours at the gym, pushing your body beyond limits
- Continuously following diets that will aid cutting weight or building muscle
- Suffering from severely negative body image and this defining your sense of self-worth
If you spot these symptoms in yourself, it’s vitally important to seek support to understand your emotional experience and the implications this could be having on your overall physical and mental health.
What to look out for in general
In case the above list didn’t correspond to your experience, here is a recap of the more ‘general’ signs and symptoms to look out for:
Preoccupation with food
You may be extremely concerned about the caloric or nutritional content of food. You might be planning food ahead of time, calculating calories or macronutrients in a very controlled way.
It might feel harder and harder to be around people, especially for social meals and celebrations. You might find that you want to keep people at arm’s length, especially those that have shown concern for you. You might be spending much more time alone in your bedroom and communicating less with your loved ones.
Anxiety at mealtimes
You might be finding mealtimes extremely anxiety provoking, especially shared meals with family or friends. You may be finding it hard to eat, particularly in front of people and when the meal has been prepared and cooked by someone else.
Preoccupation with body image
You may have developed a very negative body image. Perhaps you take photographs or “progress” pictures, or constantly check yourself in the mirror. There might be certain parts of your body that you’re preoccupied (or obsessed) with.
Desire for – or pursuit of – a different body shape or size
Perhaps you weigh yourself on a regular basis and the number on the scale determines what your day is going to be like. You may compensate for any food eaten, engaging in vigorous exercise or other “purging” activities.
Self-critical, low self-esteem
You might be incredibly self-critical, seeing yourself through a lens of worthlessness. You might find it hard to value yourself in relationships and perhaps see yourself as lesser than others. This perspective may be dictating how you live your life, attend school and make important choices about your future.
Associated mental health problems, such as anxiety or depression
As we’ve said before, eating disorders are not about food, often there are much more complex, underlying emotional causes underneath that are prompting someone to look outside of themselves as a means of coping. These may include anxiety, depression, OCD or personality disorders.
It’s understood that eating disorders last a third longer in men because of the lack of early intervention, so it’s vitally important to seek support and communicate your concerns with a healthcare professional.
There is hope
It’s important to remember that recovery from an eating disorder is absolutely possible – no matter your age, gender or cultural background.
For many people, it can feel like life becomes incredibly narrow and lonely whilst living with an eating disorder, and this can compound the beliefs that keep us trapped in the cycle of the illness. But you are not alone, and there are people who want to help and support you.
Many male celebrities are slowly coming out and sharing their experience of an eating disorder or disordered eating. For instance, Elton John has spoken of the power of sharing your experience with others and feeling a sense of camaraderie in the struggle. Zayn Malik has shared his experience of Anorexia and the difficulty in recognising the symptoms in himself. Ed Sheeran, Christopher Eccleston and Eminem are among others who have struggled with a preoccupation and compulsion in their relationship to food or their bodies.
The more that men speak out about their struggle, the more we can understand their experience of the illness and ensure improved support, intervention and awareness.
To conclude, you are not alone and there is strength in recognising your struggle. A quote to ponder:
“Courage is not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear.”