MEN & EATING DISORDERS

MARY ANNE COHEN

DAVID CALLED FOR HELP IN SOME DISTRESS, “I THINK I HAVE AN EATING DISORDER AND WOULD LIKE TO MAKE AN APPOINTMENT. I BET I’M THE FIRST MAN WHO’S EVER CALLED FOR AN EATING PROBLEM. “ACTUALLY,” I RESPONDED, “MANY MEN HAVE EATING PROBLEMS. THEY’RE JUST NOT AS BRAVE AS YOU TO PICK UP THE PHONE AND GET SOME HELP!”

David is expressing a common misconception—that eating disorders are problems of girls and women, not boys and men. In truth, more women than men do have anorexia, bulimia, and binge eating disorders, but men are not exempt from these struggles. Between 10% and 15% of people with eating disorders are estimated to be men, but this figure may be low since many men often suffer in silence and feel too ashamed to come for help. Men may also be under-represented in the statistics of eating disorders because they can hide their eating problems better than women. Our society is more tolerant and forgiving of extra pounds on men, while women are held to a stricter standard. Also, men who are obsessed with working out and building muscle may be admired as strong, masculine guys, and this may camouflage that they are suffering anxiety about their body image.

During his therapy consultation, David, a 21 year old man, spoke of his girlfriend who had recently left him for another guy. He was depressed, felt quite rejected, and decided that if he were thinner and more handsome, she would have stayed with him. David embarked on a strict dieting regime to make himself feel more attractive. But his undereating backfired, and he found himself bingeing and then making himself throw up. David revealed that he had always felt clumsy as a boy, was the last to be picked for team sports, and felt inadequate compared to his older brother whom he considered more masculine than himself. David’s story highlights some particular dynamics of male eating disorders: low self-esteem and worries about one’s masculinity, unfavorably comparing oneself to other men, and feeling inadequate in traditional male pursuits, such as sports.

Our media is replete with images depicting what a real man should look like. Where advertising once exclusively focused on skinny female models, now “buff” male models with “buns of steel” and “six-pack abs” are featured on billboards and magazines everywhere. Sports figures and handsome actors dominate the male imagination. Now, men compare themselves with the muscular often steroid-enhanced bodies of unattainably perfect male bodies and athletes and struggle with similar insecurities as women.

Men are so driven to look muscular with bulging chests and slender waists that liposuction to remove “love handles” is popular. Some men even seek saline implants to enhance their chests’ pectoral muscles and also have six saline packets surgically inserted to define the “six-pack” ripped abdomen muscles. Herb supplements to help men get “cut” and steroid drug use is more frequent to “bulk up.” In other words, male body image dissatisfaction has become rampant.

A new diagnostic category exists called “male body dysmorphia.” It means that even a man who is well built may suffer from feelings of being puny and too small. No matter how much he works out, his feelings of body inadequacy still persist. This psychological distortion is the opposite of anorexia, in which the girl feels too fat despite being quite thin. The male with body dysmorphia views himself as inferior despite being muscular while the anorexic girl feels too large despite being emaciated.

A new diagnostic category exists called “male body dysmorphia.” It means that even a man who is well built may suffer from feelings of being puny and too small. No matter how much he works out, his feelings of body inadequacy still persist. This psychological distortion is the opposite of anorexia, in which the girl feels too fat despite being quite thin. The male with body dysmorphia views himself as inferior despite being muscular while the anorexic girl feels too large despite being emaciated.

RISK FACTORS FOR MALES DEVELOPING EATING DISORDERS INCLUDE:
• They were fat or overweight as children.
• They participate in a sport that requires them to be thin, for example runners, jockeys, body builders.
• They have a job or profession that requires thinness , for example athletes, male models, actors.
• Some men with eating disorders have a history of physical or sexual abuse.

Matt was a successful business man with a family of five young children. Although he had been athletic as a younger man, the demands of his business, traveling for work, and supporting his family eroded his opportunity to exercise. Matt described coming home from work and raiding the refrigerator before and after dinner. No matter how much food his wife, Dina, prepared, it was not enough. Matt wasn’t content unless he was stuffing himself throughout the evening. He was gaining weight, and his wife urged him to get help because of her anxiety about his health.

In his therapy, Matt identified that overeating was his way to destress, to shift gears after an intense work day. Overeating was his way to reward himself for his grueling schedule, but it was beginning to take its toll on his appearance and health. Matt initially felt selfish for admitting he needed some private time for himself, given that Dina took care of the house and children all day. But, much to his surprise, Dina supported his efforts to break the binge cycle, encouraging him to join a gym and work out with a trainer. We also explored why Matt always put himself at the bottom of the list of people to be taken care of. We discovered this was related to Matt’s having to support his family of origin from an early age because of his father’s ill health. Ignoring his own needs had become automatic for him. Recognizing this pattern was illuminating in helping Matt change this behavior with his present day family.

Eating disorder therapy for men, as well as for women, involves creating a comprehensive treatment plan based on the unique needs of each person. This includes a blend of psychotherapy for resolving emotional stress plus behavioral strategies to change unwanted eating patterns. Men with eating problems can be helped; sometimes it takes a little extra courage to reach out for that help.

THE MINDFUL EATING PROJECT CAN HELP YOU GET THE CONTROL OF YOUR EATING BACK INSIDE YOURSELF
We will work with you to:
• Custom tailor an individual approach for your unique needs.
• Help you get the control of your eating back inside yourself.
• Develop and maintain healthy eating patterns.
• Regain body confidence.
Unlock what may be keeping you stuck in your eating problems.

Schedule an initial assessment with The Mindful Eating Project, and we’ll help you determine if you can benefit from treatment. To start a conversation about your eating, please contact us. Your contact is absolutely confidential.

Please feel free to call (718) 336-MEND.
The Mindful Eating Project is a division of The Safe Foundation.

Mary Anne Cohen, LCSW, BCD has been Director of The New York Center for Eating Disorders since 1982. She is also author of French Toast for Breakfast: Declaring Peace with Emotional Eating and Lasagna for Lunch: Declaring Peace with Emotional Eating. Mary Anne has hosted her own radio show on eating disorders, appears frequently on national television, and is the professional book reviewer for EDReferral.com, the largest international resource for eating disorders.