Anorexia hitting men increasingly hard: One in three cases in new study is male

Merryl Bear, Director of NEDIC, was interviewed for a feature article in the National Post in January and was quoted at length. Read the full article here.

By Sharon Kirkey
National Post, January 21, 2013

Bulimia, anorexia nervosa and other eating disorders, long thought to be serious problems for many women, are showing up among surprisingly large numbers of men, some of whom are starving themselves or exercising obsessively to look like the pictures in men’s magazines.

Yet neither men themselves, nor most doctors, think of males as being at risk for these illnesses, experts say.

poster: Men with eating disordersCommunity-based studies suggest one case in three of anorexia nervosa is a male, said Dr. Blake Woodside, director of the program for eating disorders at Toronto General Hospital. For bulimia, it is about one in four.

The stigma, isolation and confusion around suffering from what has long been perceived as a “girl’s problem” can make men so reluctant to come forward that many arrive in treatment sicker than women. “For men there is still such a stigma attached to the idea of having an eating disorder and reaching out for help,” said Joanna Anderson, clinical director at Sheena’s Place in Toronto. “If you go for treatment and you’re in a group with 10 or 12 women and you’re the only man, it’s very difficult to feel like you’re not different.”

Yet men develop eating disorders for the same reasons women do, doctors say. Most have an underlying genetic vulnerability to the disease that can be triggered by a stressful life event, such as undiagnosed psychiatric conditions, sexual or physical abuse, trouble in school, job loss – “the enormous range of things that make people feel bad,” Woodside said.

For boys, it can start with bullying or teasing, or something as simple as puberty. An eating disorder can become a coping mechanism, a desperate grasp for control at a time when it feels as if their lives are unravelling.

But there can be a strong cultural component as well. Men, like women, are under pressure to conform to the “ideal” body type, and for men, that body tends to be linked to perceptions of success, control and power, said Merryl Bear of the National Eating Disorder Information Centre, which has launched a poster campaign to raise awareness of eating disorders in men.

“There has been a much stronger link between advertising and a particular glorification of the male physique in recent years,” Bear said. “The social ideal of the male body has become much more tightly linked to personal success.”

Media images can make men feel vulnerable about “who they are and how they present (themselves) in the world,” Bear said.

“And they’re told they can manage that by controlling their bodies.”

The ideal body shape for men traditionally has been the inverted triangle, Woodside said – broad shoulders tapering to a narrow waist.

But super-skinny male models have also become increasingly popular in men’s fashion magazines, “a kind of ‘geek-thin’ thing that is a potential route into dieting behaviours for some guys,” Woodside said.

Both sexes experience the illness in the same isolating, “very painful, very difficult ways,” Woodside said. The difference with men is that when they tell family or friends they have anorexia or bulimia, people initially don’t believe them. “They say, ‘that’s an illness of girls.’”

Families are also far less likely to think “eating disorder” in a boy who suddenly begins to lose weight.

Tom Wooldridge, assistant professor of psychology at Golden Gate University in San Francisco, knows of cases where parents didn’t realize the seriousness of the situation until their son’s hair began falling out. Men often feel a sense of shame and embarrassment, he said. “It’s really common for men to feel very alienated,” Wooldridge told the Canadian Medical Association Journal in one of two articles published on eating disorders in males last week.

Woodside said greater public awareness is needed to recognize that men are at risk, “and that people shouldn’t ignore unexplained weight loss in a 20-year-old man, or failure to grow in a 14-year-old boy, or evidence of binging and purging.

“Those are not normal behaviours for men any more than they’re normal behaviours for women,” he said.