January Surprise

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Eating Disorders: Just because you’re a man doesn’t mean you’re immune

We live in a culture of contradictions: measured by our net worth, yet derided for being rich; surrounded by sexual temptation, yet scolded if we succumb; seduced by sugar and fat that we equate with love, yet humiliated for being overweight. The ideal body image, in a country in which 55% of the population is considered obese, deifies emaciated models, actresses and actors. So, how could we be surprised when some of us, including boys and men, carry the message of the culture to a self-destructive extreme and become eating-disordered?

Eating disorders, as Dr. Richard Gordon suggests, “draw upon the common cultural vocabulary of their time” (Gordon, 1990). They are extensions of the core values and conflicts within the culture - for example, be thin, be in control. Eating disorders including Anorexia nervosa and Bulimia nervosa are symptoms of our times and our culture, a culture that rewards both fierce self-control and wild self-indulgence. When so much else is beyond control, controlling what one eats may be the only strategy a man or boy has to find a sense of security, false as that may be.

It is no coincidence that men are now more susceptible to eating disorders than they used to be, or at least were thought to be. Expectations about what it is to be a man have changed, and changing roles and opportunities for women have meant that women now compete for and in jobs previously reserved for men. How to be a successful and good man is less clear and in many ways more challenging than it was was even twenty years ago.

Best-selling author Dr. Ira Sacker, (Dying to be Thin) a pediatric psychiatrist specializing in eating disorders, says that ten years ago one in twenty patients who were treated for eating disorders in the US was male. Now Sacker and other experts estimate that one in four or five people in the US who are eating disordered are male, and notes that he is treating boys as young as five and six years old for anorexia and bulimia. Unfortunately, most of those boys will drop out of treatment when they reach puberty because they are ashamed to have a”girls’ disease.”

Too many men with eating disorders do not get help, in part because eating disorders are still thought to be “women’s” diseases. There is still too little research into the subject of males and eating disorders and too few treatment centers offering programs for men. Too many men are in denial that they could be eating disordered. In fact, Harrison G. Pope,Jr. at McLean Hospital told me recently that “The single most striking finding, the most stunning finding [in a study of men with ED] was that virtually non of these men had told a professional about his problem. Some of them didn’t even know they had a recognized psychiatric disorder.”

It is time to take this illness out of the closet. Men and boys are vulnerable to eating disorders, and perhaps particularly so in the culture of 2010. We need to acknowledge this reality because eating disordered behavior takes a terrible physical, emotional, and social toll on its victims, and their family members, friends and colleagues. Studies on females show that patients with eating disorders are more likely to die from their illness than patients with any other psychological illness. This may be even more likely for men as they wait longer to seek treatment, and their bodies have a lower percentage of fat so the illness is robbing them of muscle. Starving the brain and the body erodes the ability to think clearly, to resist other illnesses, to interact with other people, and also diminishes physical strength and sexual functioning.

Eating disorders are seductive. Bingeing, for example, brings on an endorphin high, makes people feel more relaxed and powerful, and can, therefore, be addictive. Men and boys are particularly vulnerable to eating disorders in times of transition - from childhood to puberty, elementary school to high school, high school to college, college to work, then marriage and becoming a father. Dr. Catherine Steiner-Adair at Harvard University estimates that 40% of people in college who are bulimic are men. We do very little to help men prepare for and make such transitions successfully and some will become eating disordered as a result.

Eating disorders really aren’t about food. Instead they are symptoms of a person’s weak sense of self - or as I call it - the Hungry i. Too many boys and men growing up at the end of the twentieth century and the beginning of the twenty-first are not confident and have a weak sense of self, and some of them are taking their pain out on their own bodies.

What can we do?

We can recognize that eating disorders affect boys and men as well as girls and women and that people of all ages, sexes, race and class are vulnerable. We can learn to discourage instead of encourage behavior that can lead to eating disorders. Coaches, for example, can stop imposing rigid tandards for weight. We can be sensitive, we can be kind, and we can be clear about the dangers of disordered eating. We can support research about the affect of eating disorders on boys and young men because there is so little, and learn about the illness and its symptoms. And finally, we can try to change the very culture that promotes eating disordered behavior.

©2013 Barbara Kent Lawrence

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Barbara Kent Lawrence is not a professional in the field of eating disorders. I was married for 27 years to a man with eating disorders and am a researcher and professor in education. In my first book on this subject, Bitter Ice: a memoir of love, food, and obsession, I explored my former husband’s struggle with this illness, and my growing awareness of my role as an enabler. In my new book, The Hungry i: a Work Book for partners of men with eating disorders, I present the result of extensive research into the causes and complexities of eating disorders in men, drawing from literature of the field, interviews with experts, and my own experience. Men may find chapters about the history, culture, symptoms, and treatment of eating disorders and the Exercises designed to help us think about our culture and place within that culture most helpful. “Time-Outs” are more slanted to activities women may find more appealing, but I hope men will suggest Time-Outs that we can add to future editions of the book.


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