Eating Disorders Commonly Affect Men But Are Hard to Diagnose — This Is Why

There are over one million Australians living with an eating disorder, according to data from the Butterfly Foundation. Of this one million, more than 37% identify as male. That’s a large portion of men experiencing disorders which are often dismissed as something that only affects women.

In fact, these statistics could be much higher, says Dr Kieran Kennedy, a doctor and psychiatry resident with degrees in Psychology, Physiology and Medicine/Surgery.

“Because of under-diagnosis and cultural stigma that leads fewer men to present for help or admit to struggling with body image and eating, the actual proportion of men with eating disorders could be much higher,” Dr Kennedy told The Latch.

While diagnosing eating disorders in boys and men can be difficult, according to Dr Kennedy, the common risk factors are much the same in both male and females. These risk factors include perfectionism, bullying, dieting, trauma and childhood obesity but in the case of women, more is known as research in this area tends to centre the experience of women.

“For women, statistics show that engaging in ‘higher risk’ endeavours like sports or activities focused on body image, weight and size increase the risk of men struggling with eating and disordered eating behaviours,” said Dr Kennedy.

“Recent studies quote that there are significantly less research and knowledge on male eating disorders compared to those for females — so when it comes to our actual understanding of what leads toward risk for developing eating disorders in young men there’s still a lot for us to find out.”

Much like women, men also experience body dissatisfaction and face pressure to look a certain way. While women might experience a desire to stay thin in order to meet commonly held beauty ideals, men, on the other hand, often feel the need to grow their muscles and meet a societal standard of masculinity.

Culturally, boys and men are also encouraged to steer clear of vulnerability and as such, are unlikely to seek help for mental health issues they may be facing, including around eating or with body image.

“Sociocultural influences play a significant role in the development of eating disorders and we now know that men are exposed to unique cultural messages that can increase their vulnerability towards developing these illnesses,” Dr Kennedy said.

“There’s a whole lot more pressure on young men to look a certain way, and that appearance equates to success and happiness (which we of course know isn’t necessarily the case). Boys and men are far less likely in general to open up about and seek help for mental health struggles.

“Traditional and outdated stereotypes show men as rarely suffering from mental illness, and it being ‘weak’ and unmasculine to talk about emotions or fears and in turn, perpetuate this silence. Concerns about eating and body image are even more stigmatised for men because these are traditionally seen as ‘female’ concerns and struggles. So when it comes to eating disorders and struggling with body image, men get a double whammy when it comes to pressures to stay silent and not seek help.”

When it comes to looking for warning signs in the behaviour of the boys and men in your life, or even for yourself, keep an eye on anything related to body image, food and/or eating behaviour that impacts on one’s mental or physical health.

“If concerns around appearance, fitness, food or diet start to reach a point where they’re significantly impacting someone in a negative way, putting their health at risk or taking over other important areas of life then a red flag needs to be raised,” said Dr Kennedy.

“Significant anxiety and negative mental impacts from concerns about body, weight or food are important to watch out for. Similarly, if pressures and practices put our physical health at risk this is always a point to reflect that things might be getting out of hand.”

Given there are a number of different eating disorders, this also affects how it manifests and as such, there is no one-size-fits-all way to identify this behaviour in people. For example, for some, it might include calories restriction and excessive exercise while others might engage in binge eating behaviour.

“These might include a rigidity about calorie intake or type of food that starts to impact on other areas of life and cause significant distress and anxiety,” Dr Kennedy said. “It can also involve regular binge eating episodes where a high amount of ‘bad’ food is taken in in a short amount of time with an associated feeling of being out of control, guilty and wrong.

“Attaching food intake to the need to ‘compensate’ is always another sign to watch out for — feeling compelled to work off food, or vomit, use laxatives or other means to avoid calorie absorption shouldn’t be ignored. Male concerns around body image and eating often involve a strong drive for more muscle and less fat, so putting health at significant risk by the unsafe use of steroids or performance-enhancing agents can also be a sign for some that things bringing more negative than positive.”

It’s a difficult line to draw, especially given the way diet culture operates in our society and is tough to spot when much of the behaviour is accepted and encouraged (to a degree) by those who perpetrate diet culture ideals.

“It’s also really important to point out that wanting to get fit, looking after your diet or striving to feel better within ourselves through how we look and feel are not necessarily disordered or dangerous,” Dr Kennedy said.

“There’s a whole lot of positivity and health benefits to be found in the fitness industry for men (and women for that matter), so it’s about weighing up where the need for change and control is coming from as well as how these things are impacting our lives overall.”

When it comes to providing support for those who may be experiencing an eating disorder, the best thing you can do is simply be there for them and listen to what they have to say. Don’t place any judgement on the person or their actions and be sure to communicate that asking for help isn’t a sign of weakness, which is especially important in a society that encourages boys and men to “man up”.

“For someone struggling with eating (or any form of mental struggle), feeling like they’re heard and supported means a massive boost to their chance of getting help and getting better,” said Dr Kennedy.

“Encouraging men to reach out for help with these struggles is vital and gentle encouragement to book a GP appointment or to think about seeing a psychologist can really help. Whether you’re a parent, partner, sibling or mate — offering to attend the first few with them can help.”

If you are experiencing any of these concerns around body image, weight or food, please know that reaching out for help is never a sign of weakness or indicates a lack of masculinity. Just as you would visit a GP for your physical health, you need to do the same for your mental health.

“Places like SANE Australia offer great basic information, and equipping ourselves with this can help get a clearer idea of where you’re at,” said Dr Kennedy. “This stuff is tricky and complex, but reaching out early (even if that means just keeping your doctor or psychologist in the loop so you can both keep an eye on things) is important.

“Help for eating disorders and body image issues often involves psychology-based input to work on where the anxieties and concerns are coming from, and how to gradually shift thoughts, behaviours and habits that are part of the disorder.”

If you or anyone you know is struggling and needs support, call Kids Helpline on 1800 55 1800 or Lifeline on 13 11 14, both of which provide trained counsellors you can talk with 24/7. You can call the Butterfly Foundation on 1800 33 4673. You can also speak with someone confidentially at Headspace by calling 1800 650 890 or chat online here.

Read more stories from TheLatch— and follow us on Facebook.