Can you choose to have an eating disorder?
Eating disorders (ED) are complex mental health problems. Anyone, regardless of race, age or background can develop and ED. It is not your fault if you have one. Fault and blame often go hand in hand. I have trained to work in a sensitive way that doesn’t seek to blame you or anybody else in your life.
I have several years of experience working with eating disorders. I work with women, men, the BAME and LGBTQA community. I have an empathic, non-judgemental nature and I am acutely aware of how shame stops many clients from seeking help to address their eating disorder.
Do men get eating disorders?
Yes, Men get eating disorders too. Unfortunately statistical data is limited and men are less likely to seek help out of fear that they might be branded as gay.
Research suggests that up to a quarter of sufferers are male.
It is estimated that out of:
- 19 are affected by anorexia nervosa and
- 29 are affected by bulimia
The high level of stigma affecting men with eating disorders, means that it is very difficult to obtain accurate figures.
What triggers an eating disorder in men?
Eating disorders in men are often brought one by one ore more the following:
- relationship breakdown
- career changes or pressures at work
- difficult coping with pressure overall
- Illness or loss
- bullying and criticism for being overweight
- practising sports that require extreme weight control
- comments from sports coaches
Research implies that for most men the eating disorder starts to take root when they get into exercising. Reflecting on your experience as you are reading this, would you say that the same applied to you or have you identified a different path?
It is only with time that the desire to attain a perfect body, becomes more obvious and later on develops into an obsession, which leads you to limit food intake. To anyone observing from the outside, this tendency can simply be overlooked as a wish to become healthier. You can probably recall yourself that at first you went through a stage of being toned, fit and muscular and the eating disorder only manifested much later. This is what makes it harder for a man to notice the onset of the eating disorder and make it more challenging to treat it because the eating disorder has a stronger chance to become embedded long before you start noticing it.
Males who have Anorexia
One trait of anorexia is a the distortion of body shape and weight. However men with eating disorders are not overly concerned with their weight. They are far more likely to be worried about the shape of their body and certain parts in particular such as stomach, buttocks, legs, chest and face. Many men with anorexia will show a significant distortion of how they see these body parts. Many men with anorexia are also preoccupied with their genital size and this can be very difficult to discuss openly. The distortion is not just visual it also affects the value that is attributed to these parts. Men have a sense of having less value if they are unable to live up to an unrealistic body image ideal.
Males with Anorexia often exhibit certain eating and calorie burning patterns:
- avoidance of fatty foods
- excessive exercise
- drive to improve athletic performance: (boxers, runners, gymnasts, wrestlers are especially at risk)
- self induced vomitin
- taking laxatives and appetite suppresants, slimming pills or water tablets
- use of cocaine and amphetamines to maintain low body mass which could be disguised as hedonism
Excessive exercise can often be driven by having been slightly overweight in childhood and by a need to regulate difficult emotions.
From a hormonal perspective men with anorexia can experience a reduction in testosterone which may lead to a loss of sexua interest and even impotence. As men recover from the anorexia sexual interest may return and this will be apparent in the occurrence of wet dreams and more frequent masturbation.
Can Anorexia Nervosa overlap with Bulimia Nervosa in men
Yes it can and when this happens it is referred to as a bulimic subtype of anorexia nervosa.The subtype will show episodic overeating and purging in addition to the starving and over exercising behaviour of the restrictive anorexic. It is known as a subtype of anorexia nervosa because anorexia trumps bulimia due to it’s more serious and has more complications, which make it harder to treat. If you are bulimic sub type anorectic then you may find it harder to recover because you have to address two different sets of behaviour.
What thoughts do men with anorexia have
Abnormal thinking is what defines anorexia. Assessing a man based on his weight can be useful but the state of mind highlights the condition.
Core believes of anorexia include:
- Fear of normal body weight and shape
- Obessions with losing weight and modifying body shape
- self-esteem based on what body looks like instead of personal life and holistic life view
As a man with anorexia you may struggle to admit having a problem in the early stages because anorexia nervosa resolves the cognitive and emotional conflicts you are experiencing. You may be aware of the distress that anorexia causes you but you are even more aware that not having anorexia is far worse.
Additional mental featues include:
- becoming socially withdrawn
- reduced sexual desire
- shorter attention span
- difficulty concentrating
- obsessive ruminations or rituals
- hoarding belongings
- repetitive counting of belongings or laying them out in precise order
These mental features are largely caused by the effects of starvation. The combinations of these features is often referred to as the starving mind or starving mindset.
Depression is a recurring trait of the starving mind. For some men it is a key concern and so it will need additional treatment in itself. However for most men, depression may be linked to nutritional deficiency and so needs to be treated with nutritional rehabilitation.
As a man with anorexia you may have found that you have become more socially withdrawn. Perhaps you were always a little shy and introverted but it is more likely that you have become more withdrawn to help you conceal your anorexia.
Your family, partner, colleagues, friends or even yourself may have noticed a change in personality that is very different from how you were before you became anorexic. An exmaple of this might be a compliant or “good boy” becoming deceifulf, aggressive, argumentative and quick to anger. People around you may struggle with this and blaming the anorexia (the anorectic part in you) might help improve relationships.
To beging with the starving mind or anorectic mind is a small part of you but it gradually becomes your main identity. It may give a sense of control over the mental and emotional aspects of yourself. If you have relationship problems then the anorexia at first can feel like a good friend that will make you indifferent to them but the dark and dangerous nature of anorexia is exactly that: an apparently good friend who turns into a devastating enemy before you have a chance to realise it.