general

When thinking about eating disorders, many people will imagine a scenario of a thin, young, white, female, middle-class individual.  While young, white, female, and/or middle-class teenagers occupy a significant cohort of those with eating disorders, we will seldom be able to find any definitive answers about incidence. Many people with dangerous eating disorders may be overlooked by their GPs, who may have limited experience identifying and supporting individuals with eating disorders. They may consider someone in a “normal” or larger body as unlikely to have an eating disorder, despite the fact that this is assumption is grossly inaccurate.

The phrase "You don't look like you have an eating disorder" does a great deal of damage. The thing, an eating disorder is much more than a weight or shape, it is a psychiatric illness which has the highest mortality rate of any mental illness. Any person in any body weight, shape, or size can struggle with restriction and atypical anorexia nervosa. Likewise, normal and underweight people may be struggling with bingeing and purging, or just with bingeing, and so on.

But certain groups of people within our society find it challenging to access clinical support for a variety of reasons.  Shame, guilt, fear of not being believed, pre-conceived notions about who develops EDs, and beliefs that a person may not actually even have an eating disorder, as well as weight stigma and stereotypes that come from health care professionals themselves.

We want to bring some attention to those underrepresented groups, and let everyone know - no matter their weight and shape - we will treat you with respect, compassion, and empathy.  We will accept your experiences, and want you to know that many members may have struggled with similar experiences.

Eating disorders are not weight disorders. They are mental illnesses.


men with eating disorders

Eating disorders are commonly thought to be a problem for girls and women.  This gender difference may reflect our society’s different expectations for men and women. Men are generally expected to be strong and powerful. They might feel ashamed of slimmer bodies and have the desire to achieve bigger and more powerful bodies. According to a widely accepted study, there are estimates that men have a lifetime prevalence of .3% for anorexia nervosa (AN), .5% for bulimia nervosa (BN) and 2% for binge eating disorder (BED). These figures correspond to males representing 25% of individuals with AN and BN and 36% of those with BED (National Eating Disorder Association, 2016).

Eating disorders among boys and men are on the rise. A broadening definition of what constitutes an eating disorder and the evolving cultural norms regarding the male physique may both account for greater recognition of eating disorders in males.  Just like females, males can be at risk of developing all forms of eating disorders.  When investigating the risks for men, many studies have found a positive correlation between the development of an eating disorder and athletic performance. This is likely due to the focus that is placed on body fat percentage in certain sports (such as body building etc.), that leads these individuals to heavily restrict their diets and/or even purge certain foods based on which foods they believe will or won’t give them a competitive edge. It is also not uncommon for men fixated on athletic performance to engage in other drastic behaviors such as steroid use and compulsive exercise.  However, this is only one example of how young men are also at risk of developing this life threatening and debilitating disorder.

In a society that lacks support and treatment for eating disorders, there is even less available that is tailored for boys and men who struggle. In the United States, residential programs that help with treating eating disorders all accept females as patients, but only ~20% also accept males. An even smaller subset offers male-only treatment groups (Frisch, M.J., 2006).  Most therapeutic groups that do include men are often composed primarily of females and/or may be lead by female therapists which can make it very uncomfortable for a males to identify, relate, and feel welcome in these settings.  These males may feel significantly different experiences regarding body image, sexuality, co-morbid conditions as well as coping mechanisms and means of expression. Given these gender differences, it is beneficial to allow males the opportunity to discuss such topics in a single gender setting with a more behavioral and active approach to group therapy (Weltzin, 2012). Groups that tend to focus on perceived pressure to be thin, body dissatisfaction, and the cultural thin ideal may not necessarily be efficacious for males. Rather, it is suggested that eating disorder prevention programs for males focus on lowering levels of body dissatisfaction addressing subjects such as body size and shape, muscularity as well as other physical areas of concern (Vo,M., 2016).

There is a great deal of work to be done before males can comfortably access the supports they need when dealing with a debilitating eating disorder. Hopefully as awareness around male eating disorder grows in society, so will the treatment and therapeutic resources for these individuals who are often left in the dark feeling alone and ashamed.

Resources

  • Men Get Eating Disorders Too; this resource includes an online peer support page that might be helpful for adult males seeking an environment that can truly understand their struggles.

  • The National Eating Disorders Association is the largest not-for-profit organization in the United States working to prevent eating disorders, eliminate body dissatisfaction, and provide treatment referrals to those suffering from anorexia, bulimia and binge eating disorder and those concerned with body image, eating and weight issues. (206) 382-3587; toll-free information and referral helpline (800) 931-2237; nationaleatingdisorders.org

  • The National Association of Anorexia Nervosa and Associated Disorders (ANAD) is a national nonprofit organization helping eating disorder victims and their families. In addition to free hotline counseling, ANAD operates an international network of support groups for sufferers and families, and offers referrals to health care professionals across the United States and in 15 other countries. (847) 831-3438; anad.org

This article focuses on some research finding on eating disorders in the male population and goes into some detail around the different types

This article discusses programs for younger children including boys who struggle with disordered eating

This articles summarizes some shocking statistics on eating disorders in the male population

Some other helpful and interesting reads:

Atlantic Magazine blog, “Body-image pressure increasing affects boys.” March 10, 2014.

Bunnell, D. & Maine, M. (2014) “Understanding and treating males with eating disorders” in Cohn, Lemberg.

Field AE, Sonneville  KR, Crosby, RD, et al. Prospective Associations of Concerns About Physiqueand the Development of Obesity, Binge Drinking, and Drug Use Among Adolescent Boys and Young Adult Men. JAMA Pediatrics, 2014, 168 (1): 34-39. 

Weltzin, T. Carlson, T., et al. (2014) “Treatment Issues and Outcomes for Males with Eating Disorders” in Cohn, Lemberg.

Wooldridge, T. (2017, in press) Understanding Anorexia in Males: An Integrated Approach. Philadelphia, PA: Routledge.

This article focuses on some research finding on eating disorders in the male population and goes into some detail around the different types

This article discusses programs for younger children including boys who struggle with disordered eating

This articles summarizes some shocking statistics on eating disorders in the male population


People of Colour

The stereotype is that eating disorders affect primarily young, middle-class, caucasian females. But such a stereotype leaves out other important demographics, such as people (men and women) of colour.

Eating disorders do occur in other cultural contexts, though there may be important, and often understudied, differences in terms of influencing factors and manifestations.

It may be important to consider: under-reporting, treatment options in various places, cultural and socioeconomic intersections, cultural standards, and post-colonial factors. For example, Western society and the media often display European traits as a standard for beauty and it should be considered that diversity does not have proportional representation in public spaces, which may contribute to body image pressures and low self-esteem in groups that are poorly represented with limited role models. This is a noted factor in the causation of eating disorders, but not the only factor. Eating disorders are far more complicated than being caused by Western media and the "thin-ideal."

The Science of Eating Disorders blog has a five-part series of articles where they dissect and discuss eating disorders and culture (Whose Culture is it Anyway? Disentangling Culture and Eating Disorders 1-5/5)

While the following article focuses on people of colour as well as trans people, the situation in most parts of Canada is quite similar. Be aware that you might find parts of the article triggering as there are a very few mentions of weights and behaviours.  Take care of yourself if you are feeling vulnerable:

America is Utterly Failing People of Colour with Eating Disorders


Research with a specific focus on eating disorders in relation to the LGBTQ+ community is lacking.

What research there is, generally reaches similar, common-sense hypothetical conclusions: 

1. That individuals in the LGBT+ community face more discrimination which can tie in to some of the psychological and sociological pressures that contribute to eating disorders. 

2. Individuals who identify as transgender, gender-fluid, or non-binary, may struggle with significant gender dysphoria. In the context of an eating disorder, this will complicate already challenging body image issues. It should, however, be recognized that body dissatisfaction is not always resultant in a drive for thinness (Science of Eating Disorders, Impossible Binaries: Eating Disorders Among Trans Individuals), as there are different cultural attitudes towards "male" and "female" bodies in terms of what is seen as desirable. Male and female bodies both face certain pressures, that contribute to body image issues, but these pressure often differ. The male body is typically expected to be "muscular" and/or "hyper-masculine" and the female body is typically expected to be "thin and fragile" whilst retaining secondary sex characteristics.

What studies there are in this area, emphasize the sociological factors that contribute to eating disorders, and while these are important and do play a role in the development and maintenance of these illnesses; many of these studies fail to appreciate the genetic, biological, and other psychological factors that contribute to eating disorders (e.g. other mental illnesses, childhood upbringing, trauma etc.)

Some studies have found that eating disorders are less common in lesbian and bisexual women, others have found they share roughly the same prevalence (Science of Eating Disorders, Eating Disorders Among Lesbian and Bisexual Women.)

The Journal of Eating Disorders as well as the Science of Eating Disorders blog, have some useful articles and reviews on the subject.

LGBTQ+


We commonly associate eating disorders with youth and while eating disorders do affect youth, we are often not aware of how many older adults are also struggling with life-threatening eating disorders, and not able to access age-appropriate services, targeted for their specific needs. 

Older adults are thought to be the major cohort struggling with Binge Eating Disorder (BED), which is the most common and frequently, most stigmatized eating disorder.

Older adults are thought to develop eating disorders in the following instances:

  • they experience a major mid-life change (separation or divorce, job loss or change, moving, looking after elderly parents, and so forth), and begin changing their patterns of eating. Since most eating disorders are genetic in nature, a combination of stress and changing eating habits can result in development of an eating disorder.

  • they had an eating disorder as a youth, and major mid-life changes results in a relapse (although they may struggle with different symptoms than when they were younger.)

  • they have always had an eating disorder, either without diagnosis and treatment, or having been diagnosed and treated, remain afflicted.

Canada generally does not offer the kind of treatment that might better serve older adults, failing to acknowledge that they are often looking back over a life lived: often the regrets (to complete post-secondary, failure to develop a careers), and the losses (loss of family and/or loss of child custody, jobs and careers lost due to illness, inability to now ever become pregnant, either due to the consequences of their eating disorder or age).  There is increasing awareness of this cohort in the U.S., and many treatment centres now offer treatment streams reserved for adults 30 years and older.

This article provides a brief description of what life is like as an older adult with an eating disorder: Eating Disorders Deadly for older adults, too.  

Here’s a few other articles on the subject that may also be of interest:

older adults