Close your eyes for a second and imagine someone with an eating disorder. If the person you envisioned was female, you’re not alone. In fact, most of us believe that women and girls are the only ones affected by eating disorders. But the facts tell a very different story. In the U.S., at least a third of the 30 million people suffering from eating disorders are boys or men, according to the National Eating Disorders Association (NEDA). That’s 10 million people, most of whom won’t ever get the help they desperately need because they have a Y chromosome. And that, my friends, is a real—and sometimes quite deadly—tragedy. So why do we ignore men and boys with eating disorders? I’ve come up with at least three reasons:
- Even though a lot of those 10 million boys and young men know they’ve got a problem, they refuse to ask for help because they’re afraid that people will make fun of them. After all, real men don’t have eating problems right? Guys who do acknowledge that they have a problem and ask for help often find that eating disorder treatment programs accept only females.
- It never occurs to most medical professionals that boys could actually have an eating disorder. So even when the symptoms are staring them in the face, pediatricians and primary care docs too often don’t see them. Mental health professionals_people who really ought to know better—also turn a blind eye to boys. One of the big industry groups, the American Psychiatric Association, has a very informative section on its website devoted to eating disorders. But the first symptom on the list is “menstrual periods cease.” That pretty well eliminates the boys.
- Since so few professionals seriously consider the possibility that eating disorders might not be purely a female issue, they routinely exclude boys and young men from relevant research. And if they’re left out of research, they’re also left out of clinical trials for drugs and other potential therapies.
How the Media Feeds Eating Disorders
Eating disorders are typically related to body image. People suffering from anorexia, for example, look in the mirror and, no matter how skinny they are, they see an obese person. Generally speaking, girls and women worry more than boys and men do about being overweight, and some of those worries are driven by the media. Many critics put the blame on the undeniable gender-based double standard: dad-bod, for example—a nice way of saying “soft and pudgy”—is perfectly fine for men, but mom-bod includes a tight butt and a six pack. Others point to men’s magazines, movies, and TV, and the idealized images that girls and women feel they have to emulate to be considered attractive. There’s a lot of truth there. But next time you’re at the grocery store, spend a few minutes flipping through Cosmo, Shape, and other women’s magazines. You’ll find that the images of women are nearly identical: alluring, idealized, and sexy. The enormous pressure girls feel from all sides to look like those perfectly airbrushed actresses and models can make them feel terrible about their own body and sometimes leads to eating disorders. That’s the bad news. The worse news is that the media does something equally damaging to boys. Men’s magazines, movies, and TV shows feature guys with impossibly large biceps, too many abs to count, and the kind of physique most of us could never achieve. Those same idealized (and objectifying) images also show up in girls’ and women’s magazines, where they influence the expectations their readers have for men and boys. As a result, males who are overweight may feel even more pressure to lose weight—which could contribute to eating disorders. And those whose weight is perfectly fine may develop another type of disorder: “muscle dysmorphia,” also known as “bigorexia.” Bigorexics (who are almost always male) look in the mirror and, no matter how ripped they are, see a 96-pound wimp. While bigorexia isn’t as deadly as anorexia and other “traditional” eating disorders, it can still lead to a number of very serious problems. Boys and men who feel pressured to have the perfect body often become anxious and depressed (which can lead to suicide). They diet and work out obsessively and can do permanent joint and muscle damage. Those obsessions can become so consuming that homework, school attendance, and career may suffer, and they may stop spending time with friends and family because they don’t want to interrupt their workout schedule or they feel embarrassed about how skinny they are. Bigorexics may drain their bank accounts to pay for personal trainers and surgery (if exercise doesn’t produce the desired effects, it’s always possible to get that Mr. Olympia look with pec, bicep, calf, ab, and other implants). And they may load up on “supplements,” including testosterone and steroids, which have been linked to increased blood pressure and heart attack risk, reduced liver and bowel function, dementia, and sudden flashes of anger sometimes called “roid” (as in steroid) rage. If you suspect that you or someone you know has an eating disorder, including bigorexia, it’s important to find help. Now. If the person is under 18, start with his pediatrician. If he or she laughs it off or refuses to consider an eating disorder, find another doctor. If he’s over 18, set up a visit with the primary care doc or a mental health professional who has experience treating people with eating disorders. You’ll also find a ton of great resources, information, guidance, and support at the NEDA website, http://www.nationaleatingdisorders.org/