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Old 03-19-2007, 06:16 PM   #1
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'Eating Disorders: Not Just for Women'

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Eating Disorders: Not Just for Women

by Sandra G. Boodman
Washington Post, March 13, 2007


They exercise for hours, devise rigid rituals surrounding food, obsessively monitor their weight and yearn to resemble the taut-bodied celebrities whose images grace magazine covers. But the models and actors this group typically emulates are not the skeletal Kate Moss or wispy Nicole Kidman but the chiseled muscularity of soccer superstar David Beckham and actor Daniel Craig, the latest screen incarnation of James Bond. The reason: These eating disorder sufferers are male.

Long regarded as a women's problem, the trio of serious eating disorders--the self-starvation of anorexia, the gorging and purging that characterize bulimia and the uncontrolled consumption of large amounts of food that is binge eating--are increasingly affecting males.

Last month, Harvard researchers reported the results of the first national study of eating disorders, in a population of nearly 9000 adults, and found that 25% of those with anorexia or bulimia and 40% of binge eaters were men. The authors called the rate "surprisingly high" because earlier studies had estimated that males accounted for about 10% of the cases of bulimia and anorexia, which can be fatal. Binge eating is not officially recognized as a psychiatric disorder and is not considered life-threatening, but its prevalence among men surprised some eating disorders specialists.

Although disordered eating is well-known among teenage girls and young women, experts say the problem among boys and young men is frequently overlooked by parents and coaches and under-treated by doctors. Males, they now believe, appear to be vulnerable to social pressures to achieve the perfect body similar to those that have long plagued women. But unlike the female ideal, which tends to focus on a "goal weight" or overall skinniness, men's focus is nearly always on achieving "six-pack" abs.

"Men are more reluctant to admit losing control" about food, said James I. Hudson, lead author of the study, which estimated that about 9 million Americans suffer from an eating disorder at some point in their lives. The research was published last month in the journal Biological Psychiatry. Stigma, Hudson added, remains a major barrier: Many men are loath to admit having a problem that is so strongly associated with women, fearing they will seem unmanly. Even if they do, they may have trouble finding treatment: Some eating disorder programs admit only women. And in sharp contrast to the parade of female celebrities who have publicly discussed their eating disorders, few well-known men have come forward.

The most notable exception is actor Dennis Quaid, who has talked about his battle with what he termed "manorexia," for which he sought treatment. Quaid said his problem started when he lost 40 pounds to play Doc Holliday in the 1994 movie "Wyatt Earp." Actor Billy Bob Thornton has said he, too, has battled anorexia, at one point losing 59 pounds, and singer Elton John has said he suffered from bulimia. Former male model Ron Saxen has written a new book describing his ordeal with binge eating.

Some men have suffered from all three. Among them is Matt Gaebel, 22, who was hospitalized for anorexia during his sophomore year at North Carolina State University after his weight plummeted from 155 to 106 pounds. Gabel, who is 6 feet 3 inches tall, said he subsequently developed bulimia to cope with the weight he gained during treatment for anorexia, then turned to binge eating out of concern that self-induced vomiting would ruin his teeth. Binge eating, said Gaebel, who lives with his parents in Cary, N.C., "calms me down." It has also left him feeling fat as well as "very isolated and depressed"; he now weighs 225 pounds.

Isolation is not a new feeling. Gaebel said he was the only male eating disorder patient most of the months he was hospitalized at the University of North Carolina. The only male he met there, he said, was a very young boy struggling with his homosexuality. Gaebel said he worried that people might erroneously think he was gay, because male homosexuality is associated with the development of eating disorders. (Experts say the increased risk is not intrinsic, but stems from the emphasis on weight and appearance among gay men.) "I really didn't have anyone to talk to," Gaebel recalled. Although not overweight when he developed anorexia, he had been teased in middle school for his "baby fat" and "love handles." Such experiences are common among men with eating disorders, said psychologist Cynthia Bulik, director of UNC's eating disorders program.

Psychiatrist Arnold Andersen, director of the eating disorders program at the University of Iowa and a widely recognized expert on male eating problems, said he has treated teenagers who developed bulimia or anorexia after failing to make a sports team where weight is paramount, such as wrestling. Other patients include men who began dieting to meet job requirements -- and couldn't stop. "We've had a number of military people like colonels," said Andersen, who was formerly on the staffs of Johns Hopkins Hospital and the National Institutes of Health. "The military is very strict, and they're afraid they're going to get chucked out" or fail to win a promotion if they don't lose weight to meet certain requirements.

Adelaide Robb, associate professor of psychiatry at George Washington University School of Medicine, said that many of the risk factors for males are the same as for females, although boys are more likely to be overweight and are typically older than girls when they develop an eating disorder. In both sexes there is often a family history of eating disorders--Gaebel said that is true in his family--as well as perfectionist and obsessive behaviors and a history of dieting. Treatment for males and females involves cognitive therapy to overcome a distorted body image, which is at the core of eating disorders. Depression and substance abuse may also be present.

Parents of boys, Robb said, are much less likely to recognize the problem and more apt to deny it. Pediatricians, she said, often don't suspect it, either. "Boys say, 'I'm getting into shape,' " Robb said, "not, 'I'm fat and gross and need to go on a diet,' " as do girls. Initially, she added, many parents are thrilled that their teenage son who could polish off huge quantities of food in short order has sworn off junk food, carbohydrates or pizza in favor of turkey sandwiches, broiled salmon and fruit. "They often think he's adopted healthy eating habits."

"A teenage boy shouldn't be eating what his 110-pound, dieting mother would eat," Robb cautioned. "It's normal for a half-gallon of milk and a loaf of bread to disappear every 48 hours if there's a teenage boy in the house." A notable change in eating habits, she noted, should prompt a call to a physician or nutritionist.

Parents, Robb said, should model healthy behavior and avoid lamenting how chubby they are or trying to run a "fat-free" household. "When parents are hung up on their own weight issues, their kids are at higher risk," she said. "Boys can be as susceptible as girls."

Eating disorders, Robb and other experts say, appear to be caused by a combination of genetic and environmental factors. "Genes load the gun, and environment pulls the trigger," said North Carolina's Bulik. "But one of the problems I see for male eating disorder patients is just being taken seriously."
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Old 03-19-2007, 06:42 PM   #2
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In my early 20s, I volunteered at our local Gay & Lesbian Center for the Youth Group. The organizer of the Youth Group had her B.A. in Psychology and was getting her Master's in Social Work (and is now getting her Doctorate in Epidemiology), and her Master's thesis was on eating disorders along the lines of sexual orientation.

Her thesis came out as she had expected. Heterosexual women and homosexual men were the groups with the highest eating disorders. Heterosexual men came in way below the top two groups. And homosexual women had the lowest percentage of eating disorders.

Now, if I remember correctly, the theory went something like-- since male sexuality is aroused primarily through sight and viewing, then groups that were the object of male's sexual viewing had rates of high eating disorder, in an attempt to make themselves desireable to the males that were viewing them.

Now I know that there are many theories on eating disorders, and I don't know if the above theory still holds any water, or if it has since been debunked, but I remember that was the popular thought at the time.
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Old 03-19-2007, 07:09 PM   #3
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I'm not sure if the study being reported here included data on the sexual orientation of the men in question. Of course this isn't 'real' evidence, and I only bring them up because the article mentions them, but Dennis Quaid, Billy Bob Thornton and Ron Saxen aren't gay (though they're all in the public eye, which may be relevant), and neither is the former NCU student who was willing to be quoted for the article. It is true that up until now, it's been routinely assumed that male eating disorder rates were much less than this study found them to be; on the other hand, this is the largest eating disorders study to date, and it's part of the NCS-R, which is highly regarded and extensively drawn upon by mental health professionals. I don't know what source the social worker you knew was using for her data, its sample size and methodology etc. Part of the point of the article seems to be that while eating disorders among men are certainly presumed to be increasing, on the other hand they're also now suspected of having been seriously underreported for some time due to failures of relatives, friends and doctors to recognize what they're seeing, since they tend to think of eating disorders as a 'women's problem' and decide what trouble signs they need to look for accordingly.

My guess, and it's nothing more than a guess, is that while it probably remains true that eating disorders are considerably more common among gay men than straight men, the gap is probably nowhere near as large as was previously assumed. The theory you cite certainly makes sense though, and I've seen numerous arguments to that effect before.
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Old 03-19-2007, 08:10 PM   #4
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There are loads of reported cases of eating disorders among both sexes at my university. As of now there are more reported cases of females than males, but that is limited to those reported. As this article states, there is certainly a denial element.
Many of the males that are reported to having eating disorders are in athletics and/or fraternities. I don't mean to be crass, but you would think an obsession for being fit and trim would include decreasing alcoholic beverage consumption. But noooooooooooooooooooooooooo.

And you're right, yolland, eating disorders have been labeled as a "women problem" and thus I'm sure there are loads more serious cases out there than are reported.
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Old 03-19-2007, 08:17 PM   #5
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Initially, she added, many parents are thrilled that their teenage son who could polish off huge quantities of food in short order has sworn off junk food, carbohydrates or pizza in favor of turkey sandwiches, broiled salmon and fruit. "They often think he's adopted healthy eating habits."
ummm, turkey, salmon, fruit >>>>>> pizza and junk food

sure if you take it to the extreme it can become a problem, but eating healthily instead of junk food is a good thing

the problem for guys is that not only do you have to lose the fat, you also have to build muscle to become "buff." society says girls don't like fat guys and they don't like skinny guys, they like well defined muscular guys. this leads to teenage kids taking things like steroids and hgh and other harmful things, which is even more concerning.
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Old 03-19-2007, 10:43 PM   #6
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Originally posted by Chizip
the problem for guys is that not only do you have to lose the fat, you also have to build muscle to become "buff." society says girls don't like fat guys and they don't like skinny guys, they like well defined muscular guys. this leads to teenage kids taking things like steroids and hgh and other harmful things, which is even more concerning.
whats interesting about that was there was a study done on both male and female students. each student was given a spectrum that had thin, average, and overweight points listed. the males were asked to place marks on a) their perceptions of where the women in school stood on the spectrum and b) their perceptions of THEMSELVES on the spectrum and c) their perceptions on what their ideal is on the spectrum and d) their perceptions on where they think the women want them to be

Turns out, the males think the females are right in the middle, average, fine, etc. However, they thought that they themselves were overweight and that they themselves wanted to be thinner, and that the females wanted them to be thinner (I hope I am sounding coherent here...)

For the females, it was exactly the same, respectively.

In short: All the students thought that the ideal body weight was less than what they are, but in reality, those students believe that the current body weight of the opposite sex was just fine.

I just found this interesting because we all know what lengths some will go through to pursue others (sidenote: this study did not speak to gay and lesbian perceptions--delimitation right there!). However, as this study has shown, the ones they were trying to pursue think they are fine just where they are!

I wish more students could read up on this study. The pressure to be thin and superbuff is all in the mind of the individual.
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Old 03-20-2007, 12:36 AM   #7
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Quote:
Originally posted by Chizip
the problem for guys is that not only do you have to lose the fat, you also have to build muscle to become "buff." society says girls don't like fat guys and they don't like skinny guys, they like well defined muscular guys. this leads to teenage kids taking things like steroids and hgh and other harmful things, which is even more concerning.
I don't know that I'd call it 'more' concerning, except to the extent that steroid abuse is more common. But eating disorders are serious mental illnesses with serious physiological consequences, particularly anorexia which has a 10% fatality rate and from which an estimated 20% never recover, continuing to chronically struggle with the compulsion on into adulthood, with attendant longterm consequences for their health and achievements. This article perhaps doesn't emphasize the point quite so strongly as some others I read did, but one distinguishing characteristic of male anorexics and bulimics compared to females is this obsession with appearing 'buff' as well as trim, and actually this can result in an appearance which may incorrectly read as 'healthy' (or at least not unhealthy) at first glance to others, who tend to automatically equate 'skinny guy' with scrawny, no-muscle-tone guy, which is not what most male anorexics and bulimics actually look like. Although their caloric intake isn't adequate to enable 'bulking up' despite excessive exercise, typically they will have notable muscle definition (thanks to the testosterone--not something female anorexics and bulimics, who often also exercise excessively, have enough of to achieve), and the tendency to automatically perceive that as a sign of 'fitness' may override the more at-second-glance recognition that they are also far too thin.
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Old 03-20-2007, 08:46 PM   #8
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A friend of mine was/is anorexic. In 8th grade, he actually had to go into the hospital because he had a heart problem from anorexia. Now, he's fine, and has to take antidepressants, but like the article said, he worked out a lot and was a cross country runner, so I'm guessing that nobody knew until his heart gave him trouble.
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Old 03-20-2007, 09:13 PM   #9
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^ Yeah, I ran cross country for years myself, am still a distance runner today and I've encountered a few male anorexics that way myself, although none I knew well. I don't have any stats, but would be willing to bet that's one group where you find quite a bit of it.
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Old 03-21-2007, 12:26 AM   #10
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Quote:
Originally posted by redhotswami


Turns out, the males think the females are right in the middle, average, fine, etc. However, they thought that they themselves were overweight and that they themselves wanted to be thinner, and that the females wanted them to be thinner (I hope I am sounding coherent here...)

I've seen studies like this and it is interesting and I do believe that few of us see ourselves the way other people do. I know or think I'm harsher on myself than anyone else. My problem though is that we know Americans are overweight and getting bigger. So being average/middle is changing. The average woman is overweight.

Certainly someone overly concerned about their body image isn't going to want to look like the average/normal person.
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Old 03-21-2007, 11:40 AM   #11
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Originally posted by onebloodonelife
A friend of mine was/is anorexic. In 8th grade, he actually had to go into the hospital because he had a heart problem from anorexia. Now, he's fine, and has to take antidepressants, but like the article said, he worked out a lot and was a cross country runner, so I'm guessing that nobody knew until his heart gave him trouble.
In college I did a thesis paper on eating disorders and gymnastics and I sent out surveys to a sample of volunteers who had competed in the highest levels of the sport. Based on the responses I got, the person in the worst condition was actually a guy. He had been hospitalized many times and admitted he still struggled with his ED. He also said that I didn't have as much to do with body image than it did with some troubling events in his past and his low self-confidence. He also struggled with depression.


Now I don't know if this is a shot in the dark, but it seems to me that EDs are more common among women because we tend to internalize and punish ourselves more than redirect our frustrations elsewhere. When I see my male friends put down by bad experiences, they tend to react by being angry towards other people. When I feel really put down and my self-confidence is damaged, I'll blame it all on myself and think "yeah maybe if I wasn't so dumb, maybe if I had more self control and wasn't so fat..."
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Old 03-21-2007, 12:35 PM   #12
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Quote:
Originally posted by Liesje

Now I don't know if this is a shot in the dark, but it seems to me that EDs are more common among women because we tend to internalize and punish ourselves more than redirect our frustrations elsewhere. When I see my male friends put down by bad experiences, they tend to react by being angry towards other people
I agree with that, in general(and of course there are always exceptions) women do that-and we are socialized, and in some cases raised, to do that. Men tend to be far more likely to put their insecurities and self-doubts onto others, and they are socialized, and in some cases raised, to do that.
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Old 03-21-2007, 05:12 PM   #13
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Originally posted by Liesje

Now I don't know if this is a shot in the dark, but it seems to me that EDs are more common among women because we tend to internalize and punish ourselves more than redirect our frustrations elsewhere. When I see my male friends put down by bad experiences, they tend to react by being angry towards other people. When I feel really put down and my self-confidence is damaged, I'll blame it all on myself and think "yeah maybe if I wasn't so dumb, maybe if I had more self control and wasn't so fat..."
Yes, I definitely think you're on to something there. I know that for myself, I look at my body and don't like the way it looks. I have stretch marks on a good portion of my hips and most of my legs from being on Prednisone, a steroid, for my Crohn's disease. I also gained 15-20 pounds from it. Sure, I know that it's not my fault, but I still look at those areas of my body with a bit of disgust, and probably wouldn't tell anyone how I feel about it. And, so it gets internalized instead.
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Old 03-21-2007, 05:39 PM   #14
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And for many women, it's not just about looks. Women are socialized (or allow themselves to be socialized) to measure self-worth and self-confidence based on physical appearance, namely weight. Sometimes I have a bad day and say to Phil "I feel so fat and ugly today." It's not because someone told me I looked fat, but because something happened that made me feel bad, and I internalize. My body becomes the way of controlling and measuring self-worth in general. I don't really care what anyone else thinks about how I look, but if I start to feel dumb or useless at work, I feel like the easiest way to make up for it is to practice discipline and self control by losing weight. I probably sound like a broken record these days, but I've always felt EDs have far more to do with self-confidence and self-worth in general than explicitly feeling bad about one's weight or body. This is why many rape victims, girls who feel they were abandoned or not loved, and girls who suffered a traumatic event develop EDs. It is a way to continually internalize that pain but also maintain a false sense of control in their lives. No amount of research regarding the media causing eating disorders will ever convince me otherwise.
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Old 03-23-2007, 03:12 PM   #15
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This thread brings Daniel Johns of Silverchair to mind...

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