Conditions and Disorders
Male Eating Disorders
One of the most common misconceptions about men in America today is that they don’t care about the way they look. The truth is, most males (despite their outer appearance) have an idealized self-image problem. Frankly put, men, on average, want to be lean and muscular. As is the case with most women, this unrealistic ideal is spoon-fed to many American men via images in the media.
This need to be physically perfect (or even physically acceptable) has no demographic. Studies show that 25% of normal weight males see themselves as underweight, and 90% of teenaged boys strive to “bulk up” and build muscle mass.
Muscle Dysmorphia, a subclass of Body Dysmorphic Disorder (BDD), is a growing phenomenon that primarily affected male bodybuilders but is now affecting the general population with quarter neither asked nor given. This new generation of men obsess about their looks to no end, spending hours a day in the gym and spending egregious amounts of money on a growing market of supplements and cure-alls. Many men even resort to steroid abuse to achieve and maintain these new, unrealistic goals.
What we have discovered is that many men receive this “programming” at a very young age, and it informs our perceptions and self-image well into adulthood.
Once again, studies prove that one in three persons struggling with eating disorders is male, and that men, too, struggle with subclinical eating disordered behaviors such as:
- Binge Eating
- Fasting for Weight Loss
- Laxative Abuse
- and Caloric Restriction
Because of cultural bias, men are less likely than women to seek help or treatment for these disorders, because they are usually characterized in film and the media as feminine or gay. Even assessment tests are guilty of having language geared toward women and girls, reinforcing the stereotypes, myths and misconceptions about the nature of eating disorders in men.
TREATING MALE EATING DISORDERS
There is no “cookie-cutter” treatment modality for male eating disorders. Every man has his own specific configuration of biological, social and cultural factors that need to be explored in order to produce an effective treatment model. And, sadly, we are in a race between education and catastrophe: Studies have found that the risk of mortality in males with eating disorders is actually higher than it is with women. Intervening on these behaviors is vital.
Aside from the obvious malnourishing factors present in any eating disorder, men in particular have the added risk of stunted biological processes. In example, men and boys with anorexia nervosa – an eating disorder characterized by caloric restriction or a flat-out refusal to eat for fear of weight gain – usually exhibit lowered levels of testosterone and vitamin D. This is coupled with a high risk of osteopenia and osteoporosis. Ergo, in addition to treatment, testosterone replacement therapy (TRT) may be recommended.
It is for these very reasons that a multi-pronged approach to treatment should be considered once a diagnosis is in place. Psychological and nutritional counseling should form the foundation of the treatment model with medical and psychiatric monitoring forming a baseline. Treatment has to address the symptoms and medical consequences, all while factoring in biological, psychological, interpersonal and cultural forces that massage and exacerbate the eating disorder.
Although treatment is most effective before the disorder metastasizes and becomes chronic, efficacy trials have shown that even men with long-standing eating disorders can and do recover.