Male eating disorders: Misunderstood, unrecognised and undiagnosed

Eating disorders awareness week 2021 (EDAW) takes place next week (Monday 1st March - Sunday 7th March). Here at S.E.E.D, we want to help raise awareness about eating disorders, particularly the fact that there is not one particular ‘look’ for someone who has an eating disorder and that anyone, regardless of gender or anything else can reach out for help.

Eating disorders are typically thought to be a gendered psychiatric illness, and oftentimes the word “eating disorder” evokes a stereotypical image of a young underweight female. It may come as a surprise that eating disorders have presented in male patients for as long as they have in female patients. While in previous years it had long been believed that men did not experience eating disorders, clinical data across several countries during the 1970’s and 1980’s began to present a number of male patients seeking help from specialist eating disorder clinics, consequently forcing professionals to reconsider the notion that eating disorders are a female-exclusive issue.

In the 1990’s, further research highlighted that, in fact, men account for approximately 10% of eating disorders[1]. However, emerging evidence from recent years argues that this number is likely to be underestimated for two main reasons: males tend to be more reluctant to seek help, and research does not reliably capture male eating disorder experiences (as research has only recently gathered attention)[2&3]

Despite this, some data suggests that 0.3% of males are diagnosed with anorexia nervosa, 0.5% have bulimia nervosa, and 2.0% of males have binge eating disorder. Among these estimates, it is thought that approximately 40% of patients with binge eating disorder are male[2].

While emerging evidence has established that eating disorders are not gender-exclusive, is it possible for eating disorders to present differently in males and females? Taking the history of eating disorder research into consideration, it is important to acknowledge that the possibility of biological differences have largely been informed by research that uses a majority female sample.

That being said, data has suggested that males with eating disorders present greater psychiatric comorbidity (such as substance abuse, suicidal behaviours, anxiety, and depression[1]). Moreover, a significant difference between males and females is that males tend to engage in compensatory behaviours, such as compulsive exercise, which is likely to be influenced by athletic achievement (rather than a desire for thinness) which corresponds to the societal view of the ideal masculine body[4]. With respect to binge eating disorders, there is a possibility for differences in perception of what constitutes as a “binge”. While men may be more likely to report eating large amounts of food in a single sitting, they are less likely to report loss of control or feelings of distress.

There is myriad of reasons why male eating disorders receive significantly less attention than female eating disorders. For instance, previous variations of the Diagnostic Statistical Manual of Mental Disorders (e.g. the DSM-IV, which was published in 1994) presented gender-biased diagnostic criteria, which made it difficult to recognise eating disorders in males during this time[2]. Consequently, eating disorders are often viewed through a female lens, which arguably contributes to bias in healthcare professionals (alongside family and friends) and the treatment of eating disorder behaviours in male patients. Additionally, men may be less likely to seek help for their eating disorder due to fear of the stigma and isolation associated with an illness which is heavily perceived to be ‘female’[2&4]. While it is certainly possible for males to receive successful treatment in female-orientated environments, males have unique physical, social, and emotional needs, which includes the consideration of masculine identity[3].

Eating disorders in males continue to be largely misunderstood, unrecognised, and undiagnosed. Sadly, eating disorders have the highest morality rates of any other psychiatric illness, and some studies suggest that this risk is higher in males than females. During these trying times, it is more important than ever that men’s mental health is not overlooked.

As a way to raise more awareness on this pressing issue, Neil Procter, one of the founders of Old Knackers Football Club, who has previously done a football fundraiser for S.E.E.D, will be going live on S.E.E.D’s Instagram with our ambassador, April Banbury, to discuss his own experiences with eating disorder recovery, stigma, and more. Join in on this discussion on Thursday 4th March at 7pm, to find out more information on how you can help to break the stigma against male eating disorders. To visit S.E.E.D’s Instagram page, click here.

Sources:

Murray, S.B., Nagata, J.M., Griffiths, S., Calzo, J.P., Brown, T.A., Mitchison, D., Blashill, A.J. and Mond, J.M., 2017. The enigma of male eating disorders: A critical review and synthesis. Clinical psychology review, 57, pp.1-11. https://www.verywellmind.com/male-eating-disorders-4140606 Robinson, K.J., Mountford, V.A. and Sperlinger, D.J., 2013. Being men with eating disorders: perspectives of male eating disorder service-users. Journal of Health Psychology, 18(2), pp.176-186. Strother, E., Lemberg, R., Stanford, S.C. and Turberville, D., 2012. Eating disorders in men: underdiagnosed, undertreated, and misunderstood. Eating disorders, 20(5), pp.346-355.

This article was written by Ellie Tkocz, one of our lovely marketing volunteers!

If you are struggling, reach out.  Remember that you are not alone in your journey to recovery, we are here to help. Click here to book a free 20-minute consultation with a member of our team to find out how we can help you take action.