You may not know that your son is quietly trying to manage an eating disorder on his own. Yes, boys and men having eating disorders too. Most commonly associated with girls and women, boys are developing Anorexia, Bulimia, Binge Eating Disorder, Avoidant/Restrictive Food Intake Disorder and Rumination Disorder now, at alarming rates. A conservative estimate may be one in ten guys are struggling with body image and disordered eating issues. Images in the media and a weight and image-obsessed culture has contributed to anxiety about weight for boys and young men. Both genders may try to alter their body towards some 'ideal' as they perceive it, and of course body image is not always the main contributing factor for individuals with an eating disorder. It's a complex problem. We know that ED's are complicated and not an easy fix -- it is likely a mix of genetics and environment that play a role in developing and maintaining the eating disorder. Many of the underlying issues that contribute to an eating disorder including low self esteem, depression, feeling of loss of control, trauma, abuse, identity concerns, inability to cope with emotions and family communication problems -- pretty much the same for both men and women. Gone are the days where we blame mom for the problem, however parents do model behaviors for kids, and dynamics and patterns become part of the family system and overall landscape that can serve to reinforce the disorder.
Identifying the signs of anorexia in males of any age are similar to those in females, except it often looks different with males. A guy may focus on rock hard abs or athletics as examples. Often boys will exhibit withdrawal, social isolation and avoidance, whereas girls may boast about their diet successes -- but not always. Doctors often miss the signs that a boy or adolescent/young man is struggling with eating issues and a disordered self-image, which sadly, delays detection and treatment. Males also feel ashamed about having something that is typically considered a "female issue" and are less likely to ask for help. If you are concerned about someone, here are some of the key signs to look out for:
- picky eating that may begin very early
- perfectionism in many areas of life
- preoccupation with food or calories
- fears or concern about gaining weight
- frequent body checking
- body avoidance
- distorted body image
- obsessive exercise
- exercising when sick or injured
- stress and anxiety about missed workouts
- possible conflicts over sexual orientation or gender identity
- lowered testosterone
There are many different ways to treat an eating disorder including relational and interpersonal psychotherapy, CBT, DBT, Mindfulness and group support. It is critical to stop the symptoms and behaviors first, then explore the many feelings and emotions that get expressed through the symptoms. Individuals with ED's need to be assessed for the possibility of needing a higher level of care. People with eating disorders must be medically stable first and this involves a treatment team such as a GP and nutritionist on board. Missing the signs and delaying treatment for an eating disorder can lead to complex health implications. The longer one is symptomatic, the more entrenched the problem behaviors become. In the worst case scenario anorexia and bulimia can be fatal and has the highest mortality rate of all mental illnesses.
The struggle can be so quiet -- yet deadly. Helping eating disordered individuals find a language with the therapist and to remember the forgotten or dissociated "parts" of them (that they are more than their symptoms) is a longer-term goal of successful ED recovery.
Read this helpful information on eating disorders in boys and men:
National Eating Disorders Association or NEDA
MaudsleyParents.org is a family based treatment for eating disorders