When you hear the words "eating disorder," do you think of a male or female? Chances are, the majority of us picture a female. But researchers say the assumption that eating disorders only affect women is preventing men with such disorders from receiving the help and support they need.
There is no doubt that eating disorders, such as bulimia and anorexia nervosa, are more common among women. According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), an estimated 10-15% of Americans with eating disorders are male.
However, the researchers of this most recent study, including Ulla Räisänen of the University of Oxford in the UK, say that because there is poor recognition of symptoms of eating disorders in men, such estimates are likely to be higher.
To reach their findings, recently published in BMJ Open, the researchers interviewed 39 individuals between the ages of 16 and 25 years, of which 10 were men.
All participants had suffered some form of eating disorder and were asked about their experiences of the condition. The research team focused on men's responses only.
From the surveys, the research team identified four themes:
- Recognition of early signs and symptoms
- Recognition of the problem
- Getting help, and
- Initial contact with health care and support services.
'Men with eating disorders are underdiagnosed, undertreated and under-researched'
Symptoms of eating disorders in the surveyed men included going for days without eating, purging and obsessive calorie counting, exercise and weighing. However, all of these men took a long time - months and even years - to realize that these behaviors could be associated with eating disorders.
The assumption that eating disorders only affected women was reported as the main reason as to why men took so long to realize they had symptoms of the disorders themselves.
Researchers found that men with eating disorders took a long time to recognize they had symptoms of the condition, mainly because they thought it only affected women.
The researchers report that one man said he thought eating disorders only affected "fragile teenage girls." Another man said eating disorders were "something girls got."
For many of the men, it took a "crisis point," such as an emergency hospital admission, to make them realize they had an eating disorder.
Some of the men said they delayed seeking help for their condition because they thought they would not be taken seriously by health care professionals or they were unaware of where to go for help.
When the men did seek help for their eating disorders, they reported mixed experiences. Some of the men said their experience was positive and they felt their doctor was helpful.
However, many of the men said they had to visit their doctor several times before they were taken seriously.
One participant said his doctor told him he was "going through a teenage fad." Another man was told by a gastroenterologist, after experiencing severe weight loss and vomiting, that his problems were not physical. But instead of being referred to a psychologist, the gastroenterologist told him to "man up" and "not be weak but be strong and deal with the problem."
Commenting on their findings, the research team says:
"Men with eating disorders are underdiagnosed, undertreated and under-researched.
Our findings suggest that men may experience particular problems in recognizing that they may have an eating disorder as a result of the continuing cultural construction of eating disorders as uniquely or predominantly a female problem."
Recognizing early symptoms is key
According to the researchers, early detection of eating disorders in men is required to ensure prognosis is improved.
They note that primary care clinicians are key in recognizing early symptoms of eating disorders in men, and increasing awareness of such disorders in society is "crucial" to ensuring both men and women receive help and support before their symptoms become unmanageable.
"It is important to decouple the experience and (self-)management of eating disorders from feminized cultural imagery, resources and clinical practice if we wish to prevent men from (dis)missing signs and symptoms themselves, and prevent health and other professionals (e.g., teachers) from overlooking signs and symptoms in boys and young men that they may readily recognize as indicative of eating disorders in young women," they conclude.
However, the researchers note that their study does have some limitations.
For example, although the men surveyed openly spoke about their experiences with eating disorders, the participants were aged between 16 and 25. Therefore, the research does not provide an understanding of older men who have eating disorders. The team says this is something that needs to be explored further.
Earlier this year, Medical News Today reported on research showing that it is not only teenage girls who have body image pressures. The study found that teenage boys who think they are underweight are more likely to be depressed than other boys - even those who think they are overweight.