“Body dysmorphic disorder is a chronic mental illness, wherein the afflicted individual is concerned with body image, manifested as excessive concern about and preoccupation with a perceived defect of their physical appearance. An individual with BDD has perpetual negative thoughts about their appearance.” – Hunt, T.J., Thienhaus, O., & Ellwood, The mirror lies: body dysmorphic disorder, 2008
“Men have anorexia. Men have bulimia. Both are just as life threatening for men as they are for women. There are specific challenges in identifying and treating men for eating disorders, but the biggest challenge is getting men to admit they have a problem because they do not recognize the behavior or understand how much damage it can do,” said Leigh Cohn. Cohn is a writer and publisher of several books about eating disorders.
Eating disorders in men are multi-dimensional, the result of genetic factors, peer pressure, family issues, cultural messages, and possible trauma such as the death or serious illness of the father, according to Cohn.
“The incidence is higher in gay males, but we are seeing eating disorders cross the cultural line into the straight population,” Cohn said.
The drivers for men’s eating disorders are similar to those for women: an unrealistic ideal in body type, coupled with the notion that looking right will bring success in unrelated areas such as getting a good job and finding the right partner. This is tied to the cultural notion that men need to be in control, an impulse displaced onto the bodies of those with eating disorders. Some sports such as wrestling, boxing, and horse racing foster behaviors of eating disorders due to strict weight restrictions.
The National Institute of Mental Health (NIMH) reports on eating disorders such as anorexia, bulimia, and binge eating among men.
Brian Cuban discussed his own eating disorder, which was coupled with drug and alcohol use that pushed him to a very dangerous bottom.
“I probably became anorexic and bulimic when I was a freshman at Penn State. When I was young, I was heavy and my mother used fat-shaming behaviors. I was the victim of a weight-related assault in junior high school when I was stripped of my pants on a public street and forced to walk home in my underwear. No one helped. I was brought very low by substance abuse but was able to recover with help from my family. However, I still could not admit to the eating disorders. In fact, I first admitted my behavior on a blog before I was able to talk about it with my psychiatrist and my family. I really thought I was the only man out there with this. Then I Googled it and found some message boards: I was not the only one! Writing the blog was my coming out.”
“People should remember that words do damage,” Cuban continued. “It was when I understood how my mother was raised that I was able to forgive her and understand my body issue, my body dysmorphia.” The use of social media and connecting with other men impacted by eating disorders virtually has begun to embolden advocates seeking more nuanced treatment options to overcome discrimination associated with these disorders.
Cohn notes that treating males with eating disorders may require a unique approach.
“One of the biggest challenges is getting men to show up. Men are unaware they are engaging in odd behaviors such as excessive exercise without enough nutrition. There is also co-morbidity with alcohol abuse, getting calories from alcohol. But once a male enters treatment, they can be the better patients because they want to fix things. ‘Explain it to me, and I will work on it’ is how they approach it. Once they get past the stigma, they can get better,” Cohn said.
“Eventually there won’t be a stigma for male eating disorders, same as for females now. There are excellent information resources out there, including the National Eating Disorders Association. Things are slow to change.”
This article was originally published to highlight the June 2014 theme of Men's Behavioral Health.
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