“Many treatment centers and the public at large don’t have the knowledge or resources for male eating disorder treatment,” says Troy Roness, writer and advocate who, in 2009, recovered from an 11-year life-threatening addiction to exercise, anorexia and Body Dysmorphic Disorder. He now works with The National Eating Disorders Association (NEDA), the UK’s Men Get Eating Disorders Too (MGEDT) and Eating Disorders Coalition (EDC) North Dakota. “I don’t believe treatment centers and professionals are unwilling to address men who struggle; after all, statistics for men—and all populations—are rising, unfortunately. There simply isn’t enough research on the different approaches in treating men versus women, and much of the eating disorder criteria are female-oriented.”
That said, centers are starting to see more male admits as awareness increases.
“It is becoming less ‘taboo’ to be a male struggling with an eating disorder,”says Jennifer Lentzke, Director of Nutritional Services at Rosewood Centers for Eating Disorders. “We find that men are feeling more supported by their peers and the ED community, as well as the general population.”
It is more common for eating disorder treatment centers at lower levels of care (partial hospitalization, intensive outpatient and outpatient levels of care) to provide treatment for both men and women. By Lentzke’s estimates, there are only a handful of treatment centers in the country that provide inpatient and residential treatment for males.
“We find that men tend to take a more ‘self-sufficient’ approach, adding to the issue of them not seeking treatment,” Lentzke adds. “Hence, most eating disorder centers cater to the female ED population, as the centers are more likely to receive and obtain viable admits.”
There are several organizations dedicated solely to males and eating disorders, including The National Association of Males with Eating Disorders (NAMED) and Men Get Eating Disorders Too (MGEDT), as well as many others that provide screenings, information and essential resources like The National Eating Disorders Association (NEDA), MentorConnect and The National Association of Anorexia Nervosa and Associated Disorders (ANAD).
There are also some treatment centers that offer co-ed programming and male-only programming, including Rogers Memorial Hospital, McCallum Place, Canopy Cove and The Center for Eating Disorders at Sheppard Pratt.
“We have to remember that the control of food, exercise and other eating disordered behaviors are merely that—behaviors,”Roness says. “They are the symptoms of much deeper substantial trauma.”
And the truth is that this trauma can and does affect people of all genders.
“I would love to see people think of this illness as the deadly, life-threatening illness that it is, instead of vanity illnesses that only skinny white girls from affluent families get,” Colin says. “Developing an eating disorder is often due to having a genetic predisposition. This disorder is not one somebody chooses to develop. They are not mere diets. They are serious and deadly illnesses.”
“I would love to see people think of this illness as the deadly, life-threatening illness that it is, instead of vanity illnesses that only skinny white girls from affluent families get.” —Colin
A Daily Struggle
Colin is five years into his recovery journey, with almost three years of what he calls “reasonably solid recovery.”
“I committed to showing up for work: I kept all of my appointments with my therapist and dietitian, no matter how much I didn’t want to,” Colin says. “Even if I was feeling unmotivated to recover that week, or I was struggling in my eating disorder, I committed to at least show up to those appointments. I attended weekly therapy groups. I made it a priority in my day to take time from work to attend these appointments.”
When he was admitted to ERC, he had to give complete control to his treatment team and start re-feeding immediately.
“Emotionally, I was a mess—I felt like I was betraying myself by eating,” he remembers. “I felt as if I lost all control over my body. I had panic attacks, and hyperventilated at the table at one point. It wasn’t uncommon for me to curl up into a ball and sob after eating, or after being required to drink a boost because I did not complete a meal.”
There are myriad psychological studies demonstrating that eating disorders are not a vanity phase people can recognize and simply switch off—even if they realize that those behaviors are causing problems. What Colin needed is called “symptom interruption,” so his brain could recover and learn new behavioral patterns.
“I don’t think a lot of people in the general public believe that eating disorders are medical illnesses caused by brain dysfunction,” Dr. Lutter says. “Brain imaging studies show that people with eating disorders have impaired functioning of regions of the brain involved in habit learning or behavioral adaptability. Essentially, eating disorders cause people to ‘lock in’ their old behavioral patterns even when they are no longer helpful.”
And those old behaviors, even when subdued, can and do come back.
“At some point, it became obvious that my eating disorder is not happy about any of it, and it started to fight back,” Andy says. “The retaliation and consequent continuous battles can be scary and really damn hard, like waging an internal cold war with myself.”
This difficulty is not uncommon, no matter how determined someone might be.
“Understand that, even if [somebody is] fully committed to getting better, eating disorders are vicious mental health disorders and the relapse rate is generally quite high, making them hard to fully treat in the short amount of time [60 to 90 days] that they are at the Center,” Lentzke notes.
The important thing is to try and keep trying with professional help.
What You Can Do
The good news is that help is becoming evermore readily available to men suffering in silence. As awareness around male eating disorders increases, so does research. With research comes solutions. So, if you or someone you know is or may be suffering, follow these steps and seek help.
1. Be aware of signs.
One of the first signs that eating has become an issue for someone is when he or she becomes rigid and inflexible around meals, according to Dr. Lutter. This is because eating is a highly social process, and most people are able to adjust their schedules around meals in order to be with family and friends.
Patients who binge also tend to be secretive about eating because of the shame they experience when they can’t control it. If people start to isolate themselves, eat meals alone or avoid restaurants and foods that they haven’t prepared themselves, there may be cause for concern.
Also, be aware that weight fluctuation isn’t always an obvious sign that someone is suffering.
“People can be healthy at a wide range of different shapes and sizes and weight loss does not necessarily improve your health,” says Dr. Alexis Conason, a psychologist and author of the chapter “The Influence of Dieting (Hedonic Deprivation) on Food Intake: How it Can Promote Hedonic Overeating and Mindful Eating Interventions” in Hedonic Eating. She’s also the author of the Eating Mindfully blog on Psychology Today.
2. Encourage mindful eating over disordered eating.
Contrasting hedonic starvation (anorexia) with mindful eating, Dr. Conason says, is talking about the difference between illness and wellness.
“Mindful eating is a way to help people nurture their body by eating in ways that are attuned to our internal signals of hunger, fullness and satiety,” she adds. “Understand[ing] what it is that we truly want in a way that is not possible when we are trapped in the dieting mentality.”
3. Seek professional help if you or someone you know does feel trapped.
“As hard as it is to leave your job or school behind, it is absolutely the right decision to seek treatment,” Colin says. “You can always return to work or school, but you can’t get your life back from an eating disorder if you don’t take time away to get help and take care of yourself. You are not less of a man because you struggle with an eating disorder. You’re definitely NOT less of a man for seeking treatment. In the end, being willing to address the tough issues will give you a life you never thought you could have.”
You can reach out to the Eating Recovery Center by visiting their website and scheduling a free consultation here or by dialing 877-789-5758 to talk to a clinician.
Illustrations: Ben Jervis