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Do men get eating disorders?

Males and eating disorders.

Do Men Get Eating Disorders?

Some Basic Facts and Findings:men with eating disorders

Approximately 7-10 million women across the country suffer from eating disorders. Most research into these serious disorders has been conducted on females. However, as many as a million men may also struggle with the diseases!

Eating disorders include extreme attitudes, emotions and behaviors surrounding both food and weight issues. They include anorexia nervosa, bulimia nervosa, and binge eating disorder. All are serious emotional and physical problems that can have devastating effects and life-threatening consequences. Eating disorders affect both men and women. While eating disorders are less common in men, approximately 10% of those suffering from eating disorders are male (Wolf, 1991). Studies also demonstrate that cultural and media pressures on men for the "ideal body" are the rise. This increased focus on body shape, size and physical appearance will likely contribute to increased numbers of eating disorder in males. Research indicates that eating disorders in males are clinically similar to eating disorders in females (Schneider & Argas, 1987).

Studies also demonstrate that certain athletic activities appear to put males at risk for developing eating disorders. Body builders, wrestlers, dancers, swimmers, runners, rowers, gymnasts and jockeys are prone to eating disorder due to the weigh restrictions necessitated by their sports (Andersen, Bartlett, Morgan & Rowena, 1995).
Body image concerns appear to be one the strongest variables in predicting eating disorders in males. Studies have demonstrated (Wertheim et al, 1992) that the drive for thinness was a more important predictor of weight loss behaviors than psychological and/or family variables (this desire was true of both adolescent males and females).

Other studies have found that men with eating disorders tend to have more passive-aggressive personality styles and have had negative reactions to their bodies from their peers while growing up. Research also indicates that anorexic males tend to have more dependent and avoidant personalities. Males with anorexia do not tend conform to the cultural expectations for masculinity such as: to be competitiveness, muscularity/strength, physical aggressiveness, independence and competence in athletics (Kearney-Cooke & Steichen-Asch, 1990).

We are learning more about the etiology of eating disorders in males every day. There is so much more to learn. It is important to remember that the devastating effects of eating disorders cross gender lines and severely impact the health and well-being of both men and women. Further, it is important that those suffering seek help!
Anorexia Nervosa in Males: Anorexia is a life-threatening disorder that is characterized by self-starvation and excessive weight loss.

Some Symptoms include:

Food rituals
Compulsive exercise and/or preoccupation with body mass, muscles, etc.
Preoccupation with food
Refusal to maintain body weight at or above a minimally normal weight for age, height, body type, and activity level
Intense fear of gaining weight or becoming fat, even though underweight
Disturbance in the way in which one's body weight or shape is experienced
Undue influence of body weight or shape on self-evaluation, or denial of the seriousness of current low body weight
Lying about eating or difficulty eating around others
Depression, isolation, loneliness
Unrealistic and perfectionistic standards
Difficulty expressing feelings
Low self-esteem
Need for control
Possible sexual orientation and gender identity issues
Decreased interest in sex, anxiety surrounding sexual activity
Fatigue and muscle weakness
Low blood pressure and body temperature
Thinning hair or hair loss, lanugo
Heart arrhythmia and electrolyte disturbances

Bulimia Nervosa is characterized by a highly secretive cycle of binge eating followed by purging. Bulimia includes eating large amounts of food (more than most people would eat in a meal) in a short period, then getting rid of the food and calories through vomiting, excessive exercise, or laxative abuse.
Some Symptoms include:
Recurrent episodes of binge eating
A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise
Self-evaluation is unduly influenced by body shape and weight
Preoccupation with food
Hoarding, hiding, stealing food
Fear of gaining weight or becoming fat
Depression, isolation and loneliness
Difficulty expressing feelings
Possible sexual orientation and gender identity issues
Low self-esteem
Perfectionistic standards
Weight Fluctuations
Dental problems
Electrolyte imbalances

Compulsive Overeating is characterized by periods of uncontrolled, impulsive or continuous eating beyond the point of feeling full. While there is no purging, there may be fasts or repetitive diet attempts. Often there are feelings of shame and self-hatred after a binge.
Some Symptoms include:
Recurrent episodes of binge eating
Hoarding, hiding, stealing food
Eating rapidly and/or eating until uncomfortably full
Consuming large amount of food when not hungry
Body weight fluctuations
Depression, anxiety, and loneliness
Low self-esteem
Perfectionistic standards
Difficulty expressing feelings
Negative attention received about their body while growing up
Feelings of guilt and shame during and/or after a binge episode
Binge eating used to numb feelings, relieve tension, deal with anger, depression and other emotional states
Problems with heart and blood pressure and/or blood sugar problems
Joint problems

Other eating disorders may include some combination of signs and symptoms of anorexia, bulimia, and/or compulsive overeating. These behaviors may not meet the clinical criteria of an "eating disorder"; however, they can still be extremely dangerous physically and psychologically. All forms of eating disorders require professional help.

The National Association for Males with Eating Disorders, Inc.: www.namedinc.org

Andersen, R.E., et al. (1995). Weight loss, psychological and nutritional patterns in competitive male body builders. International Journal of Eating Disorders, 18, 49-57.
Andersen, ROE. (1995). Eating Disorders in Males. In K. Brownell, K. & Fairburn, C.G., (Eds.), Eating Disorders and Obesity: A comprehensive Handbook. New York: Guilford Publications, Inc.
Dept. of Health and Human Services (1987, 1995). Anorexia Nervosa and Bulimia.
Eating Disorder Awareness and Prevention, EDAP (1998). www, edap.org, Males and Eating Disorders.
Kearney-Cooke, A., & Steichen-Asch, P. (1990). Men, Body Image, and Eating Disorders. In A. Andersen (Ed.), Males with eating disorders (p. 47 New York: Brunner/Mazel.
Schneider, J.A., & Agras, W.S. (1987). Bulimia in males: A matched comparison with females. International Journal of Eating Disorders, 6, 235-242.
Shiltz, T. (1997). Eating Concerns Support Group Curriculum. Greenfield, WI: Community Recovery Press.
Wertheim, E.H. et al. (1992). Psychosocial predictors of weight loss behaviors and binge eating in adolescent girls and boys. International Journal of Eating Disorders, 12, 151-160.
Wolf, N. (1991). The beauty myth. New York: William Morrow.

An article about a man with an eating disorder: As Madison man's death shows, eating disorders aren't limited to women.

Becky Briles, of Madison, with her husband, David, pages through a journal kept by their son, Max, who died in October after struggling with anorexia nervosa, an eating disorder. The couple tried to get Max, 26, to go to an eating disorders group, but "he thought he'd be the only guy there," David Briles said.
On one of the last nights before he died, Max Briles treated himself to part of a cucumber.

He figured it had 20 calories, which would keep his total below 1,000 for the day, less than half of what health officials say an adult male should eat.

“It did seem to increase water weight, but it was totally worth it,” Briles wrote in his journal.

Briles, 26, of Madison, died in October, at least in part from anorexia nervosa, an eating disorder in which people starve themselves because they fear gaining weight even though they are thin.

His parents encouraged him to get treatment, but he refused.

“I’ll be the only guy,” he said, according to his mother, Becky Briles.

Anorexia and other eating disorders, often perceived as female conditions, also affect men, said Dr. Brad Smith, medical director of eating disorder services at Rogers Memorial Hospital, a behavioral health care system based in Oconomowoc.

Men are more reluctant than women to discuss any kind of mental health problem, but the challenge is even greater with eating disorders because they are characterized as female, Smith said.

“It adds to the stigma for a man or boy to come forward,” he said. “If a man does seek treatment, his introduction to treatment services may be in a setting where he is the only male.”

Rogers has an eating disorders program designed for men, but some programs around the country accept only women, Smith said.

About 25 percent of people with anorexia and bulimia are male, as are about 36 percent of those with binge eating disorder, according to the National Eating Disorders Association. Binge eating disorder involves eating large quantities of food recurrently, while bulimia is defined by binging and purging through vomiting, fasting or exercise.

The estimates of men with eating disorders are likely low, Smith said. One reason is that questionnaires used to diagnose anorexia focus on attaining a certain weight or size of clothes, expectations that resonate more with women than men, he said.

With men, “there’s more of a concern about the percentage of body fat,” he said.

Gay men, and men who do sports that require weight control, such as wrestling and boxing, are somewhat more prone to eating disorders than other men, Smith said.

Men and women with anorexia face similar physical complications, such as irregular heartbeats and digestive problems, Smith said. Men often see a reduction in sex drive because their testosterone levels drop.

The message for anyone with an eating disorder is the same, regardless of gender, Smith said: “Treatment is available, and the earlier we can get people into treatment, the more likely they can have success.”

Becky Briles found her son dead in his home Oct. 11, after she and her husband, David, had been out of town a couple of days.

Despite his struggle with anorexia, anxiety and depression, Max Briles was a talented musician who enjoyed playing guitar, said his parents, Becky and David Briles. "He was smart and so kind, such a little Buddha," Becky Briles said.

Max lived about a mile from his parents’ house on Madison’s West Side.

An investigator from the Dane County Medical Examiner’s Office told the family Max died a few days earlier, perhaps on Oct. 6.

An autopsy found that he had heart damage typical of anorexia, Becky and David Briles said.

At 5 feet 7 inches, Max weighed just under 100 pounds. It’s possible drug use may have contributed to his death; toxicology results, and the official cause of death, are pending.

The Brileses agreed to talk about their son’s struggle with anorexia to raise awareness about eating disorders in men. Even though Max didn’t seek help for his condition, he acknowledged he had it and was frustrated that most information about it focused on women, they said.

He was a “self-proclaimed anorexic,” obsessed with whether he looked fat and fixated on calorie intake and digestion, Becky Briles said.

“He could tell you off the top of his head how many calories are in a spoonful of this or that,” David Briles said.

“He had to know where the food was in his body,” his father said. “If it was still in his stomach, but it should have been moving down to his small intestine, we’d get a phone call. He’d say, ‘Something is wrong.’”

‘It’s prison’
After a seemingly happy early childhood, Max developed facial and vocal tics in third or fourth grade. His parents, Madison School District teachers who are now retired, sought help.

Max was diagnosed with anxiety and later with depression. Despite therapy and medications, he acted out in school and was expelled.

He graduated in 2008 from Shabazz City High School, a Madison alternative school.

Afterward, he had a hard time finding his way, his parents said. He got jobs at a grocery store, a pet store, a pizza restaurant and a delivery service, but he promptly quit them or was fired because he couldn’t abide by rules such as reporting to work at a certain time.

He lived in an apartment but couldn’t adjust to people’s noise, the Brileses said.

In 2012, he went on disability, for anxiety and depression, conditions for which he was being treated. A year later, his parents bought him a small house.

Max became preoccupied by food and his weight. He wrote daily calorie allowances on his arms. He limited himself at times to pinto beans, Jell-O and lettuce. When cooking, he had to use a particular measuring cup because he thought other cups were inaccurate.

He did push-ups and crunches over and over again, and lifted small amounts of weight in repetition, in order to become stronger but not larger, his father said.

David Briles realized the extent of the problem in 2012, on a road trip with Max up the California and Oregon coast.

Max refused to eat in restaurants, insisting that they buy cereal, soy milk and fruit from grocery stores and eat in their hotel rooms.

*We cannot diagnose or treat eating disorders by email, but we can send you information and assist you in finding resources. Information provided by the Eating Disorder Referral and Information Center is not a substitute for medical treatment or psychological care.  It is vital that you talk with your physician and a qualified mental health professional regarding eating disorder symptoms and treatment.

We cannot diagnose or treat eating disorders by email, but we can send you information and assist you in finding resources. Information provided by the Eating Disorder Referral and Information Center is not a substitute for medical treatment or psychological care. It is vital that you talk with your physician and a qualified mental health professional regarding eating disorder symptoms and treatment.

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