Eating Disorder Statistics Prove Men Struggle, Too
David Hodel
Depending on what part of the country you live in, there may be a stigma that surrounds eating disorders if you are male. For one thing, any disorder may be seen as a sign of weakness, and you may have been trained to feel shame in the face of weakness.
Culturally, you may have more awareness of females with eating disorders, movie and media references to “girls who eat their feelings” and the like. Addictive or compulsive behaviors surrounding eating, however, are more common for males than you might think.
Eating Disorder Statistics
You might be surprised by the following eating disorder statistics. From 1999 to 2009, hospitalizations for males with eating disorders rose by 53%. Of men with eating disorders, specific disorders were represented:
- Anorexia Nervosa 25%
- Binge Eating Disorder 36%
- Bulimia Nervosa 25%
Men often suffer from co-occurring conditions such as anxiety, depression, substance disorders, and excessive exercising. Some studies suggest that men face a higher mortality risk around eating disorders. Perhaps most interestingly, behaviors such as binging, taking laxatives, purging and fasting are nearly as common among males as females.
Social standards continue to shift at a dizzying rate, fueled by the ever-present influence of commentary in media and the movies. Men are more body-conscious than they were 40 years ago, and there is no shortage of commercials and depictions on film and television to reinforce the idea that if you don’t look a certain way you’re going to die alone. It is no wonder that the stresses and biology that lead to addiction and compulsion in men would more readily find expression through eating disorders.
What are the Disorders, Specifically?
When thinking about any mental disorder, it is important to take into account the severity of the behavior, compulsivity, and duration. Some eating disorders can be fatal if allowed to proceed unchallenged. As always, if you suspect you may have an eating disorder or any mental disorder, it is important to see a mental health professional for a proper diagnosis. Having said that, here are the eating disorders from the DSM-5:
Pica
Persistent eating of non-nutritive, nonfood substances over a period of at least one month. The eating of nonnutritive, nonfood substances is inappropriate to the developmental level of the individual. The eating behavior is not part of a culturally supported or socially normative practice.
If you eating behavior occurs in the context of another mental disorder (e.g., intellectual disability, autism spectrum disorder, schizophrenia) or medical condition (including pregnancy), it is sufficiently severe to warrant additional clinical attention.
Rumination disorder
Repeated regurgitation of food over a period of at least one month. Regurgitated food and maybe reach you, Reese swallowed or stood out. The repeated regurgitation is not attributable to an associated gastrointestinal or other medical condition.The evening disturbance does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, binge eating disorder, or avoidant/restrictive food intake disorder. If the symptoms occur in the context of another mental disorder (e.g., intellectual disability or another neurodevelopmental disorder), they are sufficiently severe to require additional clinical attention.
Avoidance/Restrictive food intake disorder
An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) is manifested by persistent failure to meet appropriate nutritional and or energy needs associated with one (or more) of the following:
- Significant weight loss (or failure to achieve unexpected weight gain or faltering growth and children)
- Significant nutritional deficiency.
- Dependence on enteral feeding or oral nutritional supplements.
- Mark interference with psychosocial functioning.
The disturbance is not better explained by a lack of available food or by an associate and culturally sanctioned practice. The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced.
The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention.
Anorexia Nervosa
Restriction of energy intake relative to requirements, leading to significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.
Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight. 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 persistent lack of recognition of the seriousness of the current low body weight.
Subtypes:
- Restricting type: This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise.
- Binge-eating/purging type: During the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior (i.e., self induced vomiting or the misuse of laxatives, diuretics, or enemas).
Bulimia Nervosa
Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- Eating, in a discrete period of time (e.g., within any 2-hour period), and amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances.
- 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 behaviors in order to prevent weight gain such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months. Self-evaluation is unduly influenced by body shape and weight. The disturbance does not occur exclusively during episodes of anorexia nervosa.
Binge Eating Disorder
Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- Eating, in a discrete period of time (e.g., within any 2-hour period), and amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances.
- 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.)
The binge eating episodes are associated with three (or more) of the following:
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Eating alone because of feeling embarrassed by how much one is eating
- Feeling disgusted with oneself, depressed, or very guilty afterward
- Marked distress regarding binge eating is present.
- The binge eating occurs, on average, at least once a week for 3 months
As you can see, there are very specific conditions required to qualify as an eating disorder. Many of us might display some of the behaviors described above now and then in response to stress
Eating an entire package of cookies while watching a movie does not necessarily mean you have an eating disorder. You may be behaving addictively around food as a response to stress. If you do it every week and have some of the other symptoms above, it might be worth getting a diagnosis.
Stress Management
If you find yourself behaving addictively around food, and it feels like stress is a contributor, there are some tools you can use to try and reestablish some self-control:
Be Aware
There’s an acronym H.A.L.T. to help remember some of the triggers for addictive behaviors. It stands for Hungry, Angry (or Anxious), Lonely, Tired, and I might throw an S on there for Shame. The first thing we lose when we are busy with external things is our body awareness.
If you are driving home from work, with your mind going 90 miles per hour, you might walk in the door not realizing you are hungry, open the fridge and slam the rest of the birthday cake. Checking in with your body “how do I feel right now” or “what am I feeling right now” can help you realize you’re hungry so you can make a plan for a better food choice.
Another way we become disconnected from our body is when we are angry or anxious. You might have your computer lock up and find yourself standing in the pantry, looking for something yummy to put in your mouth. Or you might hang up on an angry conversation with your spouse and want to eat a cheesecake whole out of the freezer.
If you can remember to check in when you are activated like that “wow, I’m really angry” or “okay, I feel like putting my fist through the wall” you can interrupt the reactive trip to the pantry, and hopefully use deep breathing and mindfulness techniques (see below) to calm yourself before making any food choices.
Loneliness can be a real trigger, especially late at night if we live alone or are alone for the evening. In the quiet, we come up against the feelings of loss and pain that we might have been able to ignore during the busyness of the day. Distractions (like T.V., reading, listening to music) may help for a bit, but know that your addiction is out on the lawn doing pushups, just waiting for you to open the door again.
Lastly, when we are tired, our resources are diminished and we have less capacity to make wise choices that go against our reactive impulses. If you are driving home exhausted, notice that and make a plan to be purposeful about your eating, rather than going in unprepared, and grabbing the first thing that looks good.
Deep Breathing
Anxiety and anger manifest almost identically in the body. I like to use the example of walking into a dimly lit room in the basement and seeing a snake on the floor. Suddenly, your adrenaline is pumping, cortisol (stress hormone) coursing through your brain, and in a fraction of a second you decide whether you are going to kill the snake or run from it (fight/flight) unless you freeze
Imagine now, in the next moment, you realize the thing coiled on the floor is not a snake, but a rope. What’s the first thing you do? Take a deep breath and let it out. This is your body telling your parasympathetic nervous system that it’s okay to calm down.When you feel stress, sit somewhere quiet, put your feet on the floor, eyes closed, and notice your breathing as you take several comfortable breaths. Start applying a count to it, breathing in for a slow count of three, holding it for three seconds, then breathing out on a three count, all using your diaphragm.
Put your hand on your tummy if necessary to be sure you’re hand is going out and in as you use your diaphragm. Do this for 5 to 10 minutes and check in to see how you are feeling.
Mindfulness
With this technique, you are trying to notice what you are feeling in your body and where it is, and locate yourself in the here and now. Using the breathing described above, repeat to yourself that the past is the past – it’s not happening now, and the future is not written – it’s not happening now.
All you have is now and now is enough. Try saying, “at this moment, I don’t have anywhere else to be, I don’t have anything else to do, and I have no one I’m responsible for.” Do this for 5 or 10 minutes and check in to see how you’re doing.
Closing Thought
Eating is one of the first actions we take as newborns that provides us comfort, so it is no surprise it is one of the first areas impacted when we are stressed. If you feel out of control around your eating, call a mental health professional and set up an appointment. A proper diagnosis is the first step in your journey toward health and renewed self-control.
“Jogging,” courtesy of Valerie Everett, Flickr Creative Commons, CC BY-SA 2.0; “Frustrated,” courtesy of Tim Gouw, unsplash.com, CC0 License; “Got a Problem?” courtesy of Bruloos, Pixabay.com, CC0 Public Domain License; “Walking Away,” courtesy of Tamar Willoughby, pexels.com, CC0 License