(NEW YORK) — Of the estimated 30 million people in the United States with eating disorders, about 10 million of them are men, according to the National Eating Disorders Association. Despite this, many residential treatment facilities don’t accept men, and the male diagnosis isn’t always on doctors’ radars.
The first symptom of anorexia listed on the American Psychiatric Association’s website is “menstrual periods cease,” illustrating the medical community’s predisposition to treat anorexia as a disease that affects only women.
According to Cynthia Bulik, who directs the University of North Carolina Center of Excellence for Eating Disorders, men with eating disorders face extra hurdles because doctors don’t think to diagnose them properly to begin with. They’re also ashamed because there’s a misconception that eating disorders are women’s diseases, and that they are more prevalent among gay men.
“Eating disorders really don’t care what your sexual orientation is,” Bulik said.
Bulik said she once had a male patient whose mother brought him to a pediatrician because she thought he had an eating disorder, but the pediatrician told her that was impossible because “boys don’t get eating disorders.” So the doctor gave the boy a battery of tests to find a rare disease he didn’t have.
Texas therapist Jacquelyn Ekern said many of her male patients fell into anorexia or bulimia after sports — such as wrestling — pushed them to be a certain weight in a hurry. The men who develop eating disorders after crash dieting also have underlying psychological factors that predispose them toward eating disorders, such as depression, anxiety or having a parent with an eating disorder.
To make matters worse, men are less likely to seek help once they realize they have a problem, said Dr. Vicki Berkus, who directs Eating Disorder Programs for CRC Health Group.
“I think for males it’s that males don’t talk about feeling dizzy,” Berkus said. “That old ‘pull yourself up by the bootstraps, real men don’t have issues,’ which is totally false.” It also tends to be easier for men to hide the physical symptoms of their anorexia, due to baggier clothes and difference in body type.
Even if they are correctly diagnosed and choose to seek treatment, men with eating disorders face additional challenges. Many treatment facilities only accept women. If Victor Avon, a recovered anorexic and spokesman for the National Eating Disorders Association, hadn’t found the Center for Eating Disorders Care at University Medical Center of Princeton, an hour from his home in New Jersey, he would have had to travel to Colorado, Utah or Nevada to find a place that accepted him.
Bulik said the latest Diagnostic and Statistical Manual published by the American Psychiatric Association this spring is expected to exclude the missing menstrual cycle from its anorexia description. That’s a step toward destroying the misconception that only women can get it.
“This is not something that is rare,” she said. “I think we need to get past the misperception that this is something that’s rare, because it does a huge disservice to boys and men.”
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