Boys and Men
Eating disorders are serious mental health illnesses. They are not a phase, a diet gone too far, a cry for attention or a "lifestyle choice". They can occur at any point across the lifespan, across gender, socio-economic levels and all major ethnic groups.
Statistics for Boys and Men
Approximately 1 million Australians are living with an eating disorder, that is 4% of the population. It is difficult to say exactly how many of these individuals are boys and men however our current best estimates suggest that of those diagnosed with an eating disorder males account for the following percentages:
Anorexia Nervosa 17%
Bulimia Nervosa 31%
Binge Eating Disorder 43%
Whilst the current rates of diagnosed eating disorders are lower amongst males than females, the rates of disordered eating behaviours (such as binge eating, purging, laxative abuse, and fasting for weight loss) and of subclinical disorders (where the person meets some but not all of the diagnostic criteria), are nearly as common among men as they are among women.
In addition, men are more often affected by muscle dysmorphia and muscularity-oriented eating issues. Focusing on one's body being too small or insufficiently muscular, can lead to males engaging in strict dieting, excessive and highly repetitive exercise and potentially substance abuse problems (anabolic androgenic steroids).
Recognition and Diagnosis
Eating disorders in boys and men have traditionally been under recognised and under diagnosed. This may be due to a lack of knowledge and awareness in the community, stigma in the general public, a lack of clinician knowledge, and that research, treatment and diagnosis has traditionally been focused on females and female oriented symptoms (for example lack of menstruation and a drive for thinness).
Between 1995 and 2005, a South Australian study showed that eating disorder behaviours doubled among both males and females aged 15 and older.
Changes to the way we identify eating disorders came into effect with the release of the DSM-5. This has allowed for more males to be diagnosed with an eating disorder however, males are much less likely to seek treatment for their eating disorder. This may be because they are unaware that what they are struggling with is an eating disorder, that they fear judgement or stigma or even because they have difficultly seeking help in general.
The Way Forward
More research is needed into the number of men and boys who struggle with eating disorders and the male experience of body image concerns, disordered eating, and disordered exercise behaviours.
What we do know is that for anyone with an eating disorder, early intervention results in better outcomes. It is essential that we all work together to increase awareness about eating disorders and to encourage boys and men to discuss their concerns and to seek support as soon as possible.
Recovery is possible for every individual who has an experience of an eating disorder.
Liam is one of Insideout Instute’s ambassadors. To hear his story and view on male’s and eating disorders, you can read his blog.
To seek help for yourself or someone you know, head to the InsideOut website.
References
- Hay, P.J., et al., Eating disorder behaviors are increasing: findings from two sequential community surveys in South Australia. PloS one, 2008. 3(2): p. e1541.
- Smink, F.R., D. Van Hoeken, and H.W. Hoek, Epidemiology of eating disorders: incidence, prevalence and mortality rates. Current psychiatry reports, 2012. 14(4): p. 406-414.
- Hay, P., F. Girosi, and J. Mond, Prevalence and sociodemographic correlates of DSM-5 eating disorders in the Australian population. Journal of eating disorders, 2015. 3(1): p. 19.
- Raevuori, A., A. Keski-Rahkonen, and H.W. Hoek, A review of eating disorders in males. Current opinion in psychiatry, 2014. 27(6): p. 426-430.
- Murray, S.B., et al., The enigma of male eating disorders: A critical review and synthesis. 2017. 57: p. 1-11.
- Lavender, J.M., T.A. Brown, and S.B. Murray, Men, muscles, and eating disorders: An overview of traditional and muscularity-oriented disordered eating. Current Psychiatry Reports, 2017. 19(6): p. 32.
- Griffiths, S., et al., Self‐stigma of seeking treatment and being male predict an increased likelihood of having an undiagnosed eating disorder. International Journal of Eating Disorders, 2015. 48(6): p. 775-778.