More than 30 million people in the U.S. are struggling with eating disorders. This week is National Eating Disorders Awareness Week (February 21-27), and as the deadliest mental illness impacts millions, it does not discriminate against any certain age, gender, race, ethnicity, or sexual preference. According to the National Eating Disorders Association, 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life in the U.S. alone, and an estimated 10-15% of people with anorexia or bulimia are male.
We spoke with Dr. Ovidio Bermudez, MD, chief clinical officer and medical director of child and adolescent services at Eating Recovery Center, who told us that eating disorders don’t differ significantly by gender, but while symptoms seen in both men and women might be similar, there are differences in how eating disorders are manifested in men as compared to women. “However, we see much more gender parity with binge eating disorder,” Bermudez said. “The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) cites that the 12-month prevalence of binge eating disorder among U.S. adults is 1.6% of U.S. females and 0.8% of U.S. males. So, those statistics are approaching much more equal percentages of prevalence than those we see with anorexia or bulimia, for example.”
Signs of an eating disorder
One would assume that weight loss might be one of the first signs of an eating disorder, but the American Psychiatric Association’s clinical manual for eating disorders asserts that men are more focused on shape (upper body in particular) rather than weight loss. “So, for some men, it’s more about shape than weight loss per say,” Bermudez said. “That tends to be one of the differences we notice. In other words, for men, there is less drive for thinness and they lose weight in an effort to increase muscularity.”
While eating disorders are in and of themselves illnesses, they also bring on a slew of medical problems that can leave a person on the brink of death. “Common medical problems associated with eating disorders include weight loss, lack of energy, muscular weakness, decreased balance, lower body temperature and heart arrhythmia, among other medical signs,” Bermudez said. Additionally, men often exhibit lower levels of testosterone.
There’s a wide range of psychological issues that could accompany an eating disorder, says Bermudez. For men in particular, confusion over gender identity is sometimes exhibited, as well. “Intense fear of gaining weight, depression, social isolation, strong need to be in control, rigid thinking, and decreased interest in sex are all common psychological distress signs with eating disorders,” Bermudez said.
It’s important to keep in mind that as with all eating disorders, behavioral and psychological signs can be well hidden. “For men, some of the medical problems can be less obvious – for example, low testosterone levels,” Bermudez said. “Body image is also certainly an aspect; for men with eating disorders, body image concerns focus more around strength, fitness, and upper body muscularity.”
According to Bermudez, “Seeking treatment for an eating disorder takes strength and courage. Eating disorder recovery requires the expertise and guidance of a skilled, compassionate treatment team. Talk to a therapist, dietitian or doctor about your concerns and seek help for yourself or your loved one.”