Why It's So Hard to Talk About Male Anorexia
I was a teenage boy who thought anorexia was a "girl's problem." I was wrong.
This post originally appeared in VICE UK
I led a toxic life as a teenager. But rather than the usual Strongbow binges, chain smoking, and shitty drugs, I was an anxious perfectionist, lacking in self-esteem and obsessed with a distorted image of my own body.
Between the ages of 13 and 15, anorexia nervosa controlled me, and until last summer I'd never told anyone about it. Five years after my darkest period (I'm 20 now), the admission lifted an incomprehensible weight off my shoulders.
I was oblivious to the fact that I had an eating disorder at the time, but at my worst, I abided by a meal-a-day rule. I'd hide my breakfast and skip school lunches. Any event where I had to eat out-of-step was agonizing. The amount of time I invested in planning my meals—or avoiding them—is terrifying to think about now. I wasted hours. Every day. But it was all necessary if I was to reach the impossible, stick-thin ideal I so revered.
Even the single-meal-a-day directive made me feel guilty, though. I felt like shit when I looked in the mirror or when I stepped on the scales, and even worse when I curled up in bed, disappointed at my bulging abdomen. I'd cry, then roll over onto my back so I didn't have to look down at my body. By day, I felt dizzy, faint, jaded. This was around the time when super-skinny drainpipes were in fashion, but mine weren't skinny—they were slowly getting baggier.
I was luckier than some, as I was surrounded by a caring family who certainly would have intervened at the outset had they known, but as a conniving 13-year-old with sprouting facial hair, surging hormones, and an early growth spurt, I was able to dupe them. Men with anorexia might not "look" anorexic because of the shape of their bodies, and I exploited this. Unlike women, men's body definition and musculature often remain intact when they have anorexia. An early girlfriend described me as "well chiseled." The ease at which I got away with it was thrilling.
Later, when I did begin to suspect that I had some sort of mental health problem, I went into denial. There's a great deal of stigma surrounding eating disorders, and it's one of the main reasons why men like myself initially don't seek the support and treatment we need. We feel ashamed. We can't bring ourselves to "own up" to such "weaknesses."
It was actually while reading about British men's crippling "stiff upper lip" the other day that I started thinking: What if my own teenage problems also formed part of the male propensity for self-deception? Lawrence Brown, who previously volunteered at Samaritans and now works at BEAT, the UK's leading eating disorder charity, says, "When you look at the statistics, the suicide rates among men are three times what they are for women. This speaks of the issue that men face in talking about any kind of mental health issue—including eating disorders."
Of course, there's also the added association with the female body. Back at school, for example, I couldn't accept that I suffered from anorexia because I considered it a "teenage girl" problem. That was what society had led me to believe. There's obviously enormous societal pressure on women to conform to physical ideals, but the outcome is dire for anorexic men, too, because many simply don't think they can be anorexic.
I couldn't accept that I suffered from anorexia because I considered it a "teenage girl" problem.
Sam Thomas, a former bulimia sufferer and founder of Brighton-based charity Men Get Eating Disorders Too, thinks we need to start seeing eating disorders as genderless.
"We wouldn't talk about bipolar disorder as a man's thing, or schizophrenia as a woman's thing, so it's surprising that we still talk about it [anorexia] as if it's mostly affecting women," he says. Terms like "manorexia" are incredibly unhelpful, and, as Thomas points out, often the statistics surrounding male anorexia appear as an, "Oh, men get this too, sometimes," after-thought.
Consequently, the statistics on the number of men with eating disorders probably doesn't reflect the truth. They only cover those who are referred to health services, and exclude those—like myself—who are suffering, or have suffered, in silence. The idea that 1.6 million people in the country are currently living with eating disorders is probably a significant underestimate.
Official figures suggest that 11 percent of eating disorder sufferers are male, but a more realistic "snapshot survey" conducted by the NHS Information Centre in 2007 found that roughly 25 percent of sufferers were men. And, worryingly, the Royal College of General Practitioners recently found that there's been a 66 percent rise in hospital admissions involving men with eating disorders over the past decade. "This could be a genuine rise of men getting eating disorders," suggests Thomas. "Or it could be more men hitting the crisis point before they get the help they need."
If I had mustered enough courage to talk to my doctor back then, I may have also had a tricky time getting diagnosed. Just take a look at the recent research from Oxford and Glasgow academics which found that "men with eating disorders are under-diagnosed, under-treated and under-researched."
The lack of research is what troubles me the most. Doctors often don't have the necessary training for spotting signs of eating disorders among men—particularly since physical deterioration is often harder to spot in the early stages of their illnesses. Secondly, diagnostic criteria are often skewed towards the female body. For instance, irregular menstruation is one of the main signs GPs are still trained to look out for.
They say anorexia leaves a black hole in your life, which is something I can attest to. I remember very little else about other stuff I did during this period. I do recall the music I was into (the Mars Volta), what I liked at school (languages), but little else. Had I become anorexic at the age I am now, I—or a relative—may have discovered the wonderful help accessible though the Men Get Eating Disorders Too website. There, I could have found lots of information and personal stories, 1-2-1 live-chat sessions, and a discussion board for both sufferers and carers.
Peer support groups are now up and running in Brighton and Hove too, which they hope to roll out further afield, and Thomas has recently been giving workshops to professionals with the aim of improving service provision. Next July, the first ever MGEDT conference takes place.
Elsewhere, an affiliated charity, MBEEDS, has just been set up in Scotland. The Laurence Trust already providing support to men in Northern Ireland. On a larger scale, earlier this year, BEAT launched its #beatthesilence campaign, backed by well-known male sufferers like John Stapleton and Uri Geller. But while there's growing momentum behind such charities, most people still don't know they exist.
If you become ill as young as I did—13—you may not have the wherewithal to seek help online. You wouldn't necessarily have the vocabulary for what's happening to you, or the resources to reach out. According to a recent report, spanning 12 months, the most common age for hospital admission for a man with an eating disorder was 13, with the largest rise of admissions involving young people aged ten to 19.
Clearly, we need a far more open dialogue, expanded education in schools surrounding eating disorders and mental illness across all ages, sexes, and demographics. We need to foster environments where children have the knowledge and confidence to speak up when they're not feeling well. As Thomas rightly asks, "Issues surrounding self-harm are often standard in school policies now, so why not eating disorders?"
I recovered from anorexia very slowly, on my own, just before my GCSEs. After experiencing one too many jibes like "Yeah, Huw doesn't eat, he's anorexic," I had a come-to moment. I inspected my rickety reflection one day, poked at my cheese straw-like wrists, and realized that, however hard it was, I had to start eating. So I did. Meal by meal, I—slowly—built up my appetite.
Many aren't so lucky. Between 5 percent and 20 percent of people with anorexia will die. BEAT believes that anorexia is the most deadly mental health condition. There are teenagers unknowingly killing themselves out there, and we need to expand the conversation to include everyone.
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