eNewsletter - June 2018
Behavioral Health Partners
Eating Disorders: Not just for women
Robert Allanson, LCPC, CADC
Often times, the general public views eating disorders as an issue only affecting 15-25 year old young women. And while eating disorders do largely affect females in that age range, the reality is that it is a very singular definition of eating disorders. There are many outliers and it is important to talk about them.
This article will focus on eating disorders and the male experience. According to the National Eating Disorder Association, approximately 1 in 3 people with an eating disorder is male, and subclinical disordered eating is equally as common. The prevalence of males with eating disorders has been growing since the first clinical description of anorexia in 1873. In fact, there is equal prevalence of binge eating disorders in females and males.
If we look at the historically-held views and diagnostic criteria for eating disorders, it can be easy to see why males may have seemingly flown under the radar. The reality is that the same struggle can present itself in different ways between genders. However, it is important to note that each individual is unique and stereotypically “female” symptoms can also present with male clients.
Culturally, women may struggle with societal pressures for a thin figure from the media. This has been well documented. What gets talked about less often in the media is the increasing emphasis on the ideal male physique (i.e., lean muscle, broad chest, washboard abs, and shirt-tearing biceps).
As a result, behaviors may be different according to the perceived demands. While females may focus on compensatory behaviors (e.g., purging, misusing laxatives or diuretics, etc.) or restricting behaviors, males are more commonly seen exercising excessively in pursuit of the ideal muscle definition.
In general, societal demands, stereotypes and stigmas can make it difficult to identify eating issues in males (and females as well). This is why it is important when you are working with a client to have a general understanding of eating disorder symptomology and ask questions to identify these issues.
In addition to the trademark warning signs of eating disorders present in both genders, there are some possible warning signs to look out for when working with a male suspected of disordered eating. Certain sports may place individuals at higher risk, such as those that may require or promote the need for excessive workouts, a thin frame, and/or cutting/bulking weight to perform optimally. Examples may include cross country runners, gymnasts and wrestlers, as well as bodybuilders and swimmers.
It has also been suggested that homosexual males may be at a greater risk as well. Additionally, in a clinical setting, one should remember to look for decreased testosterone and/or muscle weakness due to overtraining and, as always, a history of mental illness and/or substance abuse.
While stigma can play a role in delaying any type of mental health treatment, shame is a big issue that prevents men from seeking treatment for what is stereotypically defined as a “woman’s issue.” As behavioral health professionals, addressing this stigma and changing how we approach and assess males with eating disorders in private practice, schools and hospitals can be key.
Current popular assessments, such as the Eating Disorder Inventory-3 (EDI-3), focus more heavily on higher drives for thinness. Newer assessments, such as the Eating Disorder Assessment for Men (EDAM), focus on general eating disorder symptomology (e.g., disordered eating, body image, etc.) but also place emphasis on the motivation to be muscular and exercise habits.
When speaking with men presenting with possible eating disorder related symptomology, we can reframe how we inquire about this issue in a way that is more understanding of the male experience of eating disorders. Males are more likely than females to focus on exercise as a compulsory behavior. When viewing the excessive exercise, it may be more beneficial to look at it from an addiction perspective, sacrificing time with family, friends, school, etc. so that the exercise itch can be scratched (Rogers Memorial Hospital, 2012).
These are some questions that may be beneficial in fleshing out possible ED thought patterns or behaviors: “What goes through your mind when you miss a work-out?” “Have you ever worked out even when sick or injured?”
Ultimately, we must recognize the ways in which eating disorders can affect all genders—and that recovery is possible. The first step is to recognize stigma and stereotypes that may cloud our thinking. As clinicians, it is crucial that we educate ourselves and recognize and assess our male clients for eating disorders with the same thoroughness we do our female clients. Though it may take time and work, with the right approach and support, he will be able to see a life worth living.
- Birli, J., Zhang, N., & McCoy, V. (2012). Eating disorders among male college students. Vistas Online 101. Retrieved from https://www.counseling.org/docs/defaultsource/vistas/vistas_2012_article_101.pdf?sfvrsn=5
- Boisvert, J., & Harrell, A. (2010) Homosexuality as a risk factor for eating disorder symptomatology in men. The Journal of Men’s Studies, 17(3) Retrieved from http://journals.sagepub.com/doi/abs/10.3149/jms.1703.210.
- Kargas, K. (2017) Measures for male eating disorders with assessment testing. Retrieved from https://www.eatingdisorderhope.com/blog/male-eating-disorder-assessments.
- MacNeil, L., Best, L., & Davis, L. (2017). The role of personality in body image dissatisfaction and disordered eating: discrepancies between men and women. Journal of Eating Disorders. 5(44).
- National Eating Disorder Collaboration. (2017). Males get eating disorders too. Retrieved from http://www.nedc.com.au/eating-disorders-in-males.
- Pettersen, G., Wallin, K., & Bjork, T. (2016) How do males recover from eating disorders? An interview study. BMJ Open. Retrieved from http://bmjopen.bmj.com/content/6/8/e010760.
- Rogers Memorial Hospital. (2012). Part 2 males and eating disorders. Retrieved from https://rogersbh.org/about-us/newsroom/blog/part-2-males-and-eating-disorders.
Robert Allanson, LCPC, CADC, is a Licensed Clinical Professional Counselor and is currently certified in Drug and Alcohol Counseling. He received his undergraduate degree in Education from Elmhurst College as well as his Master’s Degree in Community Counseling from the National Louis University. Robert has worked with a diverse population of adolescents and adults within the inpatient hospitalization as well as outpatient substance abuse and mental health settings. He is currently a Clinical Therapist within Linden Oaks Medical Group, Addison. Prior to his transition to LOMG, Robert ran the adolescent substance abuse intensive outpatient program at Rosecrance McHenry County. Robert’s areas of focus have been addictions, self-harm, depression, anxiety, eating disorders, and life transitions/adjustment related issues.