Are eating disorders in men on the rise?

It's Eating Disorders Awareness Week, and figures released have suggested that more men are suffering. But what's really going on? Joanna Lowy investigates!

“I got bullied quite a lot when I was at school because of my weight, and I took it upon myself to change thinking that no one else would”, explains 32 year-old John Evans from Wales. “I did lose a bit of weight and got a lot of good feedback from it, and from there it developed into a bit of an obsession. By the time I got to university, aged 18 and four years later, I was ridiculously underweight, and was diagnosed with anorexia.”
 
To mark Eating Disorders Awareness Week, which started on Monday, reports have been a-flowing on the latest facts and figures. And this time it seems to be the men under the spotlight. For according to the NHS, the number of men reporting symptoms has risen by 66% over the past decade. But just what exactly is going on?

External factors

Nowadays, men are more vulnerable to disliking their bodies and seeking to reshape them than once before, due to the increased commercial world in which we live. But unlike women, who are often able to talk their insecurities away, men lack the skills to discuss their feelings or their health, and so, unsurprisingly may well be becoming more prone to retreating into toxic worlds of eating disorders and competitive exercise – especially given the stigma and the specialist treatment which is predominantly geared around women.
 
Research conducted by leading health charity Central YMCA made headlines this week, as it showed just how insecure men are about their appearance.
 
According to the figures, nearly one in five of young men would take protein supplements to change their body shape, one in ten would take steroids to change their bodies if they were unhappy with the way they looked, 8% of boys would take laxatives to lose weight, and one quarter of men would have cosmetic surgery to change their bodies if money wasn’t an issue. But perhaps more worryingly, a higher number of men than women - 30% and 42.4% respectively - compare their bodies to the likes of models in magazines.
 
The charity believes that men are under enormous pressure about their body image, with four in five engaging in conversation about it, the same number feeling unhappy with their level of muscularity and one in four being put off going to the gym because of body image concerns. One third of men have taken protein supplements, one in five are currently on a high protein diet, one in eight fear they may gain weight everyday and over one third would trade at least a year of life to achieve their ideal body shape.
 
Psychologist for Clinical Partners, Dr Tamara Russell, explains why this is. “Young people are of course influenced by what they see around them - the rise of male models, male grooming products and David Beckham posing in his pants are likely to be influencing what is seen as the ideal and ideas about what a man should look like”, she says. 
 
But according to occupational healthcare psychotherapist for Abermed, Jamie Patterson, it’s not just the targeted advertising which is the problem. “Although there’s been an explosion in such publications targeting men at the moment, which didn’t exist once upon a time, there’s also indirect pressure coming from female magazines, which pitch their version of the perfect male.”
 
Internal
 
But although much can be blamed on the exploding advertising culture, there are other factors at play, too. “I think it was partly my personality because I’ve got a bit of a perfectionist nature and a reserved character”, John explains. “I was desperate to get acceptance from other people, and once I lost weight the bullying stopped, so it all got intertwined. I’ve never seen a picture of Cristiano Ronaldo and thought I’ve got to look like that – it was never anything like that, more me trying to be successful at something, and something that people approved of.”
 
And as Jamie explains, internal factors, such as low self-esteem, are common. “Perhaps they come from families where there are high expectations – a high pressure to achieve”, he says.
 
 “The root causes for men and women are often the same: vulnerabilities around self-esteem, clinical perfectionism, mood intolerance and interpersonal problems”, Consultant Psychiatrist in Eating Disorders at Capio Nightingale Hospital, Dr Yoram Inspector adds. “The eating disorder is a maladaptive coping mechanism that serves as a distraction and offers the patient a chance to exert some control and mastery over their body during times of stress.”
 
More or more reported?
 
It is estimated that between 15-20% of the 1.6 million people in the UK affected by an eating disorder are male, and according to the eating disorder charity, Beat, even more men are coming forward to seek treatment.
 
But this is where the confusion lies. For although the media has jumped on the seemingly alarming statistic to bemoan the high numbers of men who are now suffering with an eating disorder, both Beat and the Department of Health (DoH) have made it clear that the figure pertains to reported cases alone, and does not necessarily reflect a picture of increased eating disorder cases in men.   
 
Historically, men may well have had to remain in the proverbial closet when it comes to body image issues. “The media is obsessed with women’s eating disorders, and governments have been sufficiently concerned to convene ‘body image’ summits but male eating disorders, compulsive exercise and body image disparagement receive little attention.”,  Professor John Morgan wrote in his 2008 self-help guide, The Invisible Man.
 
But perhaps things are changing.
 
“We are certainly seeing more men coming forward for treatment but we can’t especially say eating disorders are on the rise in men.” a spokeswoman from Beat adds. “It may be that there is better recognition and diagnosis and that people are more prepared to come forward.” 
 
“I don’t think thing’s have really changed much”, Jamie says. “The trials and tribulations of family life have always been there, and although there probably is more stress now, I wouldn’t put that as a link to eating disorders.”
 
And the figures support this too, especially when comparing the latest statistics to those over the last 20 years.
 
A national survey of 11,467 high school students and 60,861 adults in 1993, and conducted by Serdula et al, found that 24% of the men and 15% of boys were trying to lose weight. But with the YMCA research painting a similar picture, it would seem that things may not have significantly changed, especially when reaching back even further to a national survey from 1986 conducted by Cash, Winstead and Janda, which indicated that, even before the mass advertising of today, 41% of men were still dissatisfied with their weight.
 
But regardless of this, and perhaps most importantly, is the research from 1991 conducted by Wolf, which claimed that just 10% of eating disordered individuals coming to the attention of mental health professionals were male. The fact that over the last 10 years this has risen by 66% speaks volumes, and not necessarily in the multitude of negative ways which much of the media would have you believe. Ten years ago, the fact that John was suffering with an eating disorder did not even occur to him or his family.
 
“I didn’t have a clue what was the matter with me – I thought I had meningitis”, he says. “My family were concerned about me, but more because of my behaviour rather than how I looked. I didn’t have a clue about eating disorders, and it definitely wouldn’t have occurred to me that it affects men as well. Things have definitely improved now - we’re getting as much coverage at the moment as possible, so people are more aware.”
 
“The Government takes the issue of eating disorders very seriously and we are aware that men are increasingly likely to have these problems”, a DoH spokeswoman said. “Early intervention is essential for those with eating disorders, but we know that men can be slower in seeking medical help.  This is particularly true in the case of mental health problems, often because of the stigma attached.

“We are committed to tackling stigma, and this is why, for the first time, the Department is providing up to £16m of funding to continue the long-standing Time to Change campaign, tackling mental health stigma and discrimination.”
 
“I think the media is a double edged sword”, Jamie concludes. “On the one hand it can exacerbate some of these things by having models with unobtainable body shapes, but at the same time they do also bring health problems into the spotlight, and if it’s talked about more, and celebrities talk about it more, then people are more likely to talk about it too.”
 
The theme of this year’s Eating Disorders Awareness Week is ‘Breaking the Silence.’ And although we may still have a long way to go in terms of preventing the illness, it seems that when it comes to speaking out, we just might be doing better than we think.

For more information, help, or advice on eating disorders, visit the beat website here.
 
To order your copy of John’s Becoming John: Anorexia’s not just for Girls, click here.