HEALTH : Experts Say More Men Seeking Treatment for Eating Disorders

WASHINGTON —  Specialists who treat eating disorders have been noticing something different about their patients lately.

More of them are men.

“I have men coming into my office telling me they’re convinced they were passed over for promotion because the other guy was slimmer and they look more like a beach ball. Or their wife is unhappy with them because of their appearance,” says Dr. Randall Flanery, director of the eating disorders program in the behavioral medicine division of the St. Louis University School of Medicine.

“With more men’s fashion magazines on the market, more emphasis is being put on the way men look,” he adds. “Now they’re subjected to the same concerns about body image that have plagued women for years. This preoccupation with appearance can manifest itself into an eating disorder.”

The majority of those suffering from eating disorders still are women. But “the men have always been there,” says an official with the National Eating Disorders Organization, which conducts education, research and referrals from its Worthington, Ohio, headquarters. “We think what’s happening is that they are only just now coming forward for treatment.”

Generally, eating disorders manifest themselves in two major ways: anorexia nervosa and bulimia nervosa. Anorexia is a method of weight loss, and bulimia is a method of weight control. While anorexics often become gaunt, bulimics typically remain within a normal weight range.

Anorexia is an emotional disorder characterized by severe weight loss, or, in young people, failure to gain weight, according to the national organization.

“Laymen see it as ‘dieting gone wild,’ ” organization officials say, because individuals try to lose weight through severe caloric restrictions, fasting, continuous exercise, use of diet aids, diuretics, laxatives and other methods.

People suffering from anorexia nervosa are consumed with the fear of gaining weight, even as they continue to drop pounds.

Studies have suggested that one in every 250 women is afflicted, and 90% of those with the disorder are women, the organization says.

Bulimia is characterized by episodes of binge eating followed by some form of purging, usually self-induced vomiting. But bulimics often abuse laxatives or diuretics, and engage in fasting and strenuous exercise as well, according to the organization. It estimates that 20% to 30% of college-age women may display signs of bulimia.

“The binge-purge cycle is normally accompanied by self-deprecating thoughts, depressed mood and an awareness that the eating behavior is abnormal and out of control,” the organization says.

Flanery estimates that up to 1 million men may be suffering from eating disorders in this country. He says he isn’t sure whether these are new cases, or whether the problem among men is getting increased recognition.

He says both sexes tend to develop eating disorders at “key junctures” in life, such as separation from home, changing jobs or moving to a new city.

Men tend to develop eating disorders as a means of “control over their bodies,” he says, or as a result of assuming poor eating habits to get into shape for sports activities. Also, ironically, men could develop an eating disorder after being driven to diet by worry over heart disease or other health issues, he says.

Flanery and other experts say that men have an especially difficult time seeking treatment for an eating disorder, in part because men typically are more resistant than women to seeking any kind of medical help.

Also, they are reluctant to enter any kind of program “where they believe they are the only males,” Flanery says. They do not want to be labeled as having what is regarded by many as a female disease, he says.

“Because men are reluctant to seek help, the disorder is usually pretty far along by the time they finally do reach out,” Flanery says. “The good news is that men, like women, can recover from this life-threatening condition.”