Recently, I did something that I have never done before as a writer, I deleted an article that I had written only hours after it had been published. The reason: I was anxious at the amount of information I had shared about myself. Having deleted it, I was slightly disappointed with myself — writing openly about personal issues isn’t new to me. I have previously been OK with sharing sensitive parts of my life story with the general-internet-public, such as my struggles with depression or the difficulties associated with being the full-time Caregiver for my sister. When I published these articles, the feeling that they might help someone in a similar situation was enough of a motivation for me to push aside any anxiety I might have had. But there was something different about this article, it hit on a topic that I felt particularly reluctant to share — my history with an Eating Disorder (abbreviated as ‘ED’).
I think that a lot of the discomfort that I feel discussing this topic is due to my gender; I’m male encase you haven’t read the subheading. A quick google search shows me that I am not alone in my gender-motivated fears for discussing this issue:
It seems unusual that such stigma should surround an illness that is fairly prevalent in men — this study, quoted on the National Eating Disorders website, estimates that 1 in 4 people with Anorexia or Bulimia is male, while just over one in three people with Binge Eating Disorder is also male.
When I read these kinds of statistics it makes me wonder why there is such stigma associated with men suffering from an Eating Disorder?
It’s easy for me to excuse my discomfort at discussing my history with an ED as a symptom of my gender, but what do I actually mean by this?
I know that I feel uncomfortable at the idea of putting myself in a position to be defined by past events that I have tried so hard to move on from. I don’t want to be known as ‘That-guy-who-had-an-Eating-Disorder’. I get this uneasy feeling in my stomach when I imagine people who I meet or talk to looking at me and putting me in that box. Do I feel more susceptible to being labeled like this because I’m male? It’s hard to say.
Another part of my reluctance to talk is due to a feeling of guilt that I have about my past with an ED. I still, to this day, feel at least partly responsible for having had this illness. I feel that I acted in certain ways, restricting food, purging, etc. that put me into a position that gave me this illness. I kind of feel to blame. That doesn’t mean I am, no doubt there were many psychological reasons that affected my tendency to act in this way, and these reasons would have been largely outside of my control. But despite knowing this, I can’t quite shake the feeling of personal responsibility for developing an ED and the guilt that comes with this. And as with anything that you feel guilty about having done, it’s hard to discuss it with other people.
I think that this guilt is compounded somewhat by my gender; as a man, I feel that I should have been able to overcome the psychological issues that were leading me down the path towards an ED and because I wasn’t able to I feel that it makes me appear weak and less of a man. I don’t know why I believe that a man should be more able than a woman at overcoming such barriers, possibly because society has led me to think this way? That sounds like a bit of a cop-out, maybe it is, but maybe not. I know that throughout most of my life I haven’t seen men talk as openly as women about struggling with psychological issues, leading me to believe that men generally don’t struggle with such problems and so, as a man, I shouldn’t either.
I often think back to my history with an ED and feel like I was unable to do something that most people learned to do properly, without any issue, when they were young kids; eat food and fuel your body. I was a young man, in my early twenties, with a degree-level education and I couldn’t manage to eat properly. Irrespective of the valid medical reasons for this, it doesn’t stop me from feeling like something of a failure for having suffered as I did. I know that most people would tell me that I was wrong in my self-criticisms, but I can’t help but feel this way, is it because I’m a man?
Thinking about these things leads me to wonder what, if anything, the medical world has to say about the potential stigma surrounding men suffering from an ED. I would like to get a perspective on this issue beyond my own.
I spent some time searching for medical studies that were centered around the issue of male Eating Disorders and I found a recent study that took an in-depth look at the stigma that I have been talking about. What the authors of this study had to say is very interesting so I have quoted a section of the study below. I apologize for the length of the quote but I feel that it is necessary — it covers a lot of important issues and I think that it’s important that people know that the medical world acknowledges the existence of this stigma.
I have emboldened some phrases that are particularly relevant to my experiences with an ED, I will elaborate on this relevance after the quote:
“A principal issue of male EDs is the stigma surrounding the illness. The stereotype that EDs are illnesses that only affect females has led to feelings of shame and isolation among those men affected and, subsequently, delay men’s help-seeking and treatment (Arnow et al., 2017; Bjork, Wallin, & Pettersen, 2012; Dearden & Mulgrew, 2013; Griffiths et al., 2015; Pettersen et al., 2016; Robinson et al., 2012). This social stigma can challenge a man’s masculine identity and create internal conflict related to lack of coherence with gender norms (Griffiths et al., 2015). For example, a male participant in a qualitative study described the negative impact of ED stigma: “so it can be quite an isolating thought as well and no other guys have had this problem. What’s wrong with me?” (Robinson et al., 2012, p. 180).
Individuals with EDs, in general, have challenges disclosing their illness to others, and the lack of visibility of men with EDs only exacerbates this reluctance to seek help (Raisanen & Hunt, 2014). This creates a dangerous snowball effect: first, men do not receive care and, second, they continue to be under-represented in the media and literature on EDs. The aforementioned deferment of treatment can lead to progressively worsening ED symptomology and an increased risk of dangerous sequelae including death (Raisanen & Hunt, 2014). This topic is of dire importance as EDs, namely AN, have the highest mortality and suicide rates of any psychiatric disorder (Dearden & Mulgrew, 2013; MacCaughelty et al., 2016). Statistics indicate that 10.5% of individuals diagnosed with AN may die due to their illness (Birmingham, Su, Hlynsky, Goldner, & Gao, 2005).”
I distinctly remember during my recovery from my ED that on the rare occasion I tried to talk to other people about my illness it seemed like they were embarrassed for me. It was always an awkward experience, I definitely felt “shame” like the authors of this study say. In general, it made me uncomfortable with the idea of sharing my struggles and it did give me “challenges disclosing my illness with others”.
When I was in the grips of my ED I was lead to ask myself, like the man quoted above, “What’s wrong with me?” As I have already mentioned, these experiences have continued to challenge my “masculine identity” up to this day and I have a certain amount of “internal conflict” concerning whether I am somehow less of a man because I suffered from this illness.
I was desperate for some support when I was in recovery from my ED but I was conflicted about seeking it out. On the one hand, I was desperate for someone with a caring heart that I could turn to for advice, but on the other hand, I couldn’t think of anything worse than admitting my struggles to someone else. In the end, I didn’t try and find anyone because I was too worried about how they would react to my admissions. I can echo the words of the male sufferer quoted above once again; the experience was “isolating” and I didn’t really think that “other guys had this problem.”
What further compounded my problems was the fact that the medical practitioners that I spoke to during this time didn’t seem well equipped to deal with my male-ness. Some doctors simply didn’t think I had an ED, or if they did they seemed to have little empathy for my situation. More often than not I just got a puzzled look and more of that ‘I’m embarrassed for you’ facial expression.
It took me a long time to move on from my Eating Disorder. Just when I thought I had recovered I would slip back, adopting a slightly different ED sub-type (I alternated between Anorexia and Bulimia several times). It was like I was on a stomach-churning merry-go-round that only ever stopped and let me off for a moment, before I was dragged back on, each ‘ride’ making me sicker than the last. Sadly my time on that merry-go-round lasted for approximately five years.
Looking back now I think that it’s likely that I would have recovered from my ED a lot quicker if there had been less stigma surrounding the illness in men. Another study that I found on this issue explains how their male participants felt that the gender stereotypes around males with an ED had prevented them from seeking medical treatment at an earlier point in their illness, they also felt that this same stereotype had meant that “health and other professionals had been slow to recognize their symptoms because they were men” which is something I can empathize with. The authors of this study believed that the stigma associated with a man suffering from an ED also meant that men would often “fail to recognize ED symptoms until disordered behaviors become entrenched and less tractable to intervention.” Given that it took me five years before I fully recovered I think that I am living proof of what the authors of this study are trying to say here.
Now that I am looking back at the time when I had an ED with some perspective, I can begin to see how all of the negative experiences that I had (associated with the stigma of a man having this illness) built up over time and eventually lead me to believe that this stigma was based in truth. When someone seemed embarrassed for me, I started to think ‘Maybe I should be embarrassed about having this illness’. Or because no other guys were talking about these issues I started to think ‘Oh right, it’s obviously not socially acceptable to talk about this’. All such experiences amounted to me taking on the more general belief that ‘Men aren’t really meant to have an Eating Disorder, and if they do they have to suffer in silence.’ I think that I’ve carried these false beliefs with me all this time, because I never really thought about them or challenged them, which is what has led to my continued reluctance to talk about my history with an ED.
Recently, I have noticed that there is an increasing amount of men in the public eye who are choosing to open up about their own psychological issues associated with food and body image. Zayn Malik of One Direction fame talked about his past struggles with overly restricting his food intake in his autobiography and in interviews consequent to the book’s release. While British Actor Christopher Eccleston was similarly candid about his lifelong struggles with an ED in his recently released memoir in which he claimed:
“Many times I’ve wanted to reveal that I’m a lifelong anorexic and dysmorphic, I never have. I always thought of it as a filthy secret, because I’m northern, because I’m male and because I’m working class.”
The willingness of people in the world of entertainment and media to talk openly about men with EDs has also extended to the world of film; Elton John’s battle with Bulimia was depicted in harrowing detail in a recently released film based on his life. John has also spoken openly about his struggles in numerous interviews.
Back when I had an ED I had to look pretty hard to find similar accounts of males who had suffered from an ED. I remember finding some second-hand accounts of the battles that Marlon Brando and Elvis Presley had faced with food-related psychological issues, but I think that such accounts were second-hand for a reason; the men in question did not feel comfortable talking openly about their struggles back when the stigma surrounding men having an ED was very real. Thankfully things appear to be changing.
Hope for the future
The medical world does seem to have recognized that they need to reduce the stigma surrounding Eating Disorders in men. I agree with the concluding remarks of this study which are quoted on the National Eating Disorder website:
“A gender-sensitive approach with recognition of different needs and dynamics for males is critical in effective treatment. Males in treatment can feel out of place when predominantly surrounded by females, and an all-male treatment environment is recommended — when possible.”
I believe that this kind of approach to male ED treatment could help to normalize the concept of a man having this illness. By treating groups of men who have an ED together it should hopefully provide a setting in which men feel less ashamed to talk about their problems. I would definitely have appreciated a male-centered recovery community like this when I was trying to move on from my ED.
Outside of the medical world it also appears that the tide is turning. As was shown above, there’s an increasing amount of men in the public-eye coming out and talking about their struggles with ED related issues. This increased media focus on the issue should lead to men feeling more able to talk about their illness and perhaps it will give them the confidence to seek out the kind of support that I didn’t feel able to find.
During my time with an ED, the last thing that I ever imagined I would be doing in the future was writing an article about my struggles. Admittedly I failed in my first attempt at doing this, I still wasn’t ready. But I guess the fact that I’m writing this article now is a sign that times really are changing? Let’s hope so.
Thanks For Reading,