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Men and eating disorders

Posted Feb 07 2009 12:00am

Eating Disorders: Not Just a Girl Thing
By Drew Walen

42-21283662 I'm 6 feet tall and weigh 250 pounds. I have broad shoulders and a large rib cage that makes me look like an undersized football lineman. I've been in bars where a drunk guy wanted to mess with me while I'm sitting down but backed off quickly when I stood up. There is power in being a big guy, even when that size has nothing to do with spending countless hours in a gym pumping ungodly amounts of iron. And there is a terrible amount of shame as well.

That shame dates back to my elementary school days when I began to put on significant weight on my frame. I look at photos of me and I can't help but see that I clearly was fat. Not just fat. I was obese.

It didn't matter to me at the time, but it became a serious issue in middle school as early dating and flirting exploded among my peers. My skinny friends were already making out with their equally attractive pre-pubescent female counterparts while I sulked off to the food court at the mall or concession stand at the local ice rink. I was hauled off by my mother to Weight Watchers at age 12, and attempted countless diets throughout my teenage years.

I lost weight, then gained it back - plus some. I got wild cheers from family when I did well, and looks of pity when I failed. All the while I got the message that there was something seriously wrong with me and that it was morally imperative to fix it. This yo-yo pattern lasted until my early 30s.

It was at this time I entered graduate school for social work and began to investigate the social and legal prejudice against those who are obese in our country. I recognized the terrible cruelty of lower wages for equal job competency; the disgust engendered by many in the medical community for someone with fat rolls and male breasts; the media bias of what is an acceptable male physique, and the walls put up by the health insurance companies to get even minimal coverage for someone who has a Body Mass Index (BMI) in the obese category.

I would register as obese. I don't know what my actual body fat percentage is (though it is high), but there are football players in the NFL that have similar basic height-weight numbers as I do with less than 10 percent body fat. They would be denied health insurance, just as I have, based on their BMI. It's an arbitrary way for health insurance companies to avoid paying for obesity-related conditions like high blood pressure, cholesterol, etc. But BMI does not necessarily correlate to these issues, and it is very possible to be big and be healthy.

More frightening to me, however, is how image conscious teenage boys are becoming and the corollary rise in eating disorders in males. Recent studies suggest that men, once considered to account for one in 10 eating disorder cases, now make up approximately one in six.

Men are Affected Too

Anorexia Nervosa: Characterized by the drive for extreme thinness. This is found in boys desperate to avoid the teasing they received as chubby kids, particularly if they have sensitive personalities. It's also more common in athletes where weight classes are involved such as wrestling, boxing, gymnastics and running. And doctors are seeing it more among boys and men trying to avoid the medical issues of their fathers such as heart disease, diabetes and high blood pressure.

Bulimia Nervosa: More common, bulimia is characterized as a food binge followed by a purge, which could include self-induced vomiting, abuse of laxatives or diuretics, fasting, or excessive exercise. The binge eating is often a method of self-medication for depressed mood, stress, anxiety, fear or anger. The drive to meet the accepted male figure stereotype leads to the use of these purging methods, which in turn become a perpetual and self-destructive cycle. Binge eating disorder is marked by the same self-medicating response with food but without the purging behavior, and is even more common among men.

Reverse Anorexia or Body Dysmorphic Disorder: A new phenomenon which occurs almost exclusively in men; the belief is that one can never be big enough. This often leads to the abuse of steroids and other enhancement products both legal and illegal, all in an effort to avoid the deep sense of inadequacy of one's body.

Personally, I have a history of falling into a trap of starving myself for weight loss, binging for emotional salvation, exercising like mad to take care of the binge, then feeling like a big fat loser for not being 'normal'. The exercise binges have left me with a torn rotator cuff, early arthritis in my left hip and a bum right knee. When I felt pain in the moment of exercise, I'd fight through it because I believed it was more important to lose weight and build muscle.

I got so frustrated with the diet and exercise failures that I looked to an easier way out. I'd read articles and seen shows about bariatric surgery (a.k.a., stomach stapling), and decided to binge on food until I put on enough weight to have my insurance cover the operation. It was then that I reached my rock bottom. I realized I had an eating disorder and unimaginable issues with body image.

I got help from an eating disorder counselor, have worked with an eating disorder nutritionist, and spent the past year slowly dropping weight, normalizing food and exercise, and gaining a great deal of insight into the origins of my issues. So intrigued by my own recovery, I'm actually training as an eating disorder and body image psychotherapist.

Truthfully, I don't love my fat, and I don't suspect I ever will. But I've come to appreciate my assets, my struggle, and the struggle of men around the country who are dealing with our image-conscious culture.

Andrew Walen is a clinical social worker at the University of Maryland Medical Center in Baltimore, Maryland. While earning his masters degree from the University of Tennessee, he was a member of the Eating Disorder Coalition of Tennessee and the Nashville Psychotherapeutic Institute. He has lectured to middle and high school students on eating disorders, body image and self-esteem throughout Middle Tennessee. He can be reached at

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