“I had to see three GPs before I was helped” – Rise in the number of men with eating disorders

The number of men with eating disorders is far greater than previously thought, new research has shown. According to statistics from Bodywhys, men now account for one in four cases.

This is significantly more than a tenth previously reported in studies of patients enrolled in eating disorder programs.

Men are less likely to be aware that their eating habits are disrupted and are more likely to put off seeing a doctor even when their symptoms are life-threatening.

That’s the warning from Bodywhys, the Eating Disorders Association, launching Eating Disorder Awareness Month.​

Barry Murphy, the research and policy officer at Bodywhys, said men’s experiences have been a blind spot among practitioners.

“The subtleties of men’s experiences have not been captured by traditional diagnostic tools,” he said. “It’s still traditionally seen as a woman’s disease. For example, I was at a webinar last year and a guy said he was given a pink leaflet with information about periods, so it’s very difficult when they’re trying to figure out if they have a problem.”

While reported cases of anorexia, bulimia, and binge eating are increasing, binge eating disorder (BED) is now the most common among men. This involves eating large portions regularly in one sitting until the person feels uncomfortably full. This is often followed by excitement and guilt, and the person may then follow a restrictive phase before beginning the cycle again.

“Binge eating has flown under the radar because it was only officially diagnosed 10 years ago. Also, literacy related to binge eating is not well understood by the general public,” Mr. Murphy said.

Explaining the pattern of behavior, he added, “I’ve heard it been described as someone stuffing down their emotions as a way of coping and using food as an outlet.”

He said the illness could also be stage-driven. “At the beginning there is the build-up of tension, i.e. the activation of feelings. Binge eating is an attempt to block out these feelings and deal with them. After a bout, nausea and gastrointestinal issues can progress to the next stage where you say to yourself, “Right, I’m not going to let that happen again.” The person may then try a diet and then of course they have a difficult day and it starts all over again.”

The association said male athletes and bodybuilders are at higher risk from eating disorders. Mr Murphy said the need to achieve a “power-to-weight ratio” and unhelpful comments from coaches “can ignite the spark”. The pressure associated with certain athletic apparel can also be a factor.

The physical consequences of a long-term battle with eating disorders include electrolyte imbalances, which Bodywhys says are “very common,” as well as liver and stomach problems, low bone mineral density, and low testosterone levels.

Mr Murphy said men are less likely to seek help because “our culture hasn’t given men the space or tools to safely express emotional pain”.

“There is a lot of ambivalence in eating disorders. Part of the person wants help and part doesn’t,” he added.

When asked what advice he would give to men who might be slow to seek help, he said: “In a way, it’s easy for me to say ‘call a hotline,’ but in a way it’s more about starting a conversation ,What can you?’ Give yourself what will be the first step in breaking the link in your eating disorder chain?’”

Case study: “I saw three general practitioners before I found one who understood me”

“Wouldn’t you like to eat some more fruit and nuts for breakfast?” That was the oversimplified advice of a GP when Eoin Kernan sought help with his eating disorder.

The 40-year-old saw three doctors before a medical examiner recognized his problem. Describing how the difficulties began, he said, “In my 20’s and 30’s I lived the ‘life model’ that everyone lives. I was in a relationship, trying to do well at work, trying to buy a house, and we were thinking about having kids.

“I didn’t see the pressure that was building underneath in terms of my mental wellbeing. Everything came to a head in 2019 when I was 36 years old and had developed an enormous psychological burden. It happened very quickly but I had no self esteem and felt like a complete failure and I didn’t feel like I could keep up with others. I felt I had to get better.”

Mr Kernan, who owns a stand-up paddle boarding school in Howth, said he’s decided to “take a health kick”.

“I decided I wanted to improve by cleaning up my daily routines based on what I saw on social media. From what I could see the world was telling me I had to be very fit and muscular and a lot leaner. I had to follow all the rules of clean eating and be in a calorie deficit. But there’s a fine line between a safe experiment and a lot darker.”

Within a few months, he developed orthorexia, which turned into anorexia. “I started with a lot of restrictive eating habits that I couldn’t break free of. I saw factual results on the scale, which then told me I was doing better. This number became the most objective measure of my life and gave me a sense of control. It was my way of proving my worth.”

Mr. Kernan’s hair began to fall out, he began having dizzy spells and hallucinating. One day he was on a social media app to facilitate his unhealthy behavior when he came across a blog post about eating disorders. Symptoms included obsession with food, calories, and dieting, mood swings, excessive exercise, hunger denial, refusal to eat, and participation in eating rituals. “They said if I had any of those symptoms I should seek help – I had seven of the eight.”

Getting help led to “many roadblocks”. “I had to go through three different GPs before I found one who had a level of understanding. One even put me on an antidepressant and within a few weeks I was even worse. I’ve also dabbled in the public health system, and every time I walked in I met someone new and I had to tearfully retell my story. It was torture.”

Mr Kernan eventually contemplated suicide, which resulted in his being admitted to Beaumont Hospital on June 30, 2019. From there he was transferred to a residential home for inpatient treatment.

“I thought everything would be fine two weeks later. Four years later, I still see a therapist twice a month. So it shows how long it takes. You can’t pull an eating disorder off someone like a band-aid.”

Mr Kernan says his quality of life has improved since then. “Now I have tools and I’ve revised my thinking, which allows me to relate better to food and to myself. There’s hope – it’s hard, but all you have to do is take the first step,” he said.

For more information and For confidential support contact the Bodywhys hotline on 01 2107906​