MEN'S HEALTH ∙ 4 minutes read

The truth behind men and eating disorders: ‘it’s not as gender confined as you think’

By Kirsty Mason | Medically reviewed by Dr Luke Pratsides

The topic is taboo. Headlines and triggering images splashed across the internet distort our understanding of who eating disorders affect. We spoke to our lead GP at Numan, Dr Luke Pratsides, and Peter Williams, a man who suffers from binge eating disorder, to set the record straight.

Although young girls, aged 13-17, are deemed to be most at risk of developing an eating disorder, research uncovers shocking revelations about the prevalence of eating disorders in men. Men are thought to be just as likely to develop binge eating disorder as women.

And that’s just the tip of the iceberg.

Concerning research indicates that men with eating disorders are underrepresented due to the inherently ‘female’ assessment of what constitutes an eating disorder. Body concerns that are typically ‘female’, such as losing weight, are often emphasised, despite the fact that media representations of the ‘ideal’ male body shape are very different.

Dr Luke Pratsides, our lead GP, has noticed a worrying trend among young men: “In my experience, eating disorders tend to present themselves differently in men, compared to women. But that certainly doesn’t mean that they don't exist. It’s more common for men to get caught up in extreme exercise. There’s pressure on men these days to have a certain physical appearance. Especially with Instagram. In a way, it’s an eating disorder - you’re driving towards a certain body shape. I’ve come across some men who have kidney failure because they drank so many protein shakes, trying to achieve this muscular ‘ideal’. Protein shakes have creatine in them and these men are drinking unbelievable amounts. They actually end up poisoning their kidneys.

“More men than we realise have this difficult relationship with food.”

“That doesn’t mean men don’t get anorexia or bulimia. They do. But more men than we realise have this difficult relationship with food. They’re trying to achieve a certain body type and it can be extremely unhealthy. It’s not as gender confined as you think.”

Peter Williams*, 28, recalls an unhealthy relationship with food since the age of 10. “It took me some time to realise that my emotions were connected to food. Feeling down or depressed is the most common trigger for me. It’s a quick fix. Eating releases endorphins in your brain so I feel better in the short-term. But it’s a vicious cycle. Ultimately, I end up feeling worse.”

The reason why eating disorders are a women-centric phenomenon is still up for debate. It’s no secret that men, in general, are less likely to seek healthcare advice when a problem arises - something which Dr Pratsides has seen first-hand. “It’s part of a wider problem that men don’t seek help generally for their health and they often only seek help if there’s a physical symptom. I had a patient who I believe had an unrealised eating disorder. He complained of difficulty breathing when he ate. So I sent him to a respiratory specialist - nothing. A gastroenterologist - nothing. I did lung function tests. Still, nothing. He even had a camera down his throat to measure how he swallows. It’s all completely fine. He’s losing a lot of weight and he’s not eating to avoid this symptom he gets. The next step for me is to try and get him in front of an eating disorder specialist. 

“It’s more complex in that way. With many of the women I’ve dealt with, they walk in with the eating disorder and we sit down and figure out what the next steps are to improve the situation. With men, in my experience at least, it seems they feel the need to manifest a physical symptom before they feel justified to come and see their GP.”

“When my mum died, I couldn’t stop eating. Then you see my sister’s reaction. She didn’t eat anything. It was a strange contrast. We were at the opposite ends of the spectrum.”

When Peter lost a close family member, his experience was very different from his sister's. “When my mum died, I couldn’t stop eating. Everything that was in my sight, I would eat. After my mum’s funeral, I went straight to a fast food restaurant and ate until I felt sick. It was horrible. Then you see my sister’s reaction. She didn’t eat anything. It was a strange contrast. We were at the opposite ends of the spectrum.”

Binge eating disorder has grown in recognition in recent years and in contrast to anorexia and bulimia, the disorder seems to be just as prevalent in men as it is in women. It’s thought to be the most common eating disorder.

Dr Pratsides says: “When you eat, you get a release of dopamine, the same as when you exercise. A lot of men might overeat because it’s comforting. A lot of people comfort eat to the point where they’re extremely obese. I have one patient in mind who admits to this and he’s got a huge BMI - I think it’s over 50. He’s in his late 20s and he’s got diabetes. Whenever he feels stressed, whenever he feels sad, he turns to food. I ended up getting him in front of an eating disorder service because it was causing him so much physical harm and he would otherwise be healthy.”

“I gained a stone over the first lockdown. My binge eating just spiralled out of control.”

Lockdown poses a huge risk to people who suffer from an eating disorder and is thought to be responsible for the sharp rise in reported cases of eating disorders, especially among children.

Peter says: “I gained a stone over the first lockdown and it was the worst it had been in a long time. I was sad in general. I had moved to a new city and I wasn’t enjoying it. I couldn’t go out and meet people. Gyms were closed and I had a hip injury that stopped me from running. My binge eating just spiralled out of control.”

It’s a common misconception that eating disorders stay with you for life. People can, and do, make full recoveries. If you have an eating disorder, certain coping mechanisms might be worth exploring. For Peter, he found physical exercise transformed his mental state: “I think mental health and physical exercise go hand in hand. You shouldn’t focus on eliminating bad habits. Instead, slowly build on the good ones - one step at a time. Start with exercise and you’ll start eating healthier as a result. It can be an overwhelming process to begin with and getting mental and physical support is vital. It’s important to recognise that you have a mental problem, rather than just eating too much. Exercise, meditate, educate yourself about the subject and get in a routine. That’s how I managed to turn it around.”

(stock image)

*Peter’s name has been changed to protect his identity.