The Overlooked Disease

I turn over the Balance Bar I’m holding to look at the nutrition facts on the back, and the girl next to me scowls. “What are you doing?,” she asks. “Guys aren’t supposed to be worried about calories.” But it’s hard to ignore the Men’s Fitness magazine on the rack next to me screaming “Blast Away Your Fat” and “New Muscle Made Easier.”

Between five and ten percent of individuals treated for eating disorders are male. Of the three to five million American males who have been clinically recognized as having eating disorders, about half of them have clinical bulimia nervosa, and another quarter are diagnosed with anorexia.

Yet this problem goes largely unnoticed. There are few treatment options for men with eating disorders—the President of the Harvard Eating Disorder Center (HEDC), David Herzog, knew of only one center nationwide that had all-male treatment groups. And HEDC’s annual forum at Harvard during Eating Disorder Awareness Week this year ignored the problem entirely—it was entitled “Body Image, Culture & the Media: Shaping the Women of Tomorrow.” (In partial defense of HEDC, they historically have and continue to do research into eating disorders in males.)

The failure to publicize the prevalence and significance of this disease is not unique to Harvard, and its consequences are serious. Because eating disorders continue to be treated as a primarily female problem, men who are struggling with eating and body image are afraid to admit their concerns and are often unaware that help is available. It is not culturally sanctioned for men to get help.

Men often feel ashamed about having an eating disorder. They wonder “What will people think of me? Am I less masculine? Will they question my sexuality? I shouldn’t be struggling with these issues.” This is especially true because there is a commonly held stereotype that male eating disorders occur primarily among homosexuals. While homosexuals are at a high risk of developing an eating disorder, 80 percent of males suffering with eating disorders are heterosexual.

There are numerous stigmas against males with eating disorders that make treatment particularly difficult: primary care physicians are not attentive to symptoms in males, and patient groups—an important part of treatment—tend to have few or no males enrolled.

In many cases, it doesn’t cross either the patient’s or his physician’s mind that an eating disorder is a possible diagnosis. “As recently as one year ago, patients have told me that their doctors had told them they weren’t struggling with an eating disorder because they’re male,” said Roberto Olivardia, a clinician specializing in eating disorders at McLean Hospital.

As a result, men avoid treatment for much longer than women. The 1997 HEDC study found a 13.7 year delay among men before treatment for males with a binge eating disorder, and 8.4 years for bulimia nervosa, which is considerably longer than the year or two delay that face female patients. As Linda Gelda, a social worker specializing in eating disorders, confirmed, “many men have only come into treatment because of [another] medical concern. Some of them had been purging for decades, and nobody knew.”

The difficulty that men face in getting diagnosed and into treatment suggests that there may be many more men suffering with eating disorders than show up in treatment centers. In fact, many researchers believe that the reported 5-10 percent of men with eating disorders is in fact a dramatic underestimate.

What is clear about eating disorders in men is that they aren’t going away. In 1997, a Psychology Today study revealed that 41 percent of men were dissatisfied with their bodies, up from 34 percent in 1985 and only 15 percent in 1972. In the last 25 years, Playgirl models on average have shed 12 pounds of fat and gained 27 pounds of muscle, while children’s action toys have grown to proportions that steroid-popping bodybuilders can only dream of—a sort of male analog to the absurd ideal of Barbie.

Co-director of Eating Concerns Hotline Outreach (ECHO), Vanessa Fajans-Turner ’04 said that Harvard is neither immune to eating disorders in men nor the prejudices against them. She said that ECHO is trying to create channels for men to freely discuss eating concerns. “This is an unaddressed, unappealed-to sector,” she said. “That in itself should give incentive to create a more open forum to address [male eating disorders].”

While a remedy is possible, it requires each of our individual efforts. We must recognize that eating disorders do not respect any social, sexual or gender barriers. And each of us must be prepared to respect anyone’s concern about body image or eating—to deny that someone could have an eating disorder is a subtle but dangerous form of intolerance.

Most importantly, if you think you or anyone you know has an eating disorder, please contact UHS or ECHO. Help for both men and women is only a phone call away.

Jeremy D. Olson ’04, is a philosophy concentrator in Currier House.