Cosmopolitan, Good Housekeeping, and Ladies Home Journal have beckoned to women with promises of “Slimming Swimsuits,” or “The Quickest, Easiest Way To Look 10 Pounds Lighter” for years. Every female who has ever been in a grocery store knows the scenario: after picking up macaroni and cheese, grapes, fat-free chocolate pudding pops and about eight other items (just enough to exceed the 10 item express lane limit), our average female shopper winds up behind someone buying for a family of eighteen. Knowing that a quick trip to the grocery store has been irreparably stalled, she begins to scan the magazine rack. Glancing over the “Oprah Has Alien Baby” and “Elvis Sighted Waterskiing in the Antarctic,” her eyes settle on a Marie Claire, which quickly tempts her with a summary of the latest diet trend, while instructing her to “Tone That Tummy in Six Weeks Or Less!” She looks at her basket, looks at the air-brushed supermodel on the cover, glances at her reflection in the windows at the front of the store, and feels a little less confident, perhaps a little more insufficient than before.

But what if a new character in the grocery store — the young twenty-something professional male or the forty-something father of two — is casually leafing through Men’s Health, wondering how in the world his nicely rounded stomach could ever look like the washboard abs the cover model is flexing?

American society is fairly familiar with the first character described. While men have traditionally dealt with a slew of non-physical expectations — economic success, the ability to support a family, independence, etc. — women have historically confronted harsher standards for one’s physical appearance. In our age of glorified and now televised plastic surgery, low-carb diets, pectoral implants, calf-replacements, hair “product,” and air-brushed cover boys, men are increasingly confronted with many of the same body image concerns typically associated with women. Despite the fact that many men joke about the new “metrosexual” phenomenon in American society, these new standards, when not examined critically, can have lasting detrimental effects.

While schools, media and healthcare professionals often draw attention to eating disorders and body image problems in relation to women, discussion on how these issues affect males is rare, if not non-existent. Recent studies have demonstrated that men appear to be more comfortable with their bodies than women: 41 percent of men reported being dissatisfied with their weight versus 55 percent of women expressing discontentment. However, one in every ten persons that develop an eating disorder is male, and almost a quarter of males in the U.S. are actively trying to shed weight. While clearly not everyone on a diet is facing an eating disorder, knowing warning signs, personal limits and where to get help are imperative for individuals and their friends who feel that their efforts at being thin or fit are beginning to dominate their lives. And unfortunately for men, finding information and guidance can be much harder than it is for women.

RECOGNIZE eating disorders; don’t discriminate on the basis of gender Learn about eating disorders and know the warning signs TALK with young men about the ways in which cultural attitudes regarding ideal male body shape, masculinity and sexuality are shaped by the media Never emphasize body size or shape as an indication of a young man’s worth or identity as a man CONFRONT others who tease men who do not meet traditional cultural expectations for masculinity LISTEN carefully to a young man’s thoughts and feelings, take his pain seriously, allow him to become who he is VALIDATE a young man’s strivings for independence and encourage him to develop all aspects of his personality, not only those that family and/or culture find acceptable RESPECT a person’s need for space, privacy, boundaries and decisions, especially with regard to what he eats and how he looks UNDERSTAND the critical role of fathers and other male influences in preventing eating disorders; find ways to connect young men with healthy male role models

Research suggests that eating disorders in males are similar, if not completely identical to those experienced by females. While many people believe that those with eating disorders have an over-arching desire to be thin, both anorexia (wherein a person severely restricts his or her food intake), and bulimia (characterized by patterns of binge eating and purging via either laxatives or vomiting), involve much more than merely wanting a certain body type.

Anorexia and bulimia are both borne out of a desire for control of one’s life, which is why both often manifest themselves at puberty, when bodies and emotions are changing and fluctuating rapidly. Eating disorders can also be induced by outside stressors, such as traumatic situations. These can range from a death in the family to switching schools, all the way to more severe traumas, such as sexual assault or physical abuse. Many people with anorexia or bulimia are also perfectionists by nature and place much of their self-worth on their appearance and overall ability to please others. While in the midst of the eating disorder, it is common that they may become depressed, exhibit a desire to avoid social situations or even express feelings of worthlessness. Most doctors and counselors agree that, much like any person that experiences addiction, a person who has had an eating disorder never fully recovers or is “cured”— they merely learn how to treat, manage and self-monitor their condition.

Despite the clinical similarities, males face greater roadblocks in identification and treatment of such disorders. Marshall Divita, a counselor at SafePlace in Austin, states the problem very clearly: “Men’s eating disorders are under-discussed, under-diagnosed and under-reported.”
Addressing the first problem, Divita observes, “It’s under-discussed because many men feel that people will react with a ‘What’s wrong with you?’-type response. They have a fear of being judged and a fear of being alone. It is not uncommon for people to think they are one of the only guys with this problem, which can [ultimately] result in an overwhelming sense of isolation.”

Whereas, some women’s peer groups actually support and promote unhealthy eating behavior, via “Binge and Purge” parties or encouraging each other to purge after meals, men rarely involve others in their eating disorders. Divita adds that, “the eating disorder is like a prison — men fear that friends and family will never look at them the same and it is a very private thing.”

Furthermore, many male athletes dealing with the rigor of weight requirements and scrutiny face occupational hazards with regard to eating disorders. Gymnasts, runners, bodybuilders, rowers, wrestlers, jockeys, dancers and swimmers are particularly vulnerable to eating disorders.

Males, as a rule, are more likely to have the condition diagnosed at an advanced stage when treatment is more difficult. Similarly, a lack of awareness amongst doctors and parents means that little reliable data exists for male eating disorders that don’t reach highly critical stages. While no definitive study has shown that the frequency of male eating disorders is increasing, many doctors report seeing substantially more male patients with anorexia/bulimia than in the past. In fact, in a recent Arizona Central article, the head of counseling psychology at Argosy University-San Francisco Bay stated that he had seen a 12-fold increase in the number of male patients with eating disorders during the past 20 years.

“Because the research cycle is very slow (scientific literature in this area is about a year to two years behind), statistics aren’t currently showing an increase in male eating disorders,” explains Dr. Douglas Bunnel, president of the National Eating Disorders Association Board of Trustees. “However, if you look at it anecdotally, there has been an increase in males seeking treatment for eating disorders.”

While no one has definitively determined the cause(s) of this increase, we need only look as far as the grocery store checkout isle to understand some of the contributing factors. Reflecting on print and television media, Divita comments, “We have a culture that is very youth-focused, tone-focused and body-focused. People look at these magazine covers, and nobody looks like that — not even the models! They just have the benefits of Photoshop!”

A study conducted in the mid-1990s suggested that males were receiving more messages about dieting, muscularity and plastic surgery options than ever before. A similar study noted that while women’s magazines displayed more advertisements about dieting, men’s magazines contained more editorial about bodyshaping and fitness and more ads about weight lifting, bodybuilding and muscle toning.

Divita believes that, with the popularity of shows like “Extreme Makeover” and “Are You Hot,” it is only a matter of time before, “We’re going to see more of this in society. Not only are we going to make you look handsome or pretty, we’re going to make you look right.”

This emphasis on perfection or a correct versus incorrect way to look, feeds into the psychology of eating disorders. While some people can watch these shows, pick up health magazines and not be affected in a negative way, Divita notes that, “People who haven’t had an eating disorder find it very difficult to understand. A good comparison is this: if you’ve never had a sleep disturbance, you don’t know how hard it can be for people to go to sleep at night.”

Similarly, persons who are in recovery from an eating disorder may find that participating in the latest fitness trend presents unique challenges. “For people who already have an eating disorder in check, going on a fad diet can be a trigger for relapse,” Divita explains.

For this reason, awareness of warning signs and knowledge of how to get help for both males and females struggling with eating disorders is critical. But most importantly, if you feel that your eating or exercising habits may be unhealthy, consult with a therapist or healthcare provider. And for men, it is especially important to seek out a second opinion if you feel you have a problem that your doctor is not taking seriously.