By Staff Writer

The one thing that practically all eating disorder sufferers have in common is a pervasive feeling of low self-esteem brought on by a negative body image. Although we usually associate eating disorders with women, who in general are more severely affected by the social, psychological and dietary factors that lead to negative body image, men are not immune to these issues.

In fact, men have a whole set of unique risk factors that we are now only beginning to understand. Information on this topic is still developing, but it's now believed that up to 25 percent of all disordered eaters in the U.S. are male, amounting to at least 1 million individuals nationwide.

Lack of Diagnosis

Today, thanks to increasing awareness, the stigma associated with male eating disorders is being reduced, but it's still powerful - particularly in a culture where males are not as free as females to express vulnerability or emotion. Because these disorders are usually associated with women, many men are ashamed to come forward for fear that it will make them seem effeminate or weak. In other cases, there is a legitimate fear that loved ones and doctors simply won't take them seriously and their problems will be dismissed. Fear of rejection and ridicule prevents action.

Because of these fears, many male eating disorder sufferers never seek treatment, and some never even admit that there's something wrong, instead opting to suffer in silence. And in the cases where males do seek medical help or therapy, doctors are often baffled - not just because eating disorders are traditionally thought of as a female problem, but because eating disorders in men can take slightly different forms that make diagnosis difficult. With growing awareness in the medical community of the unique forms that male eating disorders can take, the problems around diagnosis should improve in the coming years.

Pressure to Look a Certain Way

The power of the modern media to create and influence cultural norms around what is and isn't beautiful is a major contributing factor to eating disorders. Body types that, in past generations, would have been perfectly acceptable are now thought of as ungainly, ugly or even cause for ridicule. More and more, U.S. culture is developing a homogenized view of beauty that places emphasis on certain features - such as tallness, thinness, clear skin and straight hair - that are unattainable to many people.

Meanwhile, the media tends to emphasize the importance of physical beauty at the expense of intelligence, kindness or other types of inner beauty. In fact, these positive personal qualities are often treated with scorn in formats such as sitcoms and reality television. All of this has helped create a generation of young people, both male and female, who tend to care far more about physical attractiveness than inner resources. This results in a set of conditions in which the risk of eating disorders is always just below the surface.

When a young person suspects that he or she can't measure up the images of beauty presented by the media, this can manifest in low self-esteem and negative body image. For females, pressure to be thin can lead to the risky behaviors associated with anorexia and bulimia, including purging, taking laxatives, over-exercising or self-starvation. Males, who face similar pressures not to be overweight, may resort to the same set of behaviors, but they're also up against additional pressures to be tall, lean and muscular. Many males will try to achieve a muscular build at any cost, including steroid abuse, compulsive weight training and overindulgence in dietary supplements.

Risk Factors in Males

• When a young male participates in a sport that demands a lean or muscular body type, he may face pressure to drastically alter his body in a short period of time. This is a rare case where an eating disorder may in fact be caused by something other than low self-esteem and negative body image. Runners are particularly at risk, as are wrestlers, who often have to get down to a certain weight in order to compete in an ideal weight class.
• Adult males with professions that require them to be thin face similar risks. Workers in the fashion industry - not just fashion models, but also salespeople in department stores, designers, stylists and trainers - face pressure to be thin. Similar pressures face people in entertainment, especially actors and other types of stage and screen performers.
• High-stress jobs or jobs that don't allow a lot of time for exercise and dietary consideration can lead men to try to cut corners in order to maintain a thin appearance. Some individuals, both male and female, get into patterns at work where they say they “don't have time” for meals, which is sometimes just a conscious or unconscious tactic to make up for lack of exercise.
• Men in relationships with partners who have eating disorders are at higher risk for developing eating disorders themselves. Particularly in relationships that have a high degree of unhealthy codependency, the self-destructive behaviors and attitudes of one partner may rub off on the other partner, creating a vicious cycle of mutual enabling.
• Eating disorders tend to be more prevalent in the gay community, where unique cultural factors and, in some places, a relatively small dating pool combine to intensify the importance of physical appearance.

Eating Disorder Treatment

Males who know they have an eating disorder and wish to seek treatment may feel discouraged by the female-centered literature and organizations that deal with these illnesses. That's why it's important to continue to spread the word about eating disorders in males, and to expand current support networks to be more inclusive and welcoming to all types of people.

Treatment for an eating disorder should involve both physical and psychological components, first with a doctor who can address bodily damage the eating disorder has caused, and then with a therapist who can help the individual change his behaviors and move forward with a healthier attitude.

An eating disorder residential treatment facility, such as Sierra Tucson in Arizona, provides comprehensive services for men and women who are struggling to overcome anorexia, bulimia and binge eating disorder. This type of treatment can provide a safe and nurturing environment for patients to overcome both their eating disorder and any underlying issues that may have contributed to the disorder for a more successful and long-term recovery.