April 24, 2013 • 25 mins
Men comprise an estimated 20 percent of anorexics, but many are going untreated. To understand why, it's necessary to explore unraveling sexual orientation, internalized homonegativity and more. Tune in to learn why calling it "manorexia" is problematic.
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Episode Transcript
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Speaker 1 (00:04):
Welcome to Stuff Mom Never told You from House top
Works dot com. Hello, and welcome to the podcast. I'm
Kristimp and I'm Caroline, and today we are looking at
the mail side of eating disorders with a special focus
on anorexia nervosa, especially because there was a pretty detailed
(00:28):
article that came out in g Q magazine in two
thousand twelve discussing the rising rates of anorexia among men. Yeah,
but also how hard it is for men to seek
treatment a lot of the time, Yeah, and also factors
that might be holding men back from seeking treatment to
(00:50):
begin with. So we wanted to take a closer look
at what's going on. And first let's start out in
six eight nine, which was when Sir Richard Morton provided
the first English language description of anorexia, and he reported
two adolescent cases, one female and one male. So even
though today we often think of anorexia as something that
(01:13):
happens to girls and women, the very first case descriptions
were of a female and a male, and Morton described
the occurrences of quote unquote nervous consumption or a wasting
away due to emotional turmoil. Alright, So moving up to
eighteen seventy four, Sir William Whitey Goal was the first
to call the condition anorexia nervosa, literally meaning nervous loss
(01:36):
of appetite. And before we go any further, UM, I
guess we should go ahead and offer um a trigger
warning for people out there who have struggled with eating
disorders before UM, We're not going to go into extreme
detail about UM specific people's experiences with eating disorders. We're
gonna be talking more UM clinically about the hallmarks of
(01:57):
it in men, and will also be mentioning bulimia and
binge eating as well. So just something to keep in
mind for any sensitive listeners out there. UM. But in
nineteen eighty, interrextener vosa, which is when you shun food
you are not eating at all or eating very very
(02:18):
little only the lowest amount of calories that you really
need to keep your body running in vosa, was officially
recognized as a psychiatric disorder, and since then, the research
on interorexia in men has been relatively scarce compared to
the research devoted to women suffering from it, and the
(02:40):
reason why there's been so much less attention paid to
men is because typically they comprise a small minority of
anorexius sufferers. For instance, in there was a study which
estimated that men comprise ten percent of the a N population,
and then in the year two thousand, The Times published
(03:01):
an article studying a Toronto study which found that that
rate had gone up to possibly one in six men
who met the full or partial diagnostic criteria for anorexia.
UM but what are we talking about, Caroline. Biologically, psychologically,
what's happening? Well, anorexia uni visa is an unhealthy way
(03:21):
to cope with emotional problems. It's not like I hate food,
I feel fat. There, it's so much more to that.
And actually there are some biological roots that researchers are investigating.
This could be genetic changes that makes some people more vulnerable,
but it's unclear exactly how or why. Some people do
tend to have a genetic tendency towards perfectionism, sensitivity, and perseverance,
(03:46):
all traits associated with anorexia, and in addition, serotonin may
play a role in the disease and for men struggling
with anorexia, the the typical male antorextic profile is someone
who tends to be ank, just obsessive, persevering and perfectionistic
with a desperty to please, as well as being hyper
(04:07):
sensitive to rejection and humiliation. All of these different forces
um that are combining and in the brain, some scientists
are are really looking into what's happening, what might be
compelling people to not want to eat, and they found
that the insula in the brain regulates our bodily awareness,
(04:27):
and when too much norap and eprin is being released
in that area, uh, anorectics will feel full even when
they're not. They'll look in the mirror and see a
fat person even if they might be severely underweight. It
also elevates their pain thresholds, so it's like their body
doesn't even notice how much physical pain it's in, and
(04:48):
it puts people in constant fight or flight mode. Basically,
you're starving yourself and all of those kind of all
those systems are out of whack um And there's an
elm men of obsessive compulsive personality traits that can even
allow someone to reject food in that way, someone who
can stick to such a strict diet and forego food.
(05:10):
And on top of all of this, there are environmental
factors such as, of course, our cultural emphasis on thinness,
and also some risk factors, particularly for men, which include
being overweight as a child and specifically being bullied for
being overweight. Weight, regulated sports participation, people who are into running, wrestling,
(05:33):
and cycling maybe more primed for an eating disorder. A
New York Times story on this in June two thousand
pointed out that the similarities between men and women who
both suffer from anorexia are striking. Um Men also suffer
from low self esteem and perfectionism. They seek to gain
control over their lives by controlling their bodies, and they
(05:55):
often suffer from depression, anxiety, alcohol and drug abuse, and
other psychiatric conditions. They also, as Kristen mentioned, have severely
disordered body image. But as Christian pointed out, Dr Catherine Hallamy,
who was the director of the Eating Disorders program at
New York Presbyterian Hospital, found that the men who suffered
from anorexia were more likely to have been involved in
(06:16):
sports such as wrestling, biking, or diving that required weight control.
So it's almost as if I do wonder whether it's
a cause and effect, Like, you know, did this come about?
Did the obsession with tracking calories and weight come about
because of the sport they were participating in, or did
this perfectionism drive them to get into such a sport. Yeah,
(06:38):
I mean, and I'm sure that that might differ from
patient to patient. Um, But the very fact that we
often consider this more of a woman's disease is debilitating
for a lot of men because obviously their plenty ofmen
on their suffering from it as well, but because we
might think of it as something that happens to women,
(06:58):
it might go unrecognized in the men that they might
not even classify their extreme weight management or food monitoring
as a form of anorexy because oh, that's something that
happens to girls, or clinicians might not recognize it as well.
And because of that, eating disorders tend to last one
third longer in men because they are less likely to
(07:20):
step forward for treatment. And speaking of treatment, there might
also be a potential gender bias that happens in diagnosis
of anorexi in particular because the diagnostic and statistical manual
includes a menorrhea, which is the absence of at least
three mentional cycles as one of the qualifiers, and obviously
men don't have mentional cycles, so that's you know, one
(07:43):
area that might be addressed, even though their endocrine cycle
is certainly disrupted. Yeah, men's testosterone levels actually plummet when
they're intorexic and their sex drive vanishes. But speaking of treatment,
I mean a lot of the residential eating disorder treatment
centers that are out there don't admit men out of
a belief that treatment should be sex specific. And this
(08:03):
was talked about in that g Q article you mentioned,
kristen Um. A lot of these programs find men might
actually remind some of these female patients about abuse they
have suffered, for instance, men that they've lived with who've
treated them poorly, and so they just would rather stick
to young women. One person was quoted as saying, look,
you know, when women are in their nightgowns on the
(08:25):
scales being weighed, talking about their periods, they don't want
men to be around, right. Um. But at the same time,
you know that that does leave a gap for men
out there who need help. The Alliance for Eating Disorder
Awarenesses two thousand eleven two thousand and twelve guide listed
five out of fifty eight residential treatment centers in the
(08:46):
US that admitted men, so less than half of them
and and the thing about treatment to that we might
not realize when it comes to anorexia is that it's
not just about putting uh plate of food in front
of one and saying eat and everything being fine. It's not.
It's not as simple as that, because the potassium and
(09:06):
calcium deficiencies that are associated with longer term intorexia are
literally causing people's bones to rot. There might be cognitive
damage involved because of that malnutrition. It can help puberty,
especially depending on the age that it starts, because like
you talked about caroline, those drops in testosterone, and there's
something called refeeding syndrome, which is if the body might
(09:29):
go into shock from eating food that can end up
killing a person. So having a place to go an
actual treatment center is a crucial resource for people who
are struggling with this. So as recently as a decade ago,
clinicians believe that only five of antorectics were male. Current estimates,
(09:51):
like we mentioned, suggests it's closer and rising fast. And
one thing one aspect that is rising for men is
been eating. And this is in a New York Times
story in August binge eating, interestingly enough, is not considered
a quote unquote woman's disease as much as like anorexia
(10:12):
or bulimia would be in the sex differences are pretty
evenly split. So they found that eight million people in
the US struggle with binge eating. It's a problem shared equally.
About eleven percent of women and seven point five percent
of men among those surveyed in a twelve study acknowledge
some degree of binge eating. The problem, though, just like
(10:33):
in these other eating disorders, is that men rarely seek treatment.
Being overweight is more socially acceptable for a man, and
one man quoted in this story basically says like, look,
if I go home or to my dorm room and
eat an entire pizza, like it's just a college guy
eating a whole pizza. Whatever, it's fine. However, he said,
you know if a woman does that, she's horrified with
(10:54):
herself and might say, oh, what's wrong? What am I
doing to myself? There's just a lot of um different
social acceptance levels for these different conditions. Now, the unfortunate
part about all of these UM the rising levels of
eating disorders UM anorexia specifically for this episode. The um
that we're talking about is not just that there are
(11:17):
Mormon suffering but it's a sign that those same socio
cultural forces that initially kind of made anorexia more of
a gender disease that was affecting more women because of
the pursuit of the thinness ideal that's often more pushed
on women, that same thing is now happening to men.
(11:40):
There was an eating disorders expert Dr Anderson was talking
to The New York Times from that two thousand article
that we cited, saying that I think that men are
simply following a decade or two behind women in terms
of being exposed to body images that are increasingly difficult
to achieve, and men still would lag behind in terms
(12:01):
of anorexia because the thinness ideal is something that's more
pedaled to women whereas for men. And this is something
we talked about in our episode on body dysmorphia. Strive
more for the look of extreme muscularity, right, And this
is brought up in an Atlantic story from April that
kind of positioned girls in their barbie dolls against boys
(12:21):
and their g I. Joe action figures, saying that some
researchers believe that most male action figures promote that hyper
muscular physique that's associated with supreme masculinity. Um, just as
women might think I'm more feminine when I'm thin and willowy,
men might think I'm more masculine if I'm big and bulky.
(12:42):
And so then you have this rise in young men
using steroids and supplements to fix what is an internal problem.
It's body dissatisfaction. And so they're also the problems of
over exercising, restricting binge eating like we talked about, but
also purging, because if you think about it, that's cologist
Dr Arnold Anderson, so that dieting is just not as
(13:04):
socially acceptable for men, so many adopt purging behaviors instead.
Like it's one thing you know in society, if a
woman orders just a salad and some lemon water, if
a man does that, you're looked at as some kind
of sissy. And I mean, for evidence of how this
big orexia as it's called that strive for muscularity and
(13:24):
also male in orexia plays out in similar ways as
it does with men, I went online and googled male finnspo.
You know those images of extremely thin men that we
often associate with women, like female fits, thinspo and even
fit spo Fit spiration is something that a lot of
social media sites like Pinterest and Tumbler have cracked down
(13:48):
on girls posting these pictures of other girls who are
extremely underweight. But it's like they completely forgot the internet
did that men and also struggle with eating disorders and
that male fins bow exists. And I was so surprised
to find just how much stuff was on there, And
(14:10):
it was as though, I mean, it's just it's just
sitting there out in plain sight, I feel like. And
yet we're just now trying acknowledging the fact that oh, okay,
eating disorders happened to men as well. And while we
might call it something catchy like men arexia, no, it's
not something different at all. It's anorexia. And it's interesting
(14:32):
what pursuing either that thin muscular ideal or that big,
bulky ideal means as far as our perceptions of masculinity.
There was a study in March March of this year
UH in the Journal of Eating Disorders that found self
perceived masculinity is higher in men with muscle dysmorphia, while
men with anorexia nervosa relate more strongly to feminine stereotypes.
(14:57):
And study leader Dr Stewart Murray said that the results
don't necessarily mean that men with anorexia were any less
masculine or the men with muscle dysmorphia were less feminine
in their control subjects. It is, however, he says, an
indication of the increasing pressures men are under to define
their masculinity in the modern world. So again dealing with
(15:19):
this issue of masculinity, which isn't an outward thing necessarily,
it's more of an internal thing. I would think your
your perception, the way you define yourself, but seeking to
do so in an outward way. How you how you
shape your body, because men are affected in the in
the same way that women are by all of these
images of idealized masculinity, whatever that form might be, whether
(15:42):
or not it is the very thin, extremely lean male
figure or like you said, kind of that bulkier stockier um,
super muscular physique um. And one thing though, that we
need to talk about is sexual orientation, because study after
study has found that, compared to the relatively low population size,
(16:06):
gay men do comprise a disproportionately large percentage of the
antero exit clinical community. And so initially, when these studies
came out. The wrong conclusion was that being gay is
somehow a risk factor for developing an eating disorder, you know,
kind of tacking on something else that must be wrong
(16:27):
with these men. But the research now has come to
find but no, that's that's really not what's going on.
It's it's a bit more nuanced than that. Yeah. Dr Anderson,
who excited, said that there's nothing about gainess itself that
increases eating disorders. But he says there's a lot in
the fact that the community is highly stereotype norms for
(16:49):
what is attractive, so again trying to fit in with those, uh,
those images that you're pursuing. And according to the National
Eating Disorder Information Center in Toronto, the combination of growing
up feeling excluded and shunned, longing for acceptance and love
on the one hand, and a culture strongly linking acceptance
and love with a particular physical appearance on the other hand,
(17:11):
creates enormous pressure to attain that ideal body and because
of that. In April two thousand seven, there was a
widely publicized study that came out in the International Journal
of Eating Disorders which found that gay and bisexually identified
men had significantly higher prevalent estimates of eating disorders than
heterosexual men. But for the women in the study, there
(17:33):
was no difference in eating disorder rates across sexual orientation.
And so they said that that highlights the socio cultural
forces at work that are just peddling all of these
images to women. It's kind of like an equal, equal
opportunity offender for women. But they're saying, well, why is
there the disparity among gay men and straight men? And
(17:55):
they think that it's kind of a dual thing of
a sexual objectification and at work kind of striving for
that thinness of deal ideal, but also an internalized homo
negativity um, which is a higher body shame that is
kind of taking on all of the negativity and prejudice
that society has heaped on gay people and internalizing that
(18:20):
into a body shame. And that's how it's manifesting in
certain cases with eating disorders. And part of why gay
men seem to be overrepresented among all men with anorexia
could be that they're just more willing to come forward
and identify themselves as having an eating disorder. Yeah, and
and it's a it's another thing to where um it
(18:41):
might just be problems that manifest themselves differently in different populations,
because heterosexual men are more likely to experience that kind
of body dysmorphia and the muscularity pursuit, while as for
gay men, it might manifest more as anorexia or bulimia.
So there's still like all these different thing ings going on. UM.
(19:02):
But one risk factor two that researchers have looked into
is a history of childhood sexual abuse. UM. There was
a study that came out again in the International Journal
of Eating Disorders in July two thousand seven, which found
the game bisexual men with a history of childhood sexual
abuse are significantly more likely to have subclinical bulimia or
(19:22):
any current full syndrome or subclinical eating disorder compared with
men without such a history. And that makes sense. I mean,
any kind of childhood trauma is often a risk factor
for these kinds of disorders because, like you mentioned, caroline,
eating disorders are often a form of emotional coping mechanism.
But I mean, as several studies have pointed out, it's
(19:44):
not the sexual orientation itself that's an independent risk factor.
There are a lot more factors involved in why men
in general and gay men also develop anorexia, and there
does seem to still be this hierarchy of research paid
to anorexia in particular, where it starts off with looking
(20:04):
at it in female populations above and beyond, and then
there is all this attention paid to gay male populations,
and now we're finally getting down to just looking at
men in general, saying, oh, wait, okay, no, this is
going on across you know, sexual orientation and affecting so
many men one in six estimated men. But they are
(20:25):
either not stepping forward of seeking treatment or maybe we're
not looking for it because we still have a gendered
perception of that um. But the reason why it's so
important that researchers continue to pay attention to it and
that public awareness is raised of eating disorders among men
is that anorexia specifically has the highest mortality rate of
(20:47):
any mental illness of even recovered anorexics don't reach life
expectancy because of the damage done to their body, like
the you know, those potassium and seemed deficiencies and how
it harms your bones, the potential cognitive deficiencies, all of
this different stuff that makes it a very dangerous mental
(21:08):
illness to let go untreated. Well, we hope this has
been helpful for you listeners, um and giving you a
little bit of perspective on something that is not talked
about as much as maybe the women and girls who
are struggling with anorexia these days. UM, if you are
someone you know are struggling with an eating disorder, we
(21:29):
do recommend you look up the Alliance for Eating Disorder
Awareness online. Yeah, you can find um plenty of resources there. Um.
And if you would like to write to us as well, UM,
we would love to hear from you. Mom. Stuff at
Discovery dot com is where you can send your letters.
You can also send us a message on Facebook. UM.
But again, if you you know, even if you might
(21:51):
not fit you know, the standard assumed definition of someone
who just never eats, it doesn't mean that you know
there might be something going on, So pay attention to
your own patterns and um, you know, if you have
a friend going through something, reach out as well, because
it's it's a dangerous disease. And now back to letters. Well,
(22:14):
we've got a couple of emails here on our episode
on gender and cleanliness, and I have one here from
Rachel who just got back from visiting her twenty two
year old brother, who lives with two other male roommates
of similar age. She says, I think when it comes
to living with people, the cleanliness of the living living
space depends on the strength and perseverance of the person
(22:36):
who has the highest standard, not the gender. My brother
in one roommate really don't care all that much about cleaning,
while the third is quite neat. However, the third one
does not insist that my brother and the other one
do their fair share of chores. I believe that my
brother is not actively ignoring messy areas, he just doesn't notice.
As a result, the neat roommate is irritated when he
(22:56):
has to do all the cleaning and trash removal, which
only seemed to apply to the kitch. And because I
disinfected the bathroom before showering, this included kicking dirty clothes
into various rooms, especially since my brother likes to leave
a trail of clothes to the shower from whatever location
he decides on showering. And I live in an apartment
with one roommate, and when I arrived, everything was grungy,
there was some mold in the bathroom, et cetera. But
(23:17):
I created a rotating weekly chore list and shared it
with my roommate. Now each have two chores to accomplish
at some point during a given week. A previous roommate
introduced me to the strategy and it worked well. Common
rooms get cleaned weekly, but there's not a lot of pressure,
and we each do our chores when we have the time.
So it sounds like a good strategy for keeping things
clean with roommates. So thanks Rachel. Indeed, and here's a
(23:41):
letter from Lily. She says, I've always been someone who
doesn't mind a little bit of clutter, and as a kid,
I would definitely let my room turn into a tornado
once in a while. My boyfriend of five years is
so much better at keeping a clean house than I am.
When we first met, his room was always neat. At first,
I thought it was just to impress me, But as
I got to know him better and now that we
lived together, I realized that being an uncluttered person is
(24:02):
a part of who he is. For example, he makes
sure the dishwashers emptied every night, and he gets annoyed
if I leave my purse or jackets lying around. His
tools are superbly organized, and so are his clothes in
his dresser. Me, on the other hand, I just don't
care as much if I leave the dishes for a
night or throw my clothes on the ground. I'll pick
them up later. But relationships are about compromise, and I
(24:22):
can say that his ability to live uncluttered has actually
made me a better person. I know that being organized
and clean makes her a better or less stressful living environment,
but knowing and doing when it comes to organization haven't
always come hand in hand. For me, having someone that
pushes me to live like that, that expects me to
do my share of the chores, has helped me developed
new habits and ultimately makes my life better. However, washing
(24:44):
the bed sheets, brushing his teeth, and washing his hands
are totally different stories. I've given up on him in
those areas, so thank you, Lily, and I agree. Living
with dude roommate, I've been forced to be a neater
person in the common space anyway. Well that's a good thing.
So thanks you everyone who has written into Mom's Stuff
at Discovery dot com, where you can send your letters.
(25:04):
You can also find us over on Facebook and follow
us on Twitter at Mom's Stuff podcast. You can follow
us on Tumbler as well. It's stuff Mom Never told
You dot tumbler dot com. And if you would like
to get smarter this week, you should add to our
website it's how stuff Works dot com for more on
(25:26):
this and thousands of other topics. Does it how stuff
works dot com
Welcome to Stuff Mom Never told You from House top
Works dot com. Hello, and welcome to the podcast. I'm
Kristimp and I'm Caroline, and today we are looking at
the mail side of eating disorders with a special focus
on anorexia nervosa, especially because there was a pretty detailed
(00:28):
article that came out in g Q magazine in two
thousand twelve discussing the rising rates of anorexia among men. Yeah,
but also how hard it is for men to seek
treatment a lot of the time, Yeah, and also factors
that might be holding men back from seeking treatment to
(00:50):
begin with. So we wanted to take a closer look
at what's going on. And first let's start out in
six eight nine, which was when Sir Richard Morton provided
the first English language description of anorexia, and he reported
two adolescent cases, one female and one male. So even
though today we often think of anorexia as something that
(01:13):
happens to girls and women, the very first case descriptions
were of a female and a male, and Morton described
the occurrences of quote unquote nervous consumption or a wasting
away due to emotional turmoil. Alright, So moving up to
eighteen seventy four, Sir William Whitey Goal was the first
to call the condition anorexia nervosa, literally meaning nervous loss
(01:36):
of appetite. And before we go any further, UM, I
guess we should go ahead and offer um a trigger
warning for people out there who have struggled with eating
disorders before UM, We're not going to go into extreme
detail about UM specific people's experiences with eating disorders. We're
gonna be talking more UM clinically about the hallmarks of
(01:57):
it in men, and will also be mentioning bulimia and
binge eating as well. So just something to keep in
mind for any sensitive listeners out there. UM. But in
nineteen eighty, interrextener vosa, which is when you shun food
you are not eating at all or eating very very
(02:18):
little only the lowest amount of calories that you really
need to keep your body running in vosa, was officially
recognized as a psychiatric disorder, and since then, the research
on interorexia in men has been relatively scarce compared to
the research devoted to women suffering from it, and the
(02:40):
reason why there's been so much less attention paid to
men is because typically they comprise a small minority of
anorexius sufferers. For instance, in there was a study which
estimated that men comprise ten percent of the a N population,
and then in the year two thousand, The Times published
(03:01):
an article studying a Toronto study which found that that
rate had gone up to possibly one in six men
who met the full or partial diagnostic criteria for anorexia.
UM but what are we talking about, Caroline. Biologically, psychologically,
what's happening? Well, anorexia uni visa is an unhealthy way
(03:21):
to cope with emotional problems. It's not like I hate food,
I feel fat. There, it's so much more to that.
And actually there are some biological roots that researchers are investigating.
This could be genetic changes that makes some people more vulnerable,
but it's unclear exactly how or why. Some people do
tend to have a genetic tendency towards perfectionism, sensitivity, and perseverance,
(03:46):
all traits associated with anorexia, and in addition, serotonin may
play a role in the disease and for men struggling
with anorexia, the the typical male antorextic profile is someone
who tends to be ank, just obsessive, persevering and perfectionistic
with a desperty to please, as well as being hyper
(04:07):
sensitive to rejection and humiliation. All of these different forces
um that are combining and in the brain, some scientists
are are really looking into what's happening, what might be
compelling people to not want to eat, and they found
that the insula in the brain regulates our bodily awareness,
(04:27):
and when too much norap and eprin is being released
in that area, uh, anorectics will feel full even when
they're not. They'll look in the mirror and see a
fat person even if they might be severely underweight. It
also elevates their pain thresholds, so it's like their body
doesn't even notice how much physical pain it's in, and
(04:48):
it puts people in constant fight or flight mode. Basically,
you're starving yourself and all of those kind of all
those systems are out of whack um And there's an
elm men of obsessive compulsive personality traits that can even
allow someone to reject food in that way, someone who
can stick to such a strict diet and forego food.
(05:10):
And on top of all of this, there are environmental
factors such as, of course, our cultural emphasis on thinness,
and also some risk factors, particularly for men, which include
being overweight as a child and specifically being bullied for
being overweight. Weight, regulated sports participation, people who are into running, wrestling,
(05:33):
and cycling maybe more primed for an eating disorder. A
New York Times story on this in June two thousand
pointed out that the similarities between men and women who
both suffer from anorexia are striking. Um Men also suffer
from low self esteem and perfectionism. They seek to gain
control over their lives by controlling their bodies, and they
(05:55):
often suffer from depression, anxiety, alcohol and drug abuse, and
other psychiatric conditions. They also, as Kristen mentioned, have severely
disordered body image. But as Christian pointed out, Dr Catherine Hallamy,
who was the director of the Eating Disorders program at
New York Presbyterian Hospital, found that the men who suffered
from anorexia were more likely to have been involved in
(06:16):
sports such as wrestling, biking, or diving that required weight control.
So it's almost as if I do wonder whether it's
a cause and effect, Like, you know, did this come about?
Did the obsession with tracking calories and weight come about
because of the sport they were participating in, or did
this perfectionism drive them to get into such a sport. Yeah,
(06:38):
I mean, and I'm sure that that might differ from
patient to patient. Um, But the very fact that we
often consider this more of a woman's disease is debilitating
for a lot of men because obviously their plenty ofmen
on their suffering from it as well, but because we
might think of it as something that happens to women,
(06:58):
it might go unrecognized in the men that they might
not even classify their extreme weight management or food monitoring
as a form of anorexy because oh, that's something that
happens to girls, or clinicians might not recognize it as well.
And because of that, eating disorders tend to last one
third longer in men because they are less likely to
(07:20):
step forward for treatment. And speaking of treatment, there might
also be a potential gender bias that happens in diagnosis
of anorexi in particular because the diagnostic and statistical manual
includes a menorrhea, which is the absence of at least
three mentional cycles as one of the qualifiers, and obviously
men don't have mentional cycles, so that's you know, one
(07:43):
area that might be addressed, even though their endocrine cycle
is certainly disrupted. Yeah, men's testosterone levels actually plummet when
they're intorexic and their sex drive vanishes. But speaking of treatment,
I mean a lot of the residential eating disorder treatment
centers that are out there don't admit men out of
a belief that treatment should be sex specific. And this
(08:03):
was talked about in that g Q article you mentioned,
kristen Um. A lot of these programs find men might
actually remind some of these female patients about abuse they
have suffered, for instance, men that they've lived with who've
treated them poorly, and so they just would rather stick
to young women. One person was quoted as saying, look,
you know, when women are in their nightgowns on the
(08:25):
scales being weighed, talking about their periods, they don't want
men to be around, right. Um. But at the same time,
you know that that does leave a gap for men
out there who need help. The Alliance for Eating Disorder
Awarenesses two thousand eleven two thousand and twelve guide listed
five out of fifty eight residential treatment centers in the
(08:46):
US that admitted men, so less than half of them
and and the thing about treatment to that we might
not realize when it comes to anorexia is that it's
not just about putting uh plate of food in front
of one and saying eat and everything being fine. It's not.
It's not as simple as that, because the potassium and
(09:06):
calcium deficiencies that are associated with longer term intorexia are
literally causing people's bones to rot. There might be cognitive
damage involved because of that malnutrition. It can help puberty,
especially depending on the age that it starts, because like
you talked about caroline, those drops in testosterone, and there's
something called refeeding syndrome, which is if the body might
(09:29):
go into shock from eating food that can end up
killing a person. So having a place to go an
actual treatment center is a crucial resource for people who
are struggling with this. So as recently as a decade ago,
clinicians believe that only five of antorectics were male. Current estimates,
(09:51):
like we mentioned, suggests it's closer and rising fast. And
one thing one aspect that is rising for men is
been eating. And this is in a New York Times
story in August binge eating, interestingly enough, is not considered
a quote unquote woman's disease as much as like anorexia
(10:12):
or bulimia would be in the sex differences are pretty
evenly split. So they found that eight million people in
the US struggle with binge eating. It's a problem shared equally.
About eleven percent of women and seven point five percent
of men among those surveyed in a twelve study acknowledge
some degree of binge eating. The problem, though, just like
(10:33):
in these other eating disorders, is that men rarely seek treatment.
Being overweight is more socially acceptable for a man, and
one man quoted in this story basically says like, look,
if I go home or to my dorm room and
eat an entire pizza, like it's just a college guy
eating a whole pizza. Whatever, it's fine. However, he said,
you know if a woman does that, she's horrified with
(10:54):
herself and might say, oh, what's wrong? What am I
doing to myself? There's just a lot of um different
social acceptance levels for these different conditions. Now, the unfortunate
part about all of these UM the rising levels of
eating disorders UM anorexia specifically for this episode. The um
that we're talking about is not just that there are
(11:17):
Mormon suffering but it's a sign that those same socio
cultural forces that initially kind of made anorexia more of
a gender disease that was affecting more women because of
the pursuit of the thinness ideal that's often more pushed
on women, that same thing is now happening to men.
(11:40):
There was an eating disorders expert Dr Anderson was talking
to The New York Times from that two thousand article
that we cited, saying that I think that men are
simply following a decade or two behind women in terms
of being exposed to body images that are increasingly difficult
to achieve, and men still would lag behind in terms
(12:01):
of anorexia because the thinness ideal is something that's more
pedaled to women whereas for men. And this is something
we talked about in our episode on body dysmorphia. Strive
more for the look of extreme muscularity, right, And this
is brought up in an Atlantic story from April that
kind of positioned girls in their barbie dolls against boys
(12:21):
and their g I. Joe action figures, saying that some
researchers believe that most male action figures promote that hyper
muscular physique that's associated with supreme masculinity. Um, just as
women might think I'm more feminine when I'm thin and willowy,
men might think I'm more masculine if I'm big and bulky.
(12:42):
And so then you have this rise in young men
using steroids and supplements to fix what is an internal problem.
It's body dissatisfaction. And so they're also the problems of
over exercising, restricting binge eating like we talked about, but
also purging, because if you think about it, that's cologist
Dr Arnold Anderson, so that dieting is just not as
(13:04):
socially acceptable for men, so many adopt purging behaviors instead.
Like it's one thing you know in society, if a
woman orders just a salad and some lemon water, if
a man does that, you're looked at as some kind
of sissy. And I mean, for evidence of how this
big orexia as it's called that strive for muscularity and
(13:24):
also male in orexia plays out in similar ways as
it does with men, I went online and googled male finnspo.
You know those images of extremely thin men that we
often associate with women, like female fits, thinspo and even
fit spo Fit spiration is something that a lot of
social media sites like Pinterest and Tumbler have cracked down
(13:48):
on girls posting these pictures of other girls who are
extremely underweight. But it's like they completely forgot the internet
did that men and also struggle with eating disorders and
that male fins bow exists. And I was so surprised
to find just how much stuff was on there, And
(14:10):
it was as though, I mean, it's just it's just
sitting there out in plain sight, I feel like. And
yet we're just now trying acknowledging the fact that oh, okay,
eating disorders happened to men as well. And while we
might call it something catchy like men arexia, no, it's
not something different at all. It's anorexia. And it's interesting
(14:32):
what pursuing either that thin muscular ideal or that big,
bulky ideal means as far as our perceptions of masculinity.
There was a study in March March of this year
UH in the Journal of Eating Disorders that found self
perceived masculinity is higher in men with muscle dysmorphia, while
men with anorexia nervosa relate more strongly to feminine stereotypes.
(14:57):
And study leader Dr Stewart Murray said that the results
don't necessarily mean that men with anorexia were any less
masculine or the men with muscle dysmorphia were less feminine
in their control subjects. It is, however, he says, an
indication of the increasing pressures men are under to define
their masculinity in the modern world. So again dealing with
(15:19):
this issue of masculinity, which isn't an outward thing necessarily,
it's more of an internal thing. I would think your
your perception, the way you define yourself, but seeking to
do so in an outward way. How you how you
shape your body, because men are affected in the in
the same way that women are by all of these
images of idealized masculinity, whatever that form might be, whether
(15:42):
or not it is the very thin, extremely lean male
figure or like you said, kind of that bulkier stockier um,
super muscular physique um. And one thing though, that we
need to talk about is sexual orientation, because study after
study has found that, compared to the relatively low population size,
(16:06):
gay men do comprise a disproportionately large percentage of the
antero exit clinical community. And so initially, when these studies
came out. The wrong conclusion was that being gay is
somehow a risk factor for developing an eating disorder, you know,
kind of tacking on something else that must be wrong
(16:27):
with these men. But the research now has come to
find but no, that's that's really not what's going on.
It's it's a bit more nuanced than that. Yeah. Dr Anderson,
who excited, said that there's nothing about gainess itself that
increases eating disorders. But he says there's a lot in
the fact that the community is highly stereotype norms for
(16:49):
what is attractive, so again trying to fit in with those, uh,
those images that you're pursuing. And according to the National
Eating Disorder Information Center in Toronto, the combination of growing
up feeling excluded and shunned, longing for acceptance and love
on the one hand, and a culture strongly linking acceptance
and love with a particular physical appearance on the other hand,
(17:11):
creates enormous pressure to attain that ideal body and because
of that. In April two thousand seven, there was a
widely publicized study that came out in the International Journal
of Eating Disorders which found that gay and bisexually identified
men had significantly higher prevalent estimates of eating disorders than
heterosexual men. But for the women in the study, there
(17:33):
was no difference in eating disorder rates across sexual orientation.
And so they said that that highlights the socio cultural
forces at work that are just peddling all of these
images to women. It's kind of like an equal, equal
opportunity offender for women. But they're saying, well, why is
there the disparity among gay men and straight men? And
(17:55):
they think that it's kind of a dual thing of
a sexual objectification and at work kind of striving for
that thinness of deal ideal, but also an internalized homo
negativity um, which is a higher body shame that is
kind of taking on all of the negativity and prejudice
that society has heaped on gay people and internalizing that
(18:20):
into a body shame. And that's how it's manifesting in
certain cases with eating disorders. And part of why gay
men seem to be overrepresented among all men with anorexia
could be that they're just more willing to come forward
and identify themselves as having an eating disorder. Yeah, and
and it's a it's another thing to where um it
(18:41):
might just be problems that manifest themselves differently in different populations,
because heterosexual men are more likely to experience that kind
of body dysmorphia and the muscularity pursuit, while as for
gay men, it might manifest more as anorexia or bulimia.
So there's still like all these different thing ings going on. UM.
(19:02):
But one risk factor two that researchers have looked into
is a history of childhood sexual abuse. UM. There was
a study that came out again in the International Journal
of Eating Disorders in July two thousand seven, which found
the game bisexual men with a history of childhood sexual
abuse are significantly more likely to have subclinical bulimia or
(19:22):
any current full syndrome or subclinical eating disorder compared with
men without such a history. And that makes sense. I mean,
any kind of childhood trauma is often a risk factor
for these kinds of disorders because, like you mentioned, caroline,
eating disorders are often a form of emotional coping mechanism.
But I mean, as several studies have pointed out, it's
(19:44):
not the sexual orientation itself that's an independent risk factor.
There are a lot more factors involved in why men
in general and gay men also develop anorexia, and there
does seem to still be this hierarchy of research paid
to anorexia in particular, where it starts off with looking
(20:04):
at it in female populations above and beyond, and then
there is all this attention paid to gay male populations,
and now we're finally getting down to just looking at
men in general, saying, oh, wait, okay, no, this is
going on across you know, sexual orientation and affecting so
many men one in six estimated men. But they are
(20:25):
either not stepping forward of seeking treatment or maybe we're
not looking for it because we still have a gendered
perception of that um. But the reason why it's so
important that researchers continue to pay attention to it and
that public awareness is raised of eating disorders among men
is that anorexia specifically has the highest mortality rate of
(20:47):
any mental illness of even recovered anorexics don't reach life
expectancy because of the damage done to their body, like
the you know, those potassium and seemed deficiencies and how
it harms your bones, the potential cognitive deficiencies, all of
this different stuff that makes it a very dangerous mental
(21:08):
illness to let go untreated. Well, we hope this has
been helpful for you listeners, um and giving you a
little bit of perspective on something that is not talked
about as much as maybe the women and girls who
are struggling with anorexia these days. UM, if you are
someone you know are struggling with an eating disorder, we
(21:29):
do recommend you look up the Alliance for Eating Disorder
Awareness online. Yeah, you can find um plenty of resources there. Um.
And if you would like to write to us as well, UM,
we would love to hear from you. Mom. Stuff at
Discovery dot com is where you can send your letters.
You can also send us a message on Facebook. UM.
But again, if you you know, even if you might
(21:51):
not fit you know, the standard assumed definition of someone
who just never eats, it doesn't mean that you know
there might be something going on, So pay attention to
your own patterns and um, you know, if you have
a friend going through something, reach out as well, because
it's it's a dangerous disease. And now back to letters. Well,
(22:14):
we've got a couple of emails here on our episode
on gender and cleanliness, and I have one here from
Rachel who just got back from visiting her twenty two
year old brother, who lives with two other male roommates
of similar age. She says, I think when it comes
to living with people, the cleanliness of the living living
space depends on the strength and perseverance of the person
(22:36):
who has the highest standard, not the gender. My brother
in one roommate really don't care all that much about cleaning,
while the third is quite neat. However, the third one
does not insist that my brother and the other one
do their fair share of chores. I believe that my
brother is not actively ignoring messy areas, he just doesn't notice.
As a result, the neat roommate is irritated when he
(22:56):
has to do all the cleaning and trash removal, which
only seemed to apply to the kitch. And because I
disinfected the bathroom before showering, this included kicking dirty clothes
into various rooms, especially since my brother likes to leave
a trail of clothes to the shower from whatever location
he decides on showering. And I live in an apartment
with one roommate, and when I arrived, everything was grungy,
there was some mold in the bathroom, et cetera. But
(23:17):
I created a rotating weekly chore list and shared it
with my roommate. Now each have two chores to accomplish
at some point during a given week. A previous roommate
introduced me to the strategy and it worked well. Common
rooms get cleaned weekly, but there's not a lot of pressure,
and we each do our chores when we have the time.
So it sounds like a good strategy for keeping things
clean with roommates. So thanks Rachel. Indeed, and here's a
(23:41):
letter from Lily. She says, I've always been someone who
doesn't mind a little bit of clutter, and as a kid,
I would definitely let my room turn into a tornado
once in a while. My boyfriend of five years is
so much better at keeping a clean house than I am.
When we first met, his room was always neat. At first,
I thought it was just to impress me, But as
I got to know him better and now that we
lived together, I realized that being an uncluttered person is
(24:02):
a part of who he is. For example, he makes
sure the dishwashers emptied every night, and he gets annoyed
if I leave my purse or jackets lying around. His
tools are superbly organized, and so are his clothes in
his dresser. Me, on the other hand, I just don't
care as much if I leave the dishes for a
night or throw my clothes on the ground. I'll pick
them up later. But relationships are about compromise, and I
(24:22):
can say that his ability to live uncluttered has actually
made me a better person. I know that being organized
and clean makes her a better or less stressful living environment,
but knowing and doing when it comes to organization haven't
always come hand in hand. For me, having someone that
pushes me to live like that, that expects me to
do my share of the chores, has helped me developed
new habits and ultimately makes my life better. However, washing
(24:44):
the bed sheets, brushing his teeth, and washing his hands
are totally different stories. I've given up on him in
those areas, so thank you, Lily, and I agree. Living
with dude roommate, I've been forced to be a neater
person in the common space anyway. Well that's a good thing.
So thanks you everyone who has written into Mom's Stuff
at Discovery dot com, where you can send your letters.
(25:04):
You can also find us over on Facebook and follow
us on Twitter at Mom's Stuff podcast. You can follow
us on Tumbler as well. It's stuff Mom Never told
You dot tumbler dot com. And if you would like
to get smarter this week, you should add to our
website it's how stuff Works dot com for more on
(25:26):
this and thousands of other topics. Does it how stuff
works dot com
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