The following content may be sensitive to those who struggle with disordered eating or body image issues.
There is a commonly held misconception that eating disorders are a lifestyle choice, similar to how society thinks of addiction or drug use. In reality, eating disorders are serious and often fatal psychological disorders characterized by a preoccupation with food, weight, and body image. Although these serious disorders have no one exact cause, there are many factors that contribute to the likelihood of a person developing one. There are several evidence-based treatment options that have been developed in response to the growing number of people who are affected by eating disorders each year.
As is true for all medical and/or mental health treatment approaches, there are none that are a one-size-fits-all. While some people may benefit from cognitive behavioral and dialectical behavior therapies, which focus partially on the regulation of emotions, others may respond better to experiential or immersive approaches such as exposure therapy. Treatments vary by clinician, type and severity of disorder, and based on the individual needs of the client.
Eating disorders are wildly complex and affect all populations regardless of gender, race, ethnicity, age, and weight. According to the National Eating Disorder Association, at any given point in time between 0.3-0.4% of young women and 0.1% of young men will suffer from anorexia nervosa. Although women are more widely affected by eating disorders, men also suffer, and it is often harder for men to seek treatment due to the lack of recognition of symptoms, social stigmas, and ideas of toxic masculinity that are pervasive in our society. Rather than seeking a professional to help, men think they need to “man up” or “tough it out,” and are therefore much less likely to acknowledge their disordered eating and much less likely to seek treatment with 25% of normal weight males perceiving themselves to be underweight. Additionally, 90% of teenage boys exercise with the goal of bulking up (NEDA). This is also true for other populations like racial minorities, gender-non conforming individuals, and people of a lower socio-economic status, so these statistics may not accurately reflect the percentage of those affected.
The lense through which we view the world, along with the social standards set forth by society for men, are both heavy influences on the way we treat eating disorders in men. Many young men are indirectly taught that only women suffer from eating disorders, and as a result of this false belief, are unaware that diagnosis is a possibility, or that there is an actual medical or mental reason for their symptoms.
Criteria for eating disorders in the DSM-5 are also unsurprisingly, gender biased. In fact, amenorrhea, or the cessation of a menstrual period was just removed from the DSM-5 as a criterion for anorexia as recently as 2013. This change allows, not only for men to be part of the conversation, but also the percentage of women who have continued to menstruate, despite displaying every other harmful symptom of eating disorders (Cowden, 2020). Additionally, men can be diagnosed with disorders that are not termed in the DSM-5. Men also may suffer from muscle dysmorphia, also cleverly termed reverse anorexia or bigorexia. With this disorder, the desired body type is not thin and frail, as we often see with women, but are “large” and muscular, which reflects modern societal standards for the male body.
There are currently eight (8) eating disorders listed in the DSM-5, which are listed below:
- Rumination Disorder
- Avoidant/Restrictive Food Intake Disorder (ARFID)
- Anorexia Nervosa
- Bulimia Nervosa
- Binge-Eating Disorder
- OSFED (Other Specified Feeding or Eating Disorder)
- UFED (Unspecified Feeding or Eating Disorder)
Disordered Eating vs. Eating Disorder
Of the eight disorders listed, only three are widely known and recognized among the general public. “The big three,” a) Anorexia Nervosa, b) Bulimia Nervosa, and c) Binge-Eating Disorder, are often regarded as the only eating disorders one could have. However, just because someone is not engaging in binging, purging, or total restriction does not mean that they are not at risk or showing symptoms for an eating disorder. Some of the often forgotten symptoms of disordered eating include: uncontrollable eating, restricting or limiting certain foods or nutrients, and ruminating or obsessing about food and exercise.
Typically, the distinguishing factor between disordered eating and an Eating Disorder is the level of functionality the client seems to be experiencing. When a pattern of eating starts to interfere with the daily activities, it can point to more of a serious issue that the person may be experiencing and may require clinical or medical intervention.
Preventing an eating disorder is hard. Developing a safe and healthy relationship with food and our bodies is hard. We are constantly surrounded by unrealistic images and expectations forced upon us by the media. Mass media significantly influences the context and space people use to learn about body ideals and what “attractiveness” looks like. However, by working against the standards set forth for us by the public, we can combat these unrealistic standards and promote healthy body image and acceptance. Prevention of eating disorders looks much different than it does for other mental health issues. When it comes to eating disorders, prevention looks like building a healthy body image and relationship with your body. Prevention also stems from battling the stigmas associated with eating disorders and working to eliminate the disconnect between men and their mental health.
Reaching out and asking for help is the first step towards battling any form of mental illness. It can be difficult to take this first step. Depending on the type of eating disorder, clients may need the additional help of a nutrition counselor who works closely with therapists to determine the most successful plan for treatment. Connecting the physical needs of clients with their mental needs plays a huge part in a successful recovery. However, eating disorder treatment does not end after initial treatment has been completed. Recovery is a lifelong commitment to bettering your health, both mentally and physically. Having a network of support systems you can rely on outside of treatment is essential to continued recovery. Relapse in eating disorders is extremely common. Practicing coping skills and having a plan of action in place in case of relapse are all ways to find success in your recovery.
Eating disorders are easily misunderstood and dismissed as they are oftentimes difficult to diagnose. Clients may be hesitant to admit to their behaviors and may be resistant to treatment; many of those affected either do not believe their behaviors are harmful to their health or do not wish to stop. This is often based out of the fear of becoming overweight. If you are struggling with an eating disorder, you are not alone. If anyone you know is suffering from an eating disorder, be kind and patient with them, and be mindful of the difficulties associated with such a disorder. Offer them support when needed, and try to reach out for help. The support systems that eating disorder survivors rely on are not only essential to physical recovery, but mental recovery as well.