Eating disorders Dr Michael Smith We usually think of men as having drinking, rather than eating problems but eating disorders affect both men and women

In this article

Identifying symptoms Living with an eating disorder

How to get help Contacts

Up to ten per cent of people with an eating disorder such as anorexia or bulimia are male, and the cause is unknown. Researchers have suggested that they stem from the pressures of a weight-conscious western society, family or relationship problems, and physical and neurological changes in susceptible people. It seems likely that several factors are at work.

One of the main problems in eating disorders is 'body image disturbance' or dysmorphia. The illnesses cause a person to have a very inaccurate perception of their own shape and body weight.

Asked to stand beside a door, for example, a man with anorexia might think he 'blocks out' the whole doorway because he is so overweight; looking at his thin forearm and bony hand, he might think he is covered in unsightly fat.

Research has suggested that male bodybuilders might have similar kinds of body image disturbance to that experienced by people with anorexia.

To confirm the diagnosis, the patient must, mistakenly, think they're too heavy, and be dieting to lose weight. People with anorexia usually have a body mass index of less than 17.5.

Other ways of trying to lose weight include:

• excessive exercise
• extreme 'fat-free' diets
• making yourself sick after meals
• purging with laxative and diuretic drugs

Some people with diabetes or thyroid problems manipulate their medication to promote weight loss.

Although anorexia means 'loss of appetite', people with anorexia are often very hungry - and may have a strong interest in watching others eat, or in helping to prepare their food.

Bulimia shares the body image disturbance of anorexia, but people with this condition are more likely to be of normal weight, and binge eating and purging is more of a problem than dieting.

The consequences are serious. Not only is it difficult to maintain a normal social life, but the illness often causes intense family upset, and it's not easy to remain fit and alert at work.

The body's systems have to work hard to adjust to the changed metabolism caused by abnormal diet, and dangerous changes can occur - particularly when people are making themselves vomit.

The Royal College of Psychiatrists factsheet lists some common problems.

Treatment needs to be long term, and is best carried out by a psychiatrist or psychologist. Some drugs, such as 'SSRI' antidepressants can help, particularly regulating binge eating.

Cognitive therapy and self-help groups can also be useful.

Eating Disorder Association (EDA)
Adult Helpline: 0845 634 1414
Youth Helpline: 0845 634 7650
Website: www.edauk.com

Anorexia and Bulimia Care
Tel: 01462 423 351
Website: www.anorexiabulimiacare.co.uk

Overeaters Anonymous
Tel: 07000 784985 (24 hour)
Website www.oagb.org.uk

This article was last medically reviewed by Dr Rob Hicks in April 2007.
First published in October 1997.