Can you tell if a friend has an eating disorder?

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"ednos", anorexia, binge eating, bulimia, Eating Disorders, low self-esteem, mental health issues, support

Can you tell if a friend has an eating disorder?

I found out during sixth form that three of my friends had had an eating disorder in their GCSE years. Each time, my immediate reaction – for which I now chide myself – was one of surprise: they’d always looked so healthy.

As someone who has since come through an eating disorder myself, and as a volunteer for Beat – the UK’s leading eating disorder charity – I’ve spent years encouraging people to look beyond the visual to recognise the disease.

Only 10% of eating disorders sufferers are anorexic – and easily identified by severe weight loss. Around 40% suffer from bulimia (binge eating and purging) and the remaining 50% from “ednos” (eating disorder not otherwise specified, a category into which binge eating falls).

Though some people struggling with bulimia or ednos are underweight, the majority have a normal BMI, while some are overweight. When I heard my friends’ admissions, I instantly fell into the trap of equating “eating disorder” with “emaciation”, forming a host of regrettable assumptions about their experiences.

It’s often assumed that anorexia is fuelled by vanity and a desire to emulate skinny celebrities. In reality, eating disorders, including anorexia, are serious mental health problems, triggered by a complex interplay of low self-worth, difficulties in coping with problems and – possibly – genetics.

To recognise and understand these conditions, we need to look for behavioural signs as well as weight changes. For example, a friend with an eating disorder may become more withdrawn, preferring to spend time alone rather than engage in social situations they used to enjoy.

They may become extremely anxious at meal times and try to get out of events that revolve around food – you may notice they have taken to eating alone.

An obsession with calories and fat content can be an indicator, as can strict avoidance of certain food groups.

Some people with eating disorders – particularly anorexia – choose to engage in lengthy discussions about food, sometimes as a way of indulging through conversation, and sometimes to find out more about others’ eating habits against which they can measure their own.

Look out for physical and emotional symptoms: side-effects can include fatigue, difficulty concentrating, insomnia, frequent illness and mood swings.

If you suspect a friend has an eating disorder and you want to help, you’ll need to raise the subject gently. Reading through these dos and don’ts before broaching the topic will help, but don’t beat yourself up if the conversation doesn’t go as well as you’d hoped: your friend will appreciate your concern.

Offering to go with your friend to a GP appointment can be a helpful first step, as GPs refer people on to services that can help them.

Peer-to-peer support can be a really valuable way of complementing professional services. Student Run Self Help (SRSH) is a network of groups run by trained students in many universities across the UK. It aims to provide a safe, confidential space for students with eating disorders to share their experiences; attendance does not require a diagnosis. Going to groups for the first time can be daunting, so offering to accompany your friend might give them the confidence to turn up.

“When students face mental health problems, they are most likely to turn to their friends for support,” says SRSH founding director Nicola Byrom. “The problems faced by young people with eating disorders are often wrapped around issues of low self-esteem, so knowing that you have friends there to support you can make the world of difference.”

Recovery can be a slow process – you’ll need patience as well as understanding to help rescue your friend from the turmoil they are going through

a helpful first step, as GPs refer people on to services that can help them.

Peer-to-peer support can be a really valuable way of complementing professional services. Student Run Self Help (SRSH) is a network of groups run by trained students in many universities across the UK. It aims to provide a safe, confidential space for students with eating disorders to share their experiences; attendance does not require a diagnosis. Going to groups for the first time can be daunting, so offering to accompany your friend might give them the confidence to turn up.

“When students face mental health problems, they are most likely to turn to their friends for support,” says SRSH founding director Nicola Byrom. “The problems faced by young people with eating disorders are often wrapped around issues of low self-esteem, so knowing that you have friends there to support you can make the world of difference.”

Recovery can be a slow process – you’ll need patience as well as understanding to help rescue your friend from the turmoil they are going through.

Waging war on web ‘thinspiration’

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'thinspiration', anorexia, bulimia, Eating Disorders, recovery

Waging war on web ‘thinspiration’

Do a quick search on Instagram and you will find reams of “thinspiration” material, usually in the form of pictures that glamorises the extreme skinniness of various models and celebrities.

Hashtags such as #thynspo, #ana (for anorexia), #mia (for bulimia) and #blithe (code for self-harm) abound. From there you can find thousands of pictures of bloody wrists and thighs, messages of despair and cries for help, and photos of underweight women that mostly focus on apparent ribs, concave stomachs, thigh gaps, and prominent hip and collar bones.

Perhaps most distressing are the pro-anorexic quotes interspersed between pictures, such as “Do it for the thigh gap”, “Skip dinner, weigh up thinner,” “1 like = 10 squats,” “Do not reward yourself with food, you’re not a dog” and the most frequently posted shibboleth, Kate Moss’s infamous quote: “Nothing tastes as good as skinny feels.”

Community support for these self-destructive illnesses is not unlike the first wave of pro-ana virtual communities of the late 1990s, though the nature of an image-based social networking service means that random friendships occur more easily thanks to hashtags, and an emphasis on imagery that dangerously ratifies the erroneous assumption that only skinny women are beautiful. There, thinstagrammers photo-blog their daily frustrations and struggles, and comment on each other’s pictures to encourage fasting. Recovery accounts sometimes pop up too, usually gently advising people to get help.

When I first scrolled through those pictures, my kneejerk reaction was disgust. The idea that Instagram users are tagging photos that promote the obsession with thinness as a lifestyle, rather than a mental illness, infuriated me. I’ve never had an eating disorder, but I know that while illnesses such as anorexia nervosa are widely accepted as containing a genetic component, many studies have also indicated the impact of sociocultural factors (peer pressure, troubled relationships, sexual abuse and the ideal beauty type prevailing in western culture) that trigger people into becoming eating-disordered.

Instagram’s policing measures have been thus far unsuccessful. The company added a pop-up disclaimer for #ana and #mia with a link to theAmerican National Eating Disorders website and in April 2012 the company publicly banned #thin, #thinspiration and #thinspo, which prompted Thinstagrammers to spell new hashtags differently – for example #thynspo or #thinspoooo. As such, Instagram’s policies might come off as more a perfunctory PR gesture (and a cover-your-ass move) than a committed strategy to police graphic content, though admittedly the problem feels like an unstoppable plague.

I wanted to try something different. Upon finding a number of pro-recovery Instagram accounts tagged with words such as #edrecovery, I decided to make one myself (@lovethighself) in order to use pro-ana hashtags in an attempt to subvert and effectively spam pro-ana communities. I posted hundreds of quotes that promoted recovery and body acceptance, as well as attractive pictures of average and plus-sized models. I also photoshopped some of the common pro-ana images to refute their harmful messaging.

These attempts were not intended to be dismissive of a mental illness I do not have, nor to raise the ire of people with anorexia or bulimia, but rather to enable users looking up these hashtags to reconsider their scrolling habits. I figured that not everyone looking at thinspiration has an eating disorder. Some who do may be on the verge of relapse from recovery, while others who don’t (yet) might be slowly becoming obsessed with their weight and curious about thinspiration and dieting tips, putting themselves at risk.

“Thinspo” has overwhelmingly been proven to cause negative effects even in the non-eating-disordered. One study published by the European Eating Disorders Review found that college women without a history of eating disorders who looked at pro-ana websites reduced their calorie intake in the following weeks, half of them unconscious they were doing so. By posting a reactionary wave of images promoting body acceptance while negating the beliefs of ana advocates, I hoped to make a difference.

I soon received tons of comments thanking me and urging me to keep posting. “Please always keep this account. I’m going through an eating disorder and I’m fighting so hard but it pulls me down a lot and I just am still trying to overcome it. My screen saver is one of your pictures and it helps me so much,” wrote one follower. Many users who self-identified as having ana or mia in their bios began to follow me, and I started following some of them, too, providing support when I could. But sadly, because of the sheer mass of thinspiration pictures posted on Instagram every day, it’s been impossible for me to truly dent the thinstagram subculture.

The degree to which western society’s ideal body type has diminished our sense of self-worth is unmeasurable, but unmistakably and dangerously high. Young girls are crying out for help, using Instagram as an emotional outlet and banding together around a service to commiserate. It’s understandable that such communities form, given the isolating effects of eating disorders. But while they can be somewhat helpful in allowing the eating-disordered to have a voice, #ana and #mia are also likely to further fuel their disorders.

As it is, thinspiration is an unstoppable movement. Until our society stops telling young girls they can only be accepted if they are thin, pro-ana users will likely always find a place to unify on the web.

Bringing up daughters: The new battlefield for parents

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advertising, alcohol, anorexia, anxiety, bulimia, daughters, Depression, Eating Disorders, family, media, mental health issues, parents, pressure, self-harm, social media, Teens

Bringing up daughters: The new battlefield for parents

It’s a freezing night in Bristol, and snow is forecast – but every seat at Colston Hall in the city centre was sold out weeks ago, and not only for Ronan Keating who’s playing in the main auditorium. Also packing them in is a 59-year-old, softly spoken Australian psychotherapist, who will take to the stage for 90 minutes with just a whiteboard and some ideas that will keep his audience on the edge of their seats.

The psychotherapist is Steve Biddulph, and most of the people queuing up to hear him are the mothers of teenage girls. A few years ago Biddulph toured Britain warning of a crisis facing boyhood: now he is back with a similar message about girlhood. And if the audience here is anything to go by, he’s definitely touched a nerve. “Parents of girls are seriously worried about their daughters,” says Saffia Farr, editor of Juno magazine and the organiser of the Bristol part of Biddulph’s country-wide tour. “They feel there’s this overwhelming tide of advertising that’s targeting their daughters, of inappropriate clothing being sold in the shops, of media messages that encourage their girls to grow up way, way before their time. And they want to know what they can do about it.”

Telling them what they can do about it is Biddulph’s mission. “A few years ago, boys were a disaster area – there was an epidemic of ADHD, they were underperforming in exams, they were drinking too much and getting involved in wild behaviour,” he says. “Back then, girls seemed to be doing just fine. But, about five years ago, that all changed – suddenly, girls’ mental health started to plummet. Everyone knew a girl, or had a girl themselves, who had an eating disorder or who was depressed or was self-harming. It was a huge change in a very short period; I started to investigate why this was happening.”

Biddulph lives and works in Australia, but the crisis he sees brewing for young girls seems to be echoed across the Western world – and, in Britain, the figures suggest it’s worse than in other countries. A few weeks ago, the charity Childline announced a 68 per cent increase in youngsters contacting them about self-harming, and said most of the increase was among girls. The problem also seemed to be affecting teenagers at a younger age, with 14-year-olds now likely to be among callers.

Anxiety and depression in teenage girls is also on the rise: research from the Nuffield Foundation last year found that the proportion of 15- and 16-year-olds reporting feeling frequently anxious or depressed has doubled in the last 30 years, and is more common in girls: it has jumped from one in 30 to two in 30 for boys, and from one in 10 to two in 10 for girls. Meanwhile, a report from the Department of Health found teenage girls in Britain are more likely to binge drink than teenage girls anywhere else in Europe; more than half of 15- and 16-year-olds admit they drink to excess at least once a month. A separate report in 2011 found that one in five girls in this age bracket who drink at least once a week have drunken sex and later regret it.

Anorexia and bulimia are also dramatically on the increase: official figures for hospital admissions released last October pinpointed a 16 per cent rise in hospital admissions for eating disorders, and showed that one in every 10 of these admissions was a 15-year-old girl.

“There’s plenty to be concerned about,” Biddulph says. “Everyone who has a teenage daughter right now sees this, in their child and among their child’s friends.” The people they blame, he says, are the advertising industry and the media. “They are driving girls’ sensibilities and making them miserable. The corporate world has identified them as a new market for products, and is preying on them.” During his talk, Biddulph describes teenage girls as being out in the wilderness, surrounded by hyenas: it’s starting to get dark, he tells his audience, but they are all alone out there.

His message, though, is one of empowerment: he encourages parents to get together, to challenge the advertising industry and to lobby the Government to impose more restrictions on advertisers.

“Take the drinks industry – about 30 per cent of the market is sales to underage drinkers,” he says. “Alcohol companies are extremely powerful – but parents are powerful, too, and they have to stand against this and stop the marketing of alcopops and push for a higher drinking age.”

But the battle needs to be fought on a domestic as well as a policy front. “What we need to do is re-evaluate how we think of teenage girls: the current philosophy is that they’re growing older, so they need us less. But I believe that teenage girls go through a kind of second babyhood, and they in fact need their parents more than ever. We have to spend time with our daughters at this age: talk to them, listen to them, keep in touch with them. Staying connected to their parents makes all the difference to how they cope with the pressures they’re up against.”

Case study

Lindsay Julian, 51, lives in Salisbury. She has three daughters: Emily is 24, Olivia is 14, and Amelia is 11. She also has a son, Alexander, 28

“Emily got into drinking when she was about 15, and she started taking drugs fairly soon after that. It was a real roller-coaster time for all of us: sometimes she’d drink a lot and run off, and we’d have no idea where she was. One time, she didn’t come back all night, and we ended up calling the police. They were difficult times.

“There are so many pressures on young girls today – you’re very aware of that as a mother of daughters. So when my younger girls got close to the age where things got difficult with Emily, I thought: we’re going to do things differently this time round. I sent them to a Steiner school, where I think the pressures are lessened: the philosophy is holistic, it’s not all about exam results, which I think can be very stressful for young girls.

“Some of my daughters’ friends spend a lot of time on social media, texting and on Facebook – but I’m careful to limit those things for my girls, and it does make a difference. They watch TV but I monitor it – in some homes, TV seems like a third parent, and I don’t want it to be like that in our house. A lot of teenage girls never switch off, they’re constantly connected, and that puts them under pressure from one another as well as from advertisers.

“We’ve got friends where you can see that their 14-year-olds are more like adults; the wanting to drink, to go to parties all the time.

“Emily is fine now: things turned around for her eventually, and she now works as a researcher and has written a book. She’s a rock for her younger sisters and I’m very proud of her. I know you could say that she was OK in the end, but I don’t think it’s an experience I’d want to go through with my younger daughters. I think their adolescence could be happier, and less fraught, than Emily’s was.”

More children have anorexia than previously thought, study finds

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anorexia, bulimia, Children, Eating Disorders, hospitalisation, treatment

2011:

More children have anorexia than previously thought, study finds

More than two and a half times as many children under 10 have anorexia nervosa as previously thought, according to the first study into eating disorders among British children.

On average, 1.5 in every 200,000 British children under 10 have anorexia, according to experts from the UCL (University College London) Institute of Child Health, who carried out the research.

Direct comparison with previous UK data is limited but a general practice registry study in the early 1990s found an incidence estimate of 0.6 per 200,000 for anorexia among children aged up to nine.

The findings have shocked experts, who called for “urgent action” to help save young lives. There are no national paediatric guidelines for the care of individuals with eating disorders.

“Recognition of eating disorders in children by GPs can be poor and, unfortunately, many eating disorder services are aimed specifically at adolescents,” said Dr Dasha Nicholls, a consultant child and adolescent psychiatrist at the UCL Institute of Child Health and the study’s lead researcher.

“Childhood eating disorders are not quick or easy to treat. For a minority of children it may be the start of a severe and enduring illness, with death rates comparable to some forms of leukaemia.

“Early-onset eating disorders – defined as those starting before 13 years of age – represent a significant clinical burden to paediatric and mental health services. Efforts to improve early detection are needed but our study also shows there is an urgent need to consider the needs of children with eating disorders separately – and not simply lower the age range of existing adolescent services,” said Nicholls.

Most of the 208 patients in Nicholls’s study were girls – 82% – but boys accounted for almost one in five cases.

More than 80% of the children in the study, to be published in the British Journal of Psychiatry, had an anorexia-like illness: 37% had diagnosable symptoms while 43% were classified as having an “unspecified eating disorder” because although they showed symptoms of anorexia they were not underweight. Only 4% had bulimia.

An additional one in five children had symptoms of disordered eating, such as food avoidance and being underweight, but did not have a preoccupation with their weight or shape.

Half were admitted to hospital, over 70% of whom had anorexia. After a year, almost two thirds were still receiving treatment. 73% had improved but 6% were worse and 10% unchanged.

Almost 44% of the children had a close family member with a history of mental illness, most commonly anxiety or depression. Another fifth had a history of early feeding problems, particularly fussy or picky eating.

Studies suggest that although the incidence of eating disorders has been fairly static over the past few decades, anorexia is being diagnosed among children in increasingly younger age groups.

Data on the rate and outcome of early-onset eating disorders is sparse. The National Inpatient Child & Adolescent Psychiatric Survey found that eating disorders were the most common diagnosis among child and adolescent psychiatric in-patients in England and Wales, 9.2% of whom were under 13.

The survey, however, did not include children on paediatric wards. “Ours are the first published data on the scale of paediatric resource used by this patient group in the British Isles,” said Nicholls.

Previous research from the NHS Information Centre has found that children aged 14 to 16 account for one in every three patients treated in hospital for an eating disorder, an 11% rise on the 2,316 cases recorded for the previous 12 months.

The centre’s data, however, found only a “small number” of 10-year-olds diagnosed with conditions including anorexia and bulimia.

A 1999 Office for National Statistics study found 0.3% of 11- to 15-year-olds had an eating disorder, with no one in the five- to 10-year-old age group.

The new study found wide variation in confidence among paediatricians over how to treat children. “This study provides the baseline figures needed to determine whether increases in hospitalisation rates are real or perceived, and can aid planning of age-appropriate services,” said Nicholls.

Because the new study gives the first estimate of the incidence of early-onset eating disorders, Nicholls said she was unable to say if there has been a rise in this group. “But we hope our research can be used as a baseline from which to monitor future trends,” she added.

The findings have galvanised concern that society’s obsession with physical appearance is making children become body-conscious at an increasingly early age. Blame has been placed on everything from poor parenting to the media and websites such as Facebook.

 Miranda

When Miranda turned eight, her parents took her to a pizza parlour to celebrate. For any other child, it would have been a common enough treat. But for Miranda, the trip was nothing short of momentous – as it signified a return to health.

Now 11, Miranda finds it hard to remember why, at seven, she developed an eating disorder so severe that she stopped eating and drinking and ended up almost 10kg underweight, with a body mass index (BMI) of 12.5. (A BMI of under 18.5 is officially underweight.)

“I remember living in a clinic with other children. None of us could eat normally,” she said. “I was there for five months. They said I had food avoidance emotional disorder. I don’t know where it came from but in my diary, I said it was like having a pixie in my tummy. The pixie was like the devil. When I wanted to eat, the pixie would fight me. At the beginning, in my diary, I said the pixie was stronger than me. But then I got stronger than him. I remember it being like he got smaller and I got bigger. The pixie’s not in my tummy any more. I hope he never comes back.”

Hospital admissions for eating disorders jump 16 per cent

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anorexia, binge eating, bulimia, Children, control, diagnosis, Eating Disorders, GPs, hospitalisation, low self-esteem, osteoporosis, suicide, treatment, young people

Hospital admissions for eating disorders jump 16 per cent

Hospital admissions for eating disorders,  which carry the highest death rate of any psychiatric condition, have leapt 16 per cent in the last year and are up by almost 50 per cent in a decade.

Experts blamed the rise on a failure by doctors to diagnose those affected early in the course of their illness, before it takes hold. There has been no increase in eating disorders overall  for 20 years.

The Health and Social Care Information Centre (HSCIC) said there were 2,290 admissions of adults and children with eating disorders, including anorexia, bulimia and related conditions in the year leading to June 2012.

That is a 48 per cent increase on the 1,533 admissions a decade ago  in 2002-3. More than nine out of ten patients were female and over half were young people aged from 10 to 19. The ages ranged from under 5 to over 60.

The small number of very young children hospitalised (under age 10)   are thought to have had mechanical problems with eating, distinct from the psychiatric condition, a spokesperson for the HSCIC said.

The eating disorders anorexia and bulimia are associated with low self esteem and a desire for control which becomes linked with body shape, size and weight. They carry a high risk of death by suicide or starvation, rising to 20 per cent after 20 years.

The US singer Karen Carpenter,  Scottish child star and TV host Lena Zavaroni and  Brazilian model Ana Carolina Reston are among celebrities who have died from anorexia.

The eating disorders charity b-eat said a media and social culture which  focused on women’s weight and shape aggravated the condition, though it did not cause it. An estimated 1.6 million people suffer from eating disorders.

Susan Ringwood, chief executive of B-eat, said: “I spoke to a 12 year old girl who said: ‘ Why have I got to go to hospital when they [celebrities] are on the front of the magazine.’ It reinforces their view that they are not ill – trapping them in their illness.”

She added:  “We know that 40 per cent of callers to our helpline have not spoken to a health professional. Lots are not putting themselves forward. Studies show community treatment has better outcomes but it is very variable across the country. People are not getting early treatment. Hospital admission is a last resort.”

The longer the condition went “unchallenged” the more serious the consequences, she said, including osteoporosis (thinning of the bones) caused by poor diet.

“We see girls of 20 with the skeleton of 80 year olds,” she said.

Dr Lucy Serpell, a clinical psychologist at University College London and expert in eating disorders, said: “The problem is the lack of good out-patient treatment and the failure of GPs to pick up the disorder and refer. When the patients come to us they are so unwell we have to get them to hospital to be stabilised. We don’t like admitting 15 year olds to hospital.”

An outpatient service for eating disorders established three years ago in north east London had seen admissions fall in three of the four boroughs where it was available – but not in the remaining one.

“We can see the difference – patients get admitted to hospital more in the fourth borough because they are not being treated soon enough. All the evidence shows people are better off where there is a specialist service.”

In anorexia sufferers lose weight rapidly, becoming skeletal and ill. Bulimia typically starts with an effort to restrict the diet severely, but this cannot be sustained and ends with a binge, followed by vomiting and the cycle begins again. Eating is the one area of their lives that they feel they can control.

Case Study

“I think it is mainly the pressure to look a certain way in the media”

Charlie Crompton, 21, spent six months in hospital when she was 17 after an eating disorder led to her weight plummeting to five stone.

“It started when I was 15 but it wasn’t until I was 17 that I was admitted to hospital. At my worst I weighed five stone. My mum had been pressuring me to go to the doctors as I was just getting thinner and thinner, they kept weighing me and I kept losing weight so the next step was hospitalisation. I think my illness was due to lots of different reasons. Just growing up is hard sometimes. I was also under a lot of exam pressure and I felt under pressure from my friends and the media to look a certain way. I wanted to look good.

Looking back it now all seems very strange. I think that when you’re ill your brain isn’t working properly so you can’t really understand what’s happening or why you are acting the way you are acting. I didn’t realise I was ill. In hospital they put you on a feeding routine to get you back into eating. That restores your weight and as your weight comes back up your brain starts to work normally again. When you have gained enough weight they let you out of hospital and you start therapy to stop you doing it again.

“For me I had actually booked a holiday about a year before so I needed to get out of hospital to go to America. I don’t think they were convinced I was ready but I was really determined not to miss that trip. I was discharged on the Friday and went on holiday on the Monday on condition that I had lots of checkups and support as soon as I got back.

“I’ve now been recovered for almost four years. I can understand why the figures might show a big increase in teenage girls being admitted to hospital. I think it is mainly the pressure to look a certain way in the media. But there’s also a lot more awareness nowadays so perhaps it is also that more people are coming forward for help.”

 

Male Anorexia

Tags

anorexia, anxiety, binge eating, Body Image, bulimia, Depression, fashion industry, health problems, Male Eating Disorders, mental health issues, obsessive compulsive hoarders, perfectionism, skinny male models

Male Anorexia

When in history has a male ever been concerned about fitting into a pair of skinny jeans? Media has hyper-focused on the skinny male model. Today’s fashion is geared towards the emaciated male in a pair of skinny jeans. This male body image does not occur naturally unless someone is ill. We now have a whole culture of men trying to obtain an impossible body image.

There appears to be a rise in the number of males with eating disorders. According to NEDA, at least one million males in the United States have an eating disorder such as anorexia or bulimia. But these numbers are skewed due to the high prevalence of undiagnosed males with eating disorders.

Twenty years ago, very few people even knew what an eating disorder was. Today, the public awareness of eating disorders has allowed some men with anorexia to come forward. But most males will not seek treatment for eating disorders because of the shame, the fact that there are fewer male residential treatment centers and the misperception that eating disorders only occurs in females or gay men.

How can you tell if someone has anorexia nervosa? A male with anorexia nervosa is less than 85 percent of normal body weight. He avoids eating, has poor body image and may exercise obsessively. He is intensely concerned about losing flab or building muscle. He believes he is fat when others are telling him that he is too thin. It is important to note that he really does see himself as fat. It is caused by deficiencies in the brain brought on by starvation. Anorexia nervosa may actually compromise the ability to reason in its victims.

People with anorexia usually also have one or more co-occurring disorders such as anxiety, obsessive-compulsive disorder or depression. Males and females both suffer many of the same symptoms of anorexia, such as:

• Dehydration (fainting)
• Performing food rituals
• Bursts of energy followed by fatigue
• Constantly talks about body image, weight and diets
• Avoids eating
• Purges (anorexia nervosa — purge type)
• Isolates
• Thin hair and brittle nails
• Excessive movements even when seated to burn calories

When someone with anorexia under-eats, the brain may dispense feelings of euphoria that briefly counteract anxious or depressed feelings. In this way, food restriction is used as an anti-depressant or a way to “zone out.” A male with anorexia uses the obsessive thoughts of weight, diet, food (not eating) and body image as a way of pushing down feelings or past traumas. This is common for all types of eating disorders.

The highest number of males with eating disorders have binge eating disorder, compulsive overeating or obesity. These boys and men often do not get treatment until they have diabetes, heart attacks or other weight-related diseases.

There are many causes of eating disorders. Genetics can make a person more predisposed to acquiring an eating disorder. This usually occurs in families who have eating disorders or other addictions.

The desire for control makes a male more vulnerable to the disease. This is often the result of feeling smothered or abandoned and misunderstood by their families. Many males report that they had parents who overemphasized physical appearances. In these families, the individual learned to keep his feelings, doubts, fears, anxieties and imperfections hidden. There may be family issues that they try to avoid by focusing on their disorders and their ability to control their food intake.

Having a perfectionistic personality type can be a factor in the development of anorexia. Most males with anorexia are above average students and may have excelled at sports. Some say perfectionism is the leading cause of male anorexia. Perfectionism leads to the desire to be good, accepted, perfect and in control — all of which are prerequisites of anorexia.

Male anorexia is lethal. When the body is not fed it will take fat from the muscles and organs to sustain life. Males generally have less fat than females, so there is the added complication of losing muscle mass. The heart is an important muscle that may be affected. In addition, potassium and electrolyte imbalances may be a risk factor for cardiac problems such as heart attacks.

With the rise in male eating disorders and associated risks, it is imperative that men with eating disorders seek help!

Skinny male models and new fashions fuel eating disorders among men

Tags

'bigorexia', 'manorexia', anorexia, binge eating, Body Image, bulimia, Bullying, Eating Disorders, fashion industry, Male Eating Disorders, mannequin, masculinity, skinny male models, stigma

http://www.guardian.co.uk/society/2010/may/16/skinny-models-fuel-male-eating-disorders?INTCMP=ILCNETTXT3487

Skinny models, clothes designed for unrealistic body shapes and pressures at work are all fuelling an increase in eating disorders and body anxiety, as well as a rise in demand for cosmetic surgery. For men. Fat is no longer just a feminist issue, since the number of men suffering problems with food and body image is rising fast, with experts suggesting that 40% of binge eaters and a quarter of anorexia and bulimia sufferers are male – compared with 10% a decade ago – while the equivalent rates for women have not changed significantly.

Along with the rise in so-called “manorexia” is the body dysmorphia condition of “bigorexia” – men who become ever more muscle-bound in their obsessive pursuit of the perfect six-pack body.

Eating disorder campaigners are worried that a shift in men’s sizing in fashion is exacerbating the crisis and have criticised a British mannequin manufacturer for its latest super-skinny male model that they say could encourage vulnerable boys and men to starve themselves in a repeat of the “size zero” trend that encouraged many women to endanger their health. Next month Rootstein will debut a mannequin with a 35in chest and a 27in waist – 12in smaller than the average British man.

The firm said it was just reflecting demand and a shift to gender-blending fashion led by the slim and cool: Mark Ronson, Russell Brand, designer Hedi Slimane, and a new crop of male models, like Calvin Klein’s Tomek Szmulewicz and Top Man’s Sam Bennett. It talked of allowing “the boys a little of what the girls were getting with a beautifully angular physique that’s all about the youthful thrill of life on the edge”.

The mannequin’s designer, Kevin Arpino, said demand was up for smaller models. “It is a collection dictated by current fashion trends for skinny jeans and very tight tailoring, as seen everywhere from Topman to Gucci and in the edgier fashion magazines like Numéro. It’s a trend which you can see in celebrities and rock stars – Russell Brand has a little bit to do with it. But I am sure that muscle boys will have their time again.”

But for Rob Richman, 35, a recovering anorexic from London, it’s a deeply worrying shift. “I’m staggered, shocked, at what the fashion industry is doing now, trying to mould men to aspire to a different shape than one that is natural, the same as they did with women. Between the tiny sizes and the six-pack look, the pressure on men just seems to have escalated,” he said.

“In my early 30s I couldn’t get clothes to fit me and I would have to buy girls’ jeans; now I can get tiny sizes on the High Street. You’re telling teenage boys to reach unrealistic and unhealthy sizes. Of course you get guys like Pete Doherty and Stephen Merchant who are naturally tall and thin, but this is about pressure to conform to a false ideal. We should allow men and women to be the different shapes and sizes they naturally are.”

Richman, who developed his eating disorder aged 12 after years of vicious bullying at his public school, said he used to be the only man at treatment clinics or hospitals. “Now I’m never the only guy. Ten years ago if a guy went to his GP it’s unlikely they would think of him having anorexia.

“Now all the ones with the really chronic levels are the men.”

But whether men are developing the “excessively muscular or excessively skeletal” shape, said Dr John Morgan, a leading eating order specialist, the risks are high.

Eating disorders have the highest morbidity and mortality rates of all psychiatric illnesses. Bullying can be a major trigger towards eating disorders in boys as young as seven.

“Ironically the government’s anti-obesity campaign has had a flip effect of making perhaps slightly overweight boys more likely to be picked on and bullied. Interesting that, while one in four children are overweight, two in three think they are,” said Dr Morgan.

“The rates of body image disparities are indeed rising among men. Ten years ago a young woman and a gay man suffered similar rates of risk while the attitude of the heterosexual male was much more ‘we’ve got beer bellies because we’re men and we don’t care’, but now that’s changed quite significantly.

“There’s a broader crisis of masculinity in our society and men are facing the same growing pains that women went through in the 50s and 60s.

“Men are being presented with many more choices, and while choice is liberating, for many young men they struggle through and there remains a lot of stigma attached to them admitting weakness; it’s such a threat to the male identity.

“The difference between men and women,” Dr Morgan went on, “tends to be that men focus on shape more than weight, and also men have the extra issue of being expected to be an ideal which is not incompatible with health, so George Clooney might have a great body but we’d also expect him to scale Mount Kilimanjaro, whereas Keira Knightley would struggle with the mountain, but that would be expected.”

The eating disorder charity Beat protested furiously at the Rootstein mannequins. A spokeswoman for Beat said that men and eating disorders was an issue that now had to be taken seriously and the charity was campaigning hard for more awareness among GPs.

“More and more men are coming forward. Generally speaking, there is just as much pressure on guys as women to have a certain body shape. Imagery presented as something to attain, skinny styles, and making sizes smaller, it’s all a dangerous ideal,” she said. “Men are subject to the same insecurities around their body and self-image as women are.”

Former TV host Steve Blacknell, 57, developed bulimia months after starting a new job in the image-obsessed music industry.

“The pressure to be thin and lovely is the same whether you’re a girl or a bloke in that world, and it’s impossible, just as the washboard stomach is an unreachable thing.

“I’d take down and burn every image on those men’s magazines and advertising hoardings of rippling abs, along with those mannequins.

“It’s hard enough being a bloke coping with an eating disorder – imagine then having to look at images like that, imagine the pressure.

“I work with the corporate world now, with men who know that how you look is very much part of the package you are presenting and so how you look is important.”

And that workplace image is what is fuelling the increase in men going for cosmetic surgery, said Liz Dale, director of the Harley Medical Group. The company has seen a 55% increase in men having “tummy tucks” and a 23% rise in Botox treatments, in the first two months of 2010 compared to the same period in 2009. “Men are a lot less embarrassed than they would have been 10 years ago. Now they are quite proud of looking after themselves and coming in for Botox and skin peels. They don’t want to look like celebs, they want to look thinner and healthier. We see a lot of City men where the pressure is more pronounced to look good,” said Dale.

John Updike wrote in a 1993 essay: “Inhabiting a male body is much like having a bank account; as long as it’s healthy, you don’t think much about it. Compared to the female body, it is a low-maintenance proposition: a shower now and then, trim the fingernails every ten days, a haircut once a month.”

Lord Byron thought having to shave every day was as bad as women having to deal with the pains of childbirth. Although Byron had his own issues with food – he was a binge-eater, according to Dr David Veale, consultant psychiatrist and co-author of Overcoming Body Image Problems – neither he nor Updike would have recognised the expectations placed on the modern man.

“There is still greater pressure on women than men,” said Veale. “But undoubtedly some men are more vulnerable – they put all their worth and identity into their appearance. At the severer end of the spectrum it is just as common to have a male sufferer as a woman.

“Eating disorders in women may well be more biologically driven with genetic links, but for men it seems to have a more sociological aspect. An individual who is teased or bullied or humiliated or suffers emotional neglect at a crucial stage of their life obviously is going to feel that impact.

“Generally human beings go around thinking we are a lot more attractive than we actually are, and the greatest paradox is that men with eating disorders are actually more unattractive the harder they try to sculpt themselves into the perfect aesthetic, not because of their bodies but because of the behaviours and their obsessions.”

PERFECT FIGURES

■ Byron, Kafka, Elvis Presley, Elton John, Uri Geller and John Prescott all suffered from eating disorders.

■ The average British man is 5ft 10in tall, has a 39in waist and weighs 13 stone, heavier than most fellow Europeans.

■ The Royal College of Psychiatrists estimated last year that one in every 1,000 young men and seven in 1,000 young women have an eating disorder.

• Symptoms of anorexia include worrying about weight, exercising more, and being unable to stop losing weight. In men and boys, erections and wet dreams stop and testicles shrink.

■ Overall male cosmetic surgery grew by 21% last year, including an 80% rise breast reductions. The most popular treatment remains nose surgery

More: http://www.guardian.co.uk/lifeandstyle/2010/may/05/skinny-male-mannequins-eating-disorder?INTCMP=ILCNETTXT3487