Understanding and Supporting Males with Eating Disorders
From Reclaiming Beauty Team Member Caitlin Craig
Males struggling with eating disorders and body image issues have historically been left out of most conversations about prevention and treatment in both research and practice. The National Eating Disorders Association estimates that 6.6 million men in the United States will be impacted by an eating disorder at some point in their lives. Despite this staggering figure, eating disorder treatment remains predominantly female-oriented.
All individuals, regardless of their gender identification, are susceptible to the biological, psychological, and sociological factors that contribute to the development of an eating disorder and body image disturbance. Males are less likely than females to seek and receive treatment for their disordered symptoms. They also tend to receive less intensive treatment, and most seek help only when their symptoms are severe.
Barriers to Eating Disorder Treatment
Some reasons for this include:
the misperception that eating disorders are a female-only issue
difficulty recognizing their symptoms as problematic due to the normalization of disordered behaviors
socio-cultural pressures related to gender and masculinity that encourage males to ignore and suppress mental and emotional hardship
Also, most assessment tools used to diagnose eating disorders are not sensitive to male-specific body composition and size criteria or to muscularity-based pathology. These factors, among many others, lead to males not receiving accurate diagnoses or access to treatment when suffering from disordered eating.
Understanding the Unique Challenges for Males
While folks with eating disorders across the gender spectrum do share some similarities, such as preoccupation with body size, shape, appearance, and weight concerns and the interconnectedness of control and self-worth, there are important differences. Males often experience a drive for muscularity (as opposed to thinness). This pursuit may involve excessive exercise, the use of performance-enhancing substances, and dietary restrictions aimed at enhancing muscle definition.
Appearance and performance-enhancing drug and supplement use can lead to dangerous medical and psychiatric complications that ripple out into all areas of life. For some, participation in athletic sports leads young males to learn ways of manipulating their bodies to influence endurance, aesthetics, and body weight. This can contribute to hyper fixation of food and body size and shape.
Nervous system dysregulation
Males in our culture can have increased challenges with emotion regulation and expression. They may use eating-disordered behaviors to manage nervous system dysregulation in subtly different ways than females. Males who internalize our culture’s external pressures to embody the mesomorphic ideal (characterized by low body fat percentage and large, well-defined musculature), may experience dissatisfaction with their muscularity and body fat. Therefore, engage in muscularity-enhancing behaviors and disordered eating. Too often these behaviors are praised and encouraged by parents, friends, romantic partners, and coaches. Unfortunately, it serves to maintain and exacerbate disordered and harmful thought and behavior patterns.
Creating Safer Spaces
It is necessary that we work to modify eating disorder treatment to address males’ unique needs. Treatment components include:
education and destigmatization of eating disorders
understanding an individual’s internal and external obstacles to recovery
exploration of the male identity
identifying and challenging unhelpful belief systems and stereotypes that perpetuate disordered perceptions and behaviors
addressing body image issues and muscle dysmorphia
support in learning ways to regulate their nervous systems and emotions
and addressing the shame, stigma, and isolation that serve to maintain an eating disorder
There are special considerations in working with gender non-confirming individuals and sexual and ethnic minority males related to what is considered ideally attractive and how the body’s appearance can be manipulated to achieve a sense of safety, belonging, and connection to others and within their communities.
Reclaiming Beauty’s Approach to Eating Disorder Therapy in Asheville, NC
At Reclaiming Beauty, we are diligently working to acknowledge these issues, examine our gender bias, and educate ourselves so that we may offer well-informed support to our male-identifying clients. Our goal is to create safer spaces for males to express their feelings and concerns about body image, weight, and food without judgment. We are mindful of our language, strive to be inclusive, and avoid perpetuating harmful stereotypes about body image and masculinity. We collaborate with other professionals (dietitians, psychiatrists, and medical doctors) to develop tailored treatment plans crucial for recovery for our male clients. As disordered eating therapists, we are perpetually shifting the focus from unrealistic societal expectations that objectify people’s bodies to emphasize overall wellness fostered by the connection of mind, body, and spirit with the hope that our clients are able to live more fulfilling lives.
From Reclaiming Beauty Team Member Caitlin Craig, MA, LCMHC, CEDS
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