Male Eating Disorders: Misconceptions and Mistreatmentblogs.brad.ac.uk/russell-delderfield/files/2014/12/MEDS-Misconcepti… · –Diets and supplements for non-competitive weight-training

Male Eating Disorders: Misconceptions and

Mistreatment

Russell Delderfield

11th December 2014 Mental Health Lunchtime Bites 1

Today’s session: 1. ‘All EDs are equal, but some EDs are more equal than others’.

Misconception 1: Methods of assessment and diagnosis that work for women will work for men

2. What do the men themselves tell us?

Misconception 2: Men’s experience of disordered eating is no different to women’s

3. When is binge-eating not binge-eating?

Misconception 3: Anorexia is the most prevalent disorder and is the biggest threat among men

4. The Second Sexism? Learning to stand by our manhood.

Misconception 4: raising our males to be ‘men’ has no effect on disordered eating

11th December 2014 www.brad.ac.uk/eating-disorders-and-men/ 2


Eating disorder

Body Dis-satisfaction

Control

Feeding

Coping

1.‘All EDs are equal, but some EDs are more equal than others’.


Eating disorder

Body dissatisfaction

Control

Feeding

Coping


• Prevalence

– Coherent rates in men under-reported until mid-2000s

– estimates have widely varied and are often imprecise (Ray, 2004; Freeman, 2005; Weltzin et al., 2005; Jones & Morgan, 2010; Darcy; 2011)

– 1 in 100 men (Hay et al., 2005)?

• Causation & Presentation

– Causes = as far as we know, essentially the same between sexes (Cohn & Lemberg, 2014)

– Presentation = symptoms are essentially the same (Striegel-Moore et al., 2009)

– But men tend to be given an atypical diagnosis (Hay et al., 2005)

– Tools for measuring causation and diagnosis = female-based (Stanford & Lemberg, 2012).



Prevalence Causation & presentation

Path & Development

Treatment & recovery

• Path & development of the disorder

– “…think it’s pretty much gender-excluding as a disorder. The reasons why you get there are probably slightly different but in the end all roads lead to Rome.” – Bill (Robinson et al., 2013: 7)

– More secrecy. More isolation? Being a “lone wolf” (Russell and Laszlo, 2013)

– Double-bind – an increased perception of stigma.

• Treatment and recovery

– engendered fear of being seen as ‘feeble’ or female

– “man-up” (Räisänen and Hunt, 2014)

– “[As the only male] you become aware of people holding back or you being purposely excluded, or people saying ‘maybe it’s best if you’re not in this group because ...’ Bill (Robinson et al., 2013: 8).




www.brad.ac.uk/eating-disorders-and-men/ 7

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11th December 2014

Josh Gareth Richard James

Sam Harry Gary Matthew

Ralph Thomas John Simon

Michael Brian Frank Ron



“No-one has known until I’ve written this…”

“In recent years, I’ve looked to pictures of women… I find attractive. I don’t think that its that I want to be a skinny woman, rather that I think they would never like me or want to be with a guy like me, fat.”

“I remember… we all just stopped talking about food and it would no longer be offered to me, my girlfriend would be called out of the room by her mother, who would 'have words’… she would come back in tears because she couldn't help me. I didn't realise I had a problem until I started binge eating though.”

“This decision not to get professional help was down to the stigma involved with having an eating disorder.”

“For a while, I was in denial about it. I thought: ‘I’m a boy. There’s no way I am bulimic.’ It became a way to punish myself, because I began to believe that I deserved the bullying. It was never about weight or even body image for me, only about emotional stress.”





Restraint in a world of abundance • Objective binge

– over-eating an amount of calories greater than your body allows

– over-eating an amount of calories greater than your body needs.

• Subjective binge

– any over-eating experienced as such even if the calories consumed are few.

(Vannucci et al., 2013; Watson et al., 2013)



Feeding men, starving women • Socially shared notions of appetite

– Food as nurturance – The ‘growing boy’ – Excess as ‘good’

• Socially misrepresented nutritional ideas about calorie intake in men – Men need more calories – Men ‘finishing-off’ others’ food’ – Eat more meat

• Socially sanctioned behaviours unique to men – eating for muscle – Diets and supplements for non-competitive weight-training

• Objective binges become little more than ‘carb- or protein-loading’ as promoted in magazines

– ‘Eat less/right…have more sex’ – the lean fat-free, masculine, desirable man.





“Men are brilliant. Being a man is brilliant. Seriously, it is. Except for penile dysmorphia, circumcision, paying the bill, becoming a weekend father, critics who’ve been hating on us for, well, pretty much fifty years – oh, and those pesky early deaths…” (Lloyd, 2014).



Benatar’s Second Sexism (2012):

• The clue in the dolls:

(Pope et al., 2000)


Combat Violence

Family Punishment

Bodily Privacy


• The level of disproportion is astounding = not just lean/contoured/muscular

• almost a 30% increase to chest size.

• “…with many contemporary figures far exceeding the muscularity of even the largest human bodybuilders” (Pope et al., 1999: 70).

• Young boys say ‘muscles are better’ (Baghurst et al., 2006; Baghurst et al., 2007; Brownell and Napolitano, 1995)


It’s not just Barbie causing damage


Who is perpetrating the second sexism?



Who is perpetrating the second sexism?



2000s To 1960s

(Pope et al., 2000)

The brain of a banker… the body of a warrior.

• Blaming the changing balance of power is too simplistic.

• ‘Society’ is an obvious answer but this leads to the awkward realisation…

• Men “police” one another (Gill et al., 2005).

• We are holding one another to account against masculinities that are not ‘natural’, that reinforce an ideal of masculinity (Connell, 2005).



Conclusions

1. Until very recently everything we know about eating disorders in men has been inferred from extensive research and clinical data from female patients. Viewed psychiatrically there is evidence that there is little difference in the presentation of disordered eating between males and females.

2. Viewed societally there are differences. There are food- and diet-related disorders that go undiagnosed in men (as opposed to women) because the end ‘product’ is currently valued at a premium.

3. Both men and women are struggling against societal preferences and sexualised embodiments of success. Our relationships with our own bodies could become increasingly dysfunctional in the 21st century – men are not immune to this.

4. Men who experience disordered eating feel ‘less masculine’ – this is not purely an internal psychological experience – there is early data that suggests this is how they are actually treated by others. Perceived “powerlessness may have become confused with femaleness” (Katzman, 1997: 72).


Conclusions


Eating disorder

Body dissatisfaction

Control

Food & Feeding

Coping

References


See my research blog at http://blogs.brad.ac.uk/russell-delderfield/ for a downloadable, full list of sources and the slides featured in today’s talk.

http://blogs.brad.ac.uk/russell-delderfield/




Documents

Male Eating Disorders: Misconceptions and Mistreatmentblogs.brad.ac.uk/russell-delderfield/files/2014/12/MEDS-Misconcepti… · –Diets and supplements for non-competitive weight-training