TW: Explicit discussion of eating disorders which could cause distress.
A toxic culture around masculinity and mental health has made eating disorders a relatively taboo subject. On the surface, the numbers clearly suggest a discrepancy between men and women when it comes to being victims of eating disorders. However, further research begins to suggest a genuine issue with the underreporting of men’s eating disorders, and that eating disorder provision is designed to target societal issues more generally experienced by women and does not necessarily cater for the idiosyncrasies of the experiences of both genders.
The initial statistics should first be addressed: research shows that women have a 1.75-3 times higher chance of having an eating disorder in their lifetime, and in the UK, around 1 in 4 people suffering with Eating Disorders are men. So, the stats are clear, women suffer more than men from eating disorders, but research suggests that viewing that as the bottom line is perhaps a part of the problem.
The wrong signpost
The underreporting of men’s disordered eating could be put down to the fact that the provision in place signposts problems that occur more in women’s disordered eating. An important distinction to be made is in weight histories: more often than not, men have been overweight in some capacity before having an eating disorder, whereas research shows that women are more likely to have felt fat and thus developed an eating disorder. This already represents a fundamental difference, as it affects the compensatory behaviour in the two groups; men become much more likely to over-exercise in order to compensate for their calories, and women use much more recognised methods like taking laxatives or attempting to vomit.
However, when Professor John Morgan at Leeds Partnership NHS Foundation created his SCOFF list (a list of questions used to indicate a possible eating disorder) he included the following questions: ‘Do you believe yourself to be fat when others say you are too thin?’ and ‘Do you ever make yourself sick if you feel too full?’. These both clearly favour the symptoms more commonly seen in women. The SCOFF list has been regurgitated on prolific ED websites like BEAT and could negatively affect the discourse surrounding Eating Disorders generally, as a result creating a certain image of what an eating disorder looks like and thus implying to men who do not fit into those question categories that they do not have an eating disorder, meaning they do not report it and their condition is left untreated. This is a fundamentally dangerous situation which can seriously affect somebody’s physical and mental health. The first stage of working out if you have an eating disorder comes from using websites and online forums, and doing things like the SCOFF test; if men with genuine eating disorders are not getting past that stage, because those components are not properly signposting issues that could more likely affect them, then it’s clear we are letting them down.
The other, and perhaps more critical, problem surrounding the potential underreporting of male disordered eating, is the perception of eating disorders as essentially a feminine issue. The BMC argues that to fully resolve the problem of men being underrepresented in eating disorder discourse, there needs to be a shift in gendered norms at a societal level. Ryan Ashuk, when conducting his masters surrounding male ED’s, reflected that there is a much higher fear in men that they will be ‘unfairly stigmatized’ as a result of this condition, and attributes this to the toxic culture which surrounds masculinity, and the fact that eating disorders have often been presented as a feminine concept which can only affect women and girls.
These clearly show a sense that men with ED’s still feel unwelcome and unwanted in our gendered society, and like they will not be treated with the love and care that is required when going through those periods of health problems and psycological distress. As a result, we should recognise that we are responsible for ensuring safe discourse around eating disorders, that makes men and boys who are suffering the same level of mental struggle feel like they can go to their local GPs and seek out the treatment they critically require.
As a lack of understanding of what a male eating disorder can look like works in conjunction with a toxic culture around masculinity, it creates an environment where we can very feasibly see a likelihood that men are not always feeling able to report when they have eating disorders. As a result, the presentation of eating disorders as an inordinately feminine struggle is constantly perpetuated and men with eating disorders feel isolated and like they cannot speak freely and get the help and attention they so desperately require.
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