Eating Disorders Resources and Support

Male eating disorders: how much do we really understand?

Last weekend’s transmission of BBC2’s Revealed…Manorexia highlighted the subject of male eating disorders. It’s a subject that’s not raised often enough, say some experts. After all it’s not unusual to read about women who have eating problems, but we seldom hear about how disorders such as anorexia and bulimia affect men.

‘Eating disorders are still rare among men,’ explains Dr Peter Rowan, consultant psychiatrist at Cygnet Hospital Ealing’s Eating Disorders Unit. ‘The incidence in males over the age of puberty who suffer with anorexia, for instance, is around 10 percent or so.

‘But the longer we study all eating disorders, the more we discover variations of disorder that don’t quite fit the classical diagnoses For instance, among women there are not only bulimics but there are also those who suffer with binge eating disorder, and, of course EDNOS (eating disorders not otherwise specified).’

According to Dr Rowan, there are also many men who have an unhealthy relationship with food who don’t fit the diagnostic criteria - which are, of course, designed for women. For instance some men are obsessed with fitness, but not necessarily because they are trying to change their body shape. Some may, for example, become addicted to exercise in an attempt to live longer and avoid coronary heart disease.

‘As a result, these men avoid certain types of food - for instance, fats - and some may develop a very unhealthy relationship to food and eat restrictively. And by doing so, they maintain a low weight,’ explains Dr Rowan.

‘It’s likely that there are more men than we recognise who have some form of abnormality of eating and attitude to food and weight - though most are probably not truly anorexic or bulimic.

‘However, it’s not clear whether or not these men should be described as ill, whether they have an eating disorder and indeed whether we should attempt to do anything about them unless they seek help. Many don’t seek help and although perhaps they should, they often lead pretty normal lives and don’t want to change.

‘On the other hand, those who do seek help are likely to have more severe symptoms and are more likely to fulfil the diagnostic criteria of anorexia nervosa or bulimia nervosa.’

How to get help

For men or women who are worried about an eating problem - whatever type of problem that is - help is available at the Eating Disorders Unit at Cygnet Hospital Ealing. The unit offers outpatient and inpatient treatment for a full range of eating disorders such as anorexia nervosa and bulimia for all patients aged 16 and over with a diagnosis of eating disorders.

The Cygnet Ealing’s EDU offers one of the largest and most experienced multi-disciplinary team of staff, including specialist consultant psychiatrists and medical team, experienced consistent nursing team, psychodynamic family, occupational, art and complementary therapists, dieticians and psychologists.

New patients are seen within 24 hours of the initial contact, some even at weekends. Treatment packages include full medical monitoring and therapeutic group sessions alongside individual work as well as family therapy. Patients also receive help with body image and achieving a normal approach to food, including planning, shopping, preparation and eating meals.

Cygnet Health Care

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At dinner time, parents will often tell their child to clean their plate. However, that old maxim might lead kids to eat more than they need, especially when portions are adult-sized or supersized.

In findings presented at The Obesity Society’s Annual Meeting on Oct. 7, children took more food when larger portions were made available to them.

Jennifer Fisher, Ph.D., associate professor of public health and researcher at the Center for Obesity Research and Education at Temple University, and her research team observed 61 children between five and six years old to determine their eating habits when normal entrée portions (275 g) and “super-sized” entrée portions (550g) were offered. The children used either teaspoons or tablespoons to serve themselves.

They found that while children served themselves larger portions when the super-sized meal was available, portion sizes varied by gender, ethnicity, and parents’ reports of child feeding practices - all environmental influences on children’s eating behavior.

Fisher theorizes that having large amounts of food available conveys a social expectation about portion size that condones larger self-served portions.

“Seeing a large amount of food in front of you can lead you to believe that someone decided this portion was the right amount to eat,” she said. “These results suggest that children take cues from their eating environments when deciding how much is enough.”

There currently is very little research on what factors affect children’s eating habits, but Fisher’s team hopes to pinpoint some of these factors to determine how children’s eating patterns develop, which could help stave off unhealthy relationships with food later on in life.

“We are interested in the cues that children take from their eating environments when serving themselves,” said Fisher. “Many questions about children’s eating habits are as yet unanswered, such as whether large quantities of food and large utensils prompt children to eat more or if the size of children’s self-served portions influences their caloric intake.”

Fisher and her team are currently exploring a number of different avenues to determine the association between the amount of food children are served and the amount they’re actually eating.

“Our goal is to try to identify ways to promote healthful choices from an early age,” she said. “We want children to grow up with good eating habits, and without having to struggle with food issues into adulthood.”

————- Article adapted by Medical News Today from original press release. ————-

Other authors on this study include Michael A. Grusak, Ph.D, and Sheryl O. Hughes, Ph.D, of the Children’s Nutrition Research Center at Baylor College of Medicine, and Leann L. Birch of the Center for Childhood Obesity Research at Penn State University. Funding for this research was provided by the United States Department of Agriculture.

Source: Renee Cree Temple University

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Many people equate the holidays with food big meals equals big times. Americans, especially, attach a lot of social and personal value to what, and how, we eat, often through family rituals or attitudes. For many, family gatherings are positive events, but for the 9 million men, women or young people who have an eating disorder, the holidays, without proper planning, can feel like nightmares.

Three out of four American women have “disordered eating” behavior, and 10 percent have an eating disorder such as anorexia or bulimia nervosa or binge eating disorder, says Cynthia Bulik, Ph.D., the William and Jeanne Jordan Distinguished Professor of Eating Disorders in the UNC School of Medicine’s department of psychiatry and director of the UNC Eating Disorders Program. Her latest book, “Crave: Why you binge eat and how to stop,” is due out in early 2009.

If you have an eating disorder, plan ahead. Bulik and the UNC Eating Disorders team offer the following suggestions to navigate the food minefields of the holidays:

– Have a “wing man” someone you trust to help run interference at family get-togethers or office parties. This should be someone who knows your triggers and can help distract you from temptations (or someone pushing your buttons), change the subject or assist you while you handle the stress.

– Make up a code signal or phrase with the wingman before going to the holiday party. If you start to feel overwhelmed give your friend the signal so that you can both step out of the room and they can offer you some support.

– Keep your support team on speed dial and call them at any time during or after a party. Talking relieves the pressure. You’re not overburdening them. They will undoubtedly have stories to share, too.

– Potlucks are your friends. Don’t hesitate to take a food you prepared that feels safe enough to you so that you will have at least one manageable entrée.

– Lavish holiday spreads don’t have to be the enemy. If faced with one, channel your inner Boy Scout or Girl Scout skills and be prepared! Before stepping in line, and before getting a plate, evaluate the options. Mindfully consider which foods you’ll sample, portion sizes and whether you feel comfortable trying a “feared food.” Make a decision and stick with it!

– If your treatment team has given you a meal plan stay on track so you aren’t starving when you get there.

– Listen with your heart, not your head. Hear the happiness and caring in a person’s tone when they tell you that you look “so much better.” They are saying they care about you. Don’t let the eating disorder lead you to misinterpret those words in a way that deprives you of hearing that people really care about you.

– Get Real! People too often have a fantasy about how “perfect” the holidays are going to be. When family members fail to live up to unrealistic expectations, it might be tempting to restrict or overeat in an effort to feel better temporarily. Try to anticipate some of the possible emotional traps in advance so you can cope (and maybe even laugh) when you encounter them.

– The well-known HALT slogan works for any type of recovery. Don’t let yourself get too hungry, angry, lonely or tired. This is especially important over the holidays.

– ‘Tis the Season to Forgive, so forgive yourself if you have an eating slip.

– Try your best not to skip appointments with your treatment team. It’s an important time to stay in touch with people who can help.

University of North Carolina at Chapel Hill School of Medicine 101 Manning Dr., 6002 East Wing Chapel Hill NC 27514 United States http://www.med.unc.edu

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