We have all seen or heard about a case of anorexia at some point.
Almost always the image that comes to mind when talking about this disorder is that of a teenager in the middle of puberty or that of a woman who has recently entered adulthood, with an obsessive fear and/or refusal to increase or maintain their current weight and a distorted image of their body that cause an overrated idea of the need to lose weight.
However, although the female sex is the most common in clinical practice, the existence of a relevant sector of men who suffer from this disorder should not be forgotten. We are therefore talking about the existence of male anorexia.
Facing the concept anorexia: what are we talking about?
To understand this disorder it is necessary to visualize what we are talking about. Anorexia is one of the most common eating disorders, with a prevalence that has increased from around 0.5% to 5% of the world population in a few years, a percentage that continues to rise over the years. Of this percentage, 90% of the cases are women (generally between 14-18 years of age), and 10% of them are men. It is the mental disorder with the highest risk of death in adolescence, being one of the few psychiatric disorders capable of causing the death of the affected person by itself.
The symptoms that lead us to suspect and diagnose this disorder are the refusal to maintain a minimum body weight, fear of gaining weight, a distorted perception of one’s own body image that induces weight loss through different strategies, either through cessation of intake, this type of anorexia being restrictive, or through compensation strategies (vomiting or exercise) in the case of purgative/compulsive type anorexia. These phenomena have caused him/her to lose at least 15% of his/her body weight, and there is also no feeling of illness on his/her part. Besides In the case of women, there is also the presence of amenorrhea or lack of menstruation..
As mentioned, 10% of anorexia cases occur in men. Within the male population suffering from anorexia, according to the studies carried out, there seem to be some risk groups.
Homosexual population
Studies show that the gay population (as well as, although to a lesser extent, the bisexual) have a higher risk of suffering from anorexiawith a high proportion of cases in this sector of the population. A hypothesis regarding the reason for this greater prevalence proposes that it is due to the existence of great emotional tension in the stage of formation of one’s own identity when assuming one’s own sexual orientation. This high tension and fear of rejection facilitates vulnerability to suffering from eating disorders by trying to reduce them by fixating on one’s own image.
Social rejection
Another group with a high number of cases is that from bullying and social rejection.. Individuals with a history of social rejection due to being overweight are at greater risk of developing male anorexia. As in the previous case, great tension is caused during the formation of identity that causes vulnerability and a fixation with one’s own body figure and the ideal of male beauty.
Elite athletes/models
A final high-risk group is child athletes.which, given the establishment of performance expectations that are too high by adults, tend to have a lower tolerance for failure, trying to correct it with a lower intake and performing a higher level of physical exercise.
Distinctive characteristics of male anorexia
Male anorexia, although it shares most of its characteristics with its female counterpartpresents a series of peculiarities that are beginning to be explored.
Social perception of illness
One of the differences derives from the lack of social perception of this disease in men.. Given the high prevalence of eating disorders in women, there is a social image that these disorders do not occur in men, that there is no male anorexia. Although in the case of women anorexia has been established as a problem of high priority and importance, in the case of men this disorder has often been undervalued, receiving little attention and not being under-researched.
Likewise, the gender role traditionally attributed to men implies that they must act as protectors.having to show strength and hide weaknesses. This means that, as a general rule, the individual does not actively seek help to deal with these problems, nor when expressing their emotions.
There is usually a feeling of weakness and social judgment that leads to keeping behaviors secret even when they become aware of the disease. Likewise, many of the acquired behaviors, such as excessive physical exercise, are seen by those who suffer from the disease as something they could not live without, so that there is a high resistance to seeking professional help. There is also a tendency to undervalue the effects and severity of the symptoms of the disorder and its effects.
Behavioral pattern
In the case of men, the typical behavioral pattern also changes. As with women, society and the prevailing canon of beauty in today’s society means that there is constant pressure regarding body image. In the case of women, this canon induces them to be thin. In the case of men, however, in addition to being thin there is the need to maintain a toned and muscular body.
Thus, although in women the most common subtype of anorexia is restrictive anorexia, in which they reduce their intake and follow varied diets, In the case of male anorexia, the purgative/compulsive subtype is more commonin which an attempt is made to reduce weight through behaviors that compensate for caloric gain and also generate muscle mass. Thus, it is more common for men to exercise compulsively.
Treatment of male anorexia
Also in the treatment of anorexia in men there are some variations.
Male anorexia, as previously indicated, It tends to be undervalued and underdiagnosed, causing men with this disorder to not usually receive treatment. and support appropriate to your needs. As a general rule, men tend to take longer to see a doctor due to this problem, which initially makes it difficult and slows down overcoming the disorder.
Male anorexia, however, has a slight advantage over its female counterpart. The response to treatment tends to be faster in males in the first phase of therapy, more behaviorally directed, due to an apparent better understanding and follow-up of direct treatments. It must be taken into account that this type of disorder in men usually occurs together with an idea of weakness or personal extravagance. This means that a specific diagnosis often brings a certain relief, given the better understanding of what is happening to them. Therefore they present a better reaction.
The treatment of this disorder is a complex phenomenon. The basic objectives of the treatment would be the restoration of weight to a healthy level, the treatment of physical and psychological complications, the improvement of motivation and eating patterns, and the modification of the perception of body image, adjusting to reality. In this sense Common treatments used are systematic desensitization, exposure with response prevention and the modification of body image. Likewise, the improvement of the support network and the prevention of relapses is also proposed.
In conclusion, it should be noted that in both males and females, anorexia nervosa is a serious disorder that can lead to the death of the patient and must be treated with the utmost priority, seriousness and respect.
Bibliographic references:
Rosen, D.S. (2003). Identifying and treating eating disorders. Pediatrics;111:204–11.
Bramon-Bosch, E.; Troop, N.A. & Treasure, J.L. (2000). Eating disorders in males: a comparison with female patients. Eur Eat Disord Rev 2000;8:321–8.
Morgan, JF & Arcelus, J. (2009). Body image in gay and straight men: a qualitative study. Eur Eat Disord Rev 2009;17:435–43.
National Institute for Health and Care Excellence (2004). Eating disorders: care interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. London: National Institute for Health and Care Excellence.
