The Food Factor

As many as 30 percent of people with eating disorders are men. It's not often talked about, and many men find it hard, even impossible, to get help since many facilities only accept females.

His image is not what 16-year-old Mike wants to see when he looks in the mirror. He says, “There was this saying that I heard somewhere, and it goes, ‘Your eyes see what mine can't see.'”

All Mike's eyes saw was an overweight teenager staring back at him. That dissatisfaction led to anorexia and then bulimia. He would eat only 500 calories every other day and would jog about 75 miles every weekend. His weight log shows how he went from 180 pounds to 112.

Mike says, “I wanted to be as skinny as I possibly could because I just didn't believe I was worth anything, and after being told that for about seven or eight years, you get used to it, and you believe it.” He believed it so much, he even tried to kill himself ... Twice.

Roberto Olivardia, Ph.D., a psychologist from McLean Hospital in Boston , says there are differences in how men and women cope with eating disorders. “With women who struggle with an eating disorder, it doesn't violate their femininity. It doesn't violate their gender in any way, whereas for men, it does, so they often struggle with, well does this make me less of a man? Does this make me gay? What does it mean?”

There are other differences as well. Men are more likely to have been involved in sports and to have been obese in the past. And nearly 70 percent of men with eating disorders have other problems like drug or alcohol dependence, depression, or obsessive-compulsive disorder.

Olivia Beckman, M.D., an eating disorder specialist, says men are also treated differently -- with a more straightforward approach. “Some of the therapy that is used in eating disorders is using a feminist approach, and that would turn off men, not only do they not want to come in, when they get in, we're talking about squishy feelings that they would not want to discuss,” says Dr. Beckman, who is from Walden Behavioral Care in Waltham, Mass.

So, doctors focus more on thoughts rather than feelings. Dr. Beckman says finding the right therapist is also important. “I would recommend that they would either see a man, or someone that's used to working with men to be able to help them best.”

Mike still struggles with his body image but considers himself “mostly recovered.” He says the best therapy came from writing a book about his disorder. He says: “I still have moments where I believe I'm not worth anything, and I still purge about once a week or so, but that's better than six times a day, so I'm doing better. I'm on the road to recovery, but there's still bumps along that road.”