‘Women’s’ Eating Disorders Show Up in Men
To look at him, one would never guess that Jason has an eating problem. At 21, he’s a sturdy man with a well-developed body and a California tan.
Yet nine months ago, Jason (not his real name) weighed 130 pounds. A year ago, he weighed 112. That’s not bad if you’re just over 5 feet tall. But Jason is 6-feet even.
Jason is one of about 20,000 males nationwide who have anorexia nervosa, an eating disorder generally considered a “woman’s disease,” whose victims resist food to the point of starvation.
Because anorexia is so rare among men--90% to 95% of its victims are women--experts can only speculate on why a man would develop the disease.
Questions concerning sexuality and self-identity seem to be common factors. Some researchers have found that many anorexic men had no sexual experiences during adolescence, while others have lost their interest in sex because severe weight loss causes a decrease in hormones.
Societal Pressures
While homosexuals are no more susceptible to anorexia than are heterosexuals, researchers say, gay men who suffer from eating disorders do feel the same societal pressures as heterosexual women to stay slim to please a lover or to boost their own self-image.
And, perhaps unlike women, some men see anorexia as a test of their physical strength, a way to prove to themselves that they “can live forever,” as one researcher said, or that they are worth something despite neglect or criticism from friends and family.
In Jason’s case, severe depression over grades and the difficulty of making friends in college led to his two-year bout with anorexia.
“It was kind of like, ‘Yeah, I can endure the pain of not eating anything so that kind of validates me as a person’ since my grades didn’t show what kind of person I was,” he said.
His illness also forced him to question his sexuality: “I just thought, ‘Am I a woman?,’ and I know I’m not. I’m me and it happened.”
Another anorexic, Daryl (not his real name), says he has no doubts about his sexuality--he is heterosexual. However, his interest in sex is very low:
“If there were on (a) table a cookbook and a Playboy, I would read the cookbook.”
Daryl, whose father died when he was 13, traces his obsession with food to a lack of affection from his mother. This problem has created a psychological hunger, he said, because a mother is supposed to be “where a baby gets fed from and nourished.”
Dr. Joel Yager, director of UCLA’s Eating Disorders Clinic, said that almost all of his male anorexic patients have been heterosexual, although his male patients with bulimia, the self-induced vomiting of food, seemed to show a higher rate of homosexuality.
“The gay men who I have seen with bulimia have said to me that having a slim body shape to be an attractive gay is very, very important,” said Yager, who added that the “passive partner” in particular strives for a figure that is “boylike or girlish.”
More Heterosexual Men
At ESTEEM, a nonprofit eating-disorders clinic in Santa Monica, psychologist Arlene Alexander said that most of the males that come to the clinic are homosexual, though she said she is “seeing a trend” of more heterosexual men at the clinic.
“I would say the similarity between gay men and straight women is that the relationships that they’re in are based upon an image, not who they are as a person,” said Alexander, who estimated that 15% of the clinic’s patients are men. “Gay men are often subject to the same strict standards of physical beauty as straight women are.”
Appearance aside, anorexic men may also be seeking a sense of physical immortality, said Dr. Harry Gwirtsman, Yager’s colleague at UCLA. He speculated that a man in his 30s may feel a self-imposed pressure to “live forever” through exercise as he feels “age creeping up.” Eventually, the man may associate weight loss with good health and will begin dieting, sometimes adopting poor eating habits.
Yager said that several of his male bulimics were former wrestlers or gymnasts who had to battle weight gain. Such men do not see any harm in excessive weight loss because it was acceptable for them to starve for athletic competitions, he said.
Alexander, the executive director of ESTEEM, said she believes anorexics, though obsessed with food, starve themselves to overcome the pain of unfulfilled emotional needs.
For Daryl, his relationship with his mother created such needs.
“I guess I didn’t feel like I’d gotten nourished from my mom . . . in another way so I went to the food.”
And to the bottle. Toward the end of his third year at USC, Daryl, now 25, compounded his eating disorder with alcoholism.
He would get drunk to “relax his prohibitions” against eating or to numb hunger pains, said Dr. Carole Edelstein, his psychiatrist at UCLA, where he started treatment in 1982.
Before seeking help at UCLA, Daryl dropped out of college to see a psychologist, thinking that with therapy he could “get everything fixed and go back into the world.”
But therapy was not the quick-fix Daryl thought it would be. He ended up working in a deli and eating only one meal a day--at dinner time, when he could “relax and enjoy it,” he said.
Later, after moving from his mother’s Westside home to an apartment in the Fairfax District, Daryl’s eating habits worsened. He would put off his daily meal until late at night when his roommate went to bed.
“When I moved out of my mom’s house and I was on my own, I felt like I just went into the world (by myself),” Daryl said, still looking like a teen-ager with his bony 5-foot-10 build, high-top sneakers and 501 jeans.
He compared his insecurity about moving out with the anxiety some female teen-age anorexics have about the physical changes of puberty.
“With me it’s not that I don’t want to develop into a man, I just don’t want to develop into an adult, I guess, with responsibilities,” he said.
After moving out, Daryl drank more than he ate, surviving on alcohol two out of every three days. “A lot of the vitamins I was getting were from . . . whatever, the Vitamin C from the orange juice in a screwdriver,” he said.
That was two summers ago, when Daryl was admitted to the hospital at UCLA for the first time. He stayed five days then decided to leave without telling anyone, walking out of the hospital ward to his Fairfax apartment. The next day, he checked out of the hospital against medical advice, he said.
After another 10-day hospital stay that fall, Daryl returned to live with his mother, who told him to stop drinking or move out. So in January, 1985, Daryl went to an alcohol-treatment center in Inglewood and hasn’t had a drink since, he said.
In March, his condition worsened. His weight, which he estimated at 150 pounds in college, had dropped to its lowest, 105, and he was exercising to the point of exhaustion. Psychiatrist Edelstein said she thought Daryl was dying.
He would not eat, but would go running and fall down in the street. Too weak to pick himself up, he would crawl to the curb and rest before running off again, Edelstein said.
The psychiatrist talked with Daryl’s mother and decided to hospitalize him a third time. After five months, he gained 10 pounds.
Released from the hospital a month and a half ago, Daryl now weighs 113 pounds.
He has been working in an architect’s office and said he wants to study architecture--his subject in college--again.
For Jason, anorexia was a way not to fill a need for love or affection, but to try to fit in with a world that he found uncomfortable.
He went from being a successful Southern California high school student three years ago to being an insecure freshman at Georgetown University where “everybody had to get A’s all the time,” he said.
He spent most of his time at college in his room because it was “easier than going out and meeting people” and his grades “were not what they were in high school,” he said.
Jason was actually gaining weight until he came home one Thanksgiving and someone told him he was “getting fat,” he said.
After the break, he was determined to diet to his high school weight of 150 pounds and ate only a can of tuna every day.
Throughout the school year he continued to starve himself. He would vomit after each meal and take drugs, mostly amphetamines, to lose weight.
When Jason moved to an off-campus apartment at the end of his sophomore year, he wanted to start to eat again but could not overcome his bulimic impulses.
After losing 55 pounds by the summer’s end, he took a leave of absence from school and came back to Los Angeles.
Shocked to see him so thin, Jason’s parents were “looking through the phone book” for help the morning after he got home, he said.
Even though Jason gained weight with therapy, he kept throwing up and his depression continued. In December, he contemplated suicide and “took a lot of pills. I scared myself and threw them all up,” he said.
Since then, Jason has switched psychologists, gained more weight, and has been working as a bookkeeper. Though physically healthy, Jason, who now weighs 165 to 170 pounds, still sees his psychologist. He realizes that he might have killed himself if he didn’t “snap out of” his depression. “I knew I had to put a stop to everything and get it together,” he said.
