Silence and Guilt : Eating disorders have long been associated with women. But men also succumb to self-hatred and the battle to look good.

Most everyone has heard stories or seen made-for-TV movies about women and girls who starve themselves into barely walking skeletons or gorge on massive loads of food that are then vomited.

Although about 7 million women across the United States suffer from eating disorders, including anorexia nervosa and bulimia--life-threatening and often chronic illnesses for which exact causes are not known--an estimated 1 million American men also struggle with the diseases.

Dennis Henning, 32, is one of them. Before his fourth stay in an inpatient program last year, the Los Angeles resident and former model spent a dozen years inhabiting a surreal terrain where foods were land mines that catapulted him to either binge and purge repeatedly, exercise compulsively or starve for weeks.

“My mind was warped,” he says now.

And then there’s Jack Hoag, 42, a Wisconsin litigation attorney and former college basketball player who about two decades ago began starving himself and exercising three to four hours a day, a pattern that persisted throughout law school.

“I was sick,” he says now.

Yet despite their years of suffering, it wasn’t easy for either man to seek help.

“Men are supposed to be men, and eating disorders are not something men are supposed to have,” Henning says. “If a woman asks for help, people say that’s great, she’s trying to get better. If a man comes out with it, he’s seen as pathetic.”

Robert Flanery, director of the Eating Disorders Program at the St. Louis University School of Medicine, says he and his colleagues are seeing more middle-aged men who are concerned about their appearance.

“They see looking like the Pillsbury Dough Boy as a work disadvantage--a barrier to promotion,” he says. “Five years ago, this wasn’t the case.”

Flanery says the phenomenon parallels increasing societal focus on men’s fashion and general concerns about the health consequences of being overweight. “Traditionally, women were twice as likely to seek weight-loss treatment,” he says. “But now, it looks like it’s going to be more 50-50.”

Adds Vivian Meehan, founder and president of the Illinois-based National Assn. of Anorexia Nervosa and Associated Disorders: “What starts out as a way to deal with life then takes hold of them.”

Cynthia Adams, professor of allied mental health at the University of Connecticut, says there are three types of men who develop eating disorders.

One is young men raised to play the role of a female in the family.

“It’s not that they’re effeminate,” she says. “It’s that they’re raised to be more tied to mother’s apron strings--more helpful, more nurturing. They’re also less secure about appearances.”

The second group is young athletes, who develop the disorders while trying to compete. For example, wrestlers, whom Adams calls the “original bulimics” often vomit before weighing in and then gorge before the actual meet, setting up a pattern they cannot stop.

The last pocket is the “guy who is afraid to get old,” the man in his late 30s or early 40s.

“Along with the little red sports car and the second wife, he’s determined to stay youthful through thinness,” Adams says. “He pushes too far--running eight to 12 miles a day--and ends up in trouble.”

For Hoag, anorexia began during his last year of college, where he was on the basketball team and preparing to go to law school. He’s not quite sure what caused him to drop 70 pounds from his 6-foot, 3-inch frame, but speculates that a variety of factors contributed to it.

“I’ve always been a Type A-kind of driven person,” he says. “That works positively when things are going well, but when not, it can work in a negative manner.”

Hoag says his problem was characterized by an “irrational pursuit to have more of what in your mind is the perfect body. I wanted no body fat and all muscle,” he says.

“Rationally, I knew you have to eat to do that, but the connection was, losing weight equaled loss of fat, not muscle.”

His weight plummeted to 105 pounds, and his problem continued through law school. He entered a hospital program in 1976, but continued to run during lunch breaks and dropped out of treatment after a week.

“Everyone thinks people with anorexia don’t like food,” he says. “But the truth is, you’re obsessed with it. You’re living to eat, not eating to live.”

He did well in school, but became progressively isolated socially. He remembers his family’s concern. He remembers his own crying.

Says Hoag: “I’d forgotten how to eat. I wanted to get better, but I didn’t know how.”

One morning after graduating from law school, he was listening to a radio talk show while driving to work. The guest was a Chicago hypnotist who stopped people from smoking.

“The people whom he’d hypnotized said they no longer thought about their problem, and I thought, ‘Bingo, I want to forget about mine.’ ”

He called the hypnotist and drove to Chicago that night. “That very first night I felt relaxed, something that I hadn’t felt for a long, long time.” He continued with the hypnotist for eight months and got progressively better. Now, he’s a happily married father, exercises reasonably and maintains his college weight of 175 pounds. “The hypnotist was the catalyst,” he says, “but getting better happens only when you’re ready.”

Experts say that even though eating disorders in males were observed 300 years ago, they have since been overlooked, understudied and underreported.

Dr. Arnold Andersen, a psychiatry professor at the University of Iowa, is one of the nation’s leading researchers on the phenomena. In addition to his academic and clinical work, he has edited a book of studies--”Males With Eating Disorders” (Brunner/Mazel, 1990)--and is writing another for families faced with the problem.

“We have to go back to where the roots are formed to understand these diseases,” he says, adding that although the disorders look the same for men and women, the paths for getting there are different. For example, while women who develop eating disorders feel fat before they began dieting, they typically are near average weight, whereas the majority men actually are medically overweight. So why do fewer males than females develop full-blown eating disorders?

Andersen says definitive answers are not available, but sociocultural influences have a lot to do with it. “There’s clearly less general reinforcement for slimness and dieting for males than for females,” he says. “But when subgroups of males are exposed to situations requiring weight loss--such as occurs with wrestlers, swimmers, runners and jockeys--then a substantial increase in the behaviors of self-starvation or bulimia follows, suggesting that behavioral reinforcement, not gender, is the crucial element.”

For Henning, who says he was never overweight, it all began when he was 19 and living in Los Angeles. He and a friend--both models--started eating and throwing up.

“Modeling had nothing to do with it,” he says. “We just loved to eat.” Henning moved to New York City, where his food habit cost him $100 to $300 a day.

“I’d consume 15,000 calories a day,” he recalls. “Fast food, sweets--anything I could stuff down my throat. I’d get out of work and go to a pastry shop and spend $100 to $200 on pastries.”

He describes his eating as having had a “numbing effect, like taking novocain.”

He knew he was out of control, especially when his chest cavity weakened after six straight years of throwing up five or six times daily. But the only way he could stop bingeing and purging was to stop eating for two weeks at a time. Yet even the water and soda he allowed himself during those periods were vomited.

Back in California, he saw a therapist and tried inpatient programs, but nothing took until last summer when he completed a 60-day stay at a Studio City hospital. “I was just ready,” he says. “I had lost everything, and it was either do this or die.”

Today he eats well and feels much better. He attends Alcoholics Anonymous meetings for the structure they offer and surrounds himself with different people than he used to.

He’s writing a book and a documentary about his experience and plans to give seminars. Recently, he discussed his illness on a TV talk show.

“It’s still not that easy,” he says, “but every day I remember what happened and I never want to go back.”