It's Not Just About Weight: Eating Disorders as Emotional Disorders

In my estimate, most people are unaware that last month (February) was "eating disorders awareness month." I never understood the logic of relegating a disease or disorder to one particular month, so I am going to routinely call attention to this topic throughout the year.

Eating disorders are too often willfully ignored, and in men, the problem is compounded by the fact that the disorders are still thought of as primarily affecting girls and women. While studies indicate that eating disorder prevalence has between a 6:1 to 10:1 female-to-male ratio(1), the actual numbers are obfuscated by the fact that men are more reluctant to admit they have a problem. I have first hand knowledge of this, because I am a male with eating disorder who, up until now, has remained silent on the issue.

For those of you wondering, yes, I am truly a psychological mess, but my condition has a certain degree of order to it. Pardon the expression, but my eating disorder feeds off of my depression and vice-versa. I use food to fill an emptiness that goes far beyond mere physical hunger, and the resulting self-disgust at my own weakness forces me to compensate by both purging and enduring extreme exercise. It's not a weight issue, or even a body image issue, it's an emotional issue that at its core reflects my feelings of inadequacy and failure. In future posts, I will discuss the cause and evolution of my disorder, but for now I will just say that I am making significant progress in dealing with it.

At first glance, it appears that I am bulimic, but as is the case with nearly half of all people with a recognized eating disorder(2), my problem falls into the category of ‘eating disorder not otherwise specified’ (EDNOS). The reason for this is that the diagnostic criteria for bulimia (and anorexia as well) is ridiculously narrow.

Despite evidence to the contrary, the American Psychology Association adheres to the notion that eating disorders are primarily about weight. For a certain percentage of sufferers this is true; they have a fixation of being thin and an abhorrence of becoming fat. However, many people with eating disorders, including myself, are of normal weight and are generally not preoccupied with being as thin as possible. Instead, their eating disorders are intertwined with emotional instability(3). But thanks to the American Psychology Association's stringency and outdated mode of thinking, most people with eating disorders are shunted to the diagnostic no-man's-land of EDNOS. I believe that this is at least in part the reason that many people with eating disorders fail to receive the proper treatment. In order to defeat the symptom (the eating disorder), you have to address the underlying cause.

I know that there are no cures for eating disorders, but they can be managed. I have found that confronting the issue head-on through therapy or even simply talking to a friend makes a tremendous difference in dealing with the problem. Others may feel more comfortable remaining anonymous, but I suggest that you reach out to someone just the same. If you suspect that someone you know has an eating disorder, don't be afraid to approach them with your concerns. They may deny it or take offense at the suggestion, but at least they will then be aware that there is someone they can turn to. Men, don't be afraid to seek help if you have an eating disorder. You might encounter doctors or therapists who dismiss you out of hand simply because you are a guy. Forget them, and keep searching until you find someone who shows an understanding. Believe me, there is help out there.

Again, I will continue to address this subject matter with personal accounts of my own struggles, serious discussions on advancements in treating eating disorders, and fictional stories that I hope will both inspire and motivate.

Remember, you are not alone.

Sources:

1.) Kathleen N. Franco. "Eating Disorders." Cleveland Clinic Website. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry-psychology/eating-disorders/

2.) Frédérique R. E. Smink, Daphne van Hoeken, and Hans W. Hoek. Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates. Curr Psychiatry Rep. 2012 August; 14(4): 406–414.

3.) Eric Strother, Raymond Lemberg, Stevie Chariese Stanford, and Dayton Turberville. Eating Disorders in Men: Underdiagnosed, Undertreated, and Misunderstood. Eat Disord. 2012 October; 20(5): 346–355.