A Few Facts
1% to 5% of all men have seriously unhealthy eating behaviors that would qualify as eating disorders. That's several million in the entire US 10% to 15% of people with eating disorders are male.

Of men with eating disorders
  • 79% to 83% have binge eating disorder, described as impulsive gorging or continuous eating;
  • 10% to 13% have bulimia, described as binge eating and then purging by use of self-induced vomiting, laxatives, prolonged fasting and excessive exercise;
  • 4% to 6% have anorexia, described as self-starving and, even if extremely underweight, having a distorted image of their bodies as fat.
So it's a guy thing too. Probably more guys than most people think have some form of eating disorder.

How does it show?

With men, it often shows up at the gym. You may be an athletic type, who doesn't eat much, but exercises a lot. You may be very intent on molding your body into a certain bulk or musculature. Or you may start off having a "good" reason to be dieting (e.g., wrestlers), but end up with eating patterns so out of whack that you are basically bingeing and purging your way between meets in an attempt to "make weight." You may compulsively run long distances to the point that you are just muscle and bone.

You may binge eat, or eat compulsively ("all the time"), or at the other extreme, you may restrict your food intake to the point of starvation. You also may vomit to get rid of what you have eaten, but make excuses for your behavior that at first may seem plausible. Often, like many women with disordered eating, you hide what you are doing so well that your disorder is camouflaged, and peers or family members aren't aware of the extent of your difficulties. Because eating disorders are so associated with females, there is both an extra stigma and an extra denial that comes into play regarding men whose eating and body image are disturbed. This makes it harder to see eating disorders in men--but all the more important to acknowledge.

Men are subject to cultural messages
Men are understandably affected by society's messages about the importance of their physical appearance. Whole magazines, fashion, hair and cosmetic industries devoted to making you "look good" have developed in recent years. The trim and buff aesthetic for men has subtly infected our culture through billboards, ads that get played during the commercial breaks on televised games--it's everywhere. Just like women, you internalize all the messages out there, and then hold yourself to
unrealistic standards. Guys can be very critical of themselves, saying things like: "You don't look good. You're out of shape. What a gut! That guy looks better. How can I get a girlfriend looking like this?" This negative self-talk, so influenced by cultural messages, can make you feel you need to change your appearance, setting yourself on the path to developing unhealthy eating or exercise habits.

What else is behind it?
Experience shows that men with eating disorders, like women with eating disorders, generally have low self-esteem or even self-loathing. You may hide it, but such strong negative feelings and attitudes toward yourself are very powerful and damaging nonetheless. In addition to this, an understanding of male psychology in today's culture gives us clues into what causes guys to develop eating disorders. Interviews with thousands of college men revealed that a large percentage of them:
  • Feel invulnerable (unrealistically so)
  • Or feel a need to conceal it when they do feel vulnerable
  • Know little about health issues
  • Are confused about their male peers
  • Find it hard to talk with peers about self-harmful, questionable behavior
What does this suggest?
It suggests that perhaps in colleges today, you don't readily have ways of revealing your uncertainties and sensitivities, especially with your male peers, who could be your best source of support and feedback. On top of that, men are not getting all the information you could use--or maybe men are not asking the questions and are left feeling confused or uninformed.

What is the role of genetics and biology?
It is now becoming clear that genetics and biological predisposition play a critical, though not exclusive role in the development of an eating disorder.  Studies of people with anorexia and bulimia have found links to specific chromosomes, and a 2006 study led by the University of North Carolina, Chapel Hill, estimated that 56% of the responsibility for developing anorexia nervosa is determined genetically.  Other studies have examined variations in serotonin and dopamine receptors in patients with anorexia and bulimia which could serve to reinforce eating disorder symptoms like food restriction.

What is the significance of biological predisposition for people with eating disorders?
Firstly, it can lessen some of the shame and blaming that goes on when someone develops an eating disorder.  Too often, people with eating disorders blame themselves for becoming preoccupied with food and their bodies, not realizing the extent to which these obsessions can be driven by biological susceptibilities.  People can be much more compassionate with themselves when they understand that—even though there may have been times when they’ve consciously chosen to use a disordered behavior in order to cope—they didn’t choose the disorder itself.  Understanding the biological contribution may also allow some people to feel less shame about utilizing psychiatric medications like antidepressants or anti-anxiety drugs as part of their recovery.

Does this mean that socio-cultural factors aren’t important in the development of an eating disorder?
Not at all. Plenty of people have variable neurotransmitter levels and do not struggle with eating or body image, and many other people with eating disorders have no corresponding predisposition.  Even for people with a predisposition, it is the environment in which they live that can mitigate or promote the expression of their genetic tendencies.  This is one of the reasons that it remains critical to address the “thinness culture.”  Another is that dieting—with its potential for malnourishment and disruption of brain chemistry—can contribute to an existing problem in susceptible individuals, or create a completely new one to deal with.  In fact, dieting has been called “ a necessary, but not sufficient condition for the development of an eating disorder.”  When it comes to understanding and treating eating disorders, it’s important to think in terms of both nature AND nurture.
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Our flight into Brazil put us into the Amazon city of Manaus, where we met with Antonio Matas, the most highly respected herbalist in that area. Antonio shared stories with us about his decades of healing work using rain-forest plants.

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I asked Antonio if he used these plants himself. He smiled again. "Sometimes. After all, I've been married to the same woman for 43 years."

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