Looking into the small mirror above the washroom sink, Liam Kelly’s bloodshot eyes filled with tears. A moment ago he had made himself sick in the bathroom, now he had an excruciating pain in his throat, his face was puffy and his body exhausted, while his mind was screaming, “I need aid.”
The 42-year-old Irish teacher, who lives in Abu Dhabi, says he still vividly remembers several such nerve-wracking moments spent in his bathroom as he battled bulimia, in secret, for more than 25 year.
“I ate as much as I wanted and then threw it all up in the bathroom. I knew it was wrong, but I was ashamed to tell others,” says Kelly, who finally overcame her eating disorder in 2016 at the age of 38.
Long stereotyped as a syndrome suffered by skinny, white and affluent girls, eating disorders are also prevalent among men, many of whom are ashamed to seek help, for what is supposed to be a “women’s disorder”.
“When I would come out of the bathroom after the purge, I would fake a sneeze, to hide the look of my face,” Kelly says. “The line boys don’t cry used to destroy me. I never went to a doctor. I was too afraid that people would find out about my bulimia.
Notions of masculinity
Tellingly, few studies have been conducted on eating disorders in men. However, the statistics that do exist support Kelly’s claim that, in reality, even though men suffer as much as women, there is far more stigma and little awareness of the dietary issues they face.
In the United States alone, according to the National Eating Disorders Association, eating disorders will affect 10 million men at some point in their lives, and they are less likely to seek help, due to cultural biases . A 2015 report, funded by the UK Medical Research Council, also found that 25% of people with eating disorders are men and less than 10% of them have sought professional treatment.
As traditional societal notions of masculinity expect men to be strong and stoic, this prevents them from revealing their vulnerabilities.
Carine el Khazen, vice president of the Middle East Eating Disorders Association and clinical psychologist at the American Center for Psychiatry and Neurology in Dubai, says: “A strong man is not expected to display emotions or show a sign of weakness. They are supposed to always be well and not struggle. I believe that these stereotypes surrounding eating disorders are still very prevalent in the Middle East, due to which men come later for treatment.
Types of eating disorders
Affecting 70 million people worldwide, an eating disorder is a serious mental health problem related to eating behaviors, emotions and thoughts. The most common of these are: anorexia nervosa, characterized by food restrictions and an intense fear of gaining weight; bulimia nervosa, in which a person has episodes of bulimia and self-induced vomiting; and overeating and binge eating disorders, where a person loses control of their eating and consumes large amounts of food in a short period of time.
For as long as he can remember, 52-year-old Joe Smith (name changed on request), a legal professional, admits he has been a compulsive eater. “There are foods that I cannot eat in small portions; once i take a bite, my mind reacts and i need to devour as much as possible in the shortest possible time,” he explains.
The food loses its taste and texture, and in the end, after a bout of bingeing, Smith admits he is left with hearty remorse and overweight.
“But the very next day, my mind begins to obsess over another frenzy.”
Physical and mental impact of eating disorders
Abnormal eating habits naturally impact a person’s health, emotions and daily life. People with eating disorders can damage their digestive system, teeth, bones and heart. They also often have low self-esteem, anxiety and depression. Most alarming of all is that the condition can be fatal.
Reem Shaheen, Counseling Psychologist and Managing Director of the BE Psychology Center for Emotional Wellbeing, Dubai, says: “Eating disorders are a disturbing mental illness that can directly cause death.
“According to the National Association of Anorexia Nervosa and Associated Disorders in the United States, 5 to 10 percent of anorexics die within 10 years of contracting the disease, and 18 to 20 percent of them after 20 years. In fact, the anorexia nervosa has the highest mortality rate of any psychiatric illness.
Social media and the pandemic a trigger
The growing attention to outward appearance, sports culture, and near-perfect body images broadcast on social media has further triggered unhealthy eating habits.
“The prominence of body image due to social media has probably put more pressure on men to conform to certain stereotypes of muscular bodies and their outward appearance,” says Dr Victoria Mountford, Consultant Clinical Psychologist at Maudsley Health, Abu Dhabi.
She says the pandemic and stay-at-home measures have also led to an increase in the number of men coming to see her for treatment for an eating disorder.
“For people with eating disorders, it’s important to have some degree of control. Unfortunately, the pandemic won out. We have lost structure and routine, which [further] allowed the eating disorder to take over.
During the movement restrictions, there were also consistent messages about cutting extra weight. While some people have developed emotional eating, others have started exercising too much.
Help is at hand
A silver lining is that with better diagnostic information, GPs are able to detect eating disorders, which could be responsible for the rise in detection of eating disorders in men.
Celebrities have also recently opened up about their eating issues, leading to more talk about men’s mental health.
Singer Ed Sheeran recently opened up about his bouts of binge eating and British actor Christopher Eccleston wrote in his memoir I like the bones of you about his lifelong struggles with anorexia.
Kelly writes a series of books, under the title William worried, documenting his struggles with anxiety and bulimia. “I was in an isolated place for many years. I don’t want others to suffer like me; I tell them to treat their bodies with love,” he says.
No matter how complex these eating disorders are, they can be resolved with specific treatment. Psychological therapy is one of the most important tools to aid in recovery.
“The gold standard treatment for eating disorders is Enhanced Cognitive-Behavioral Therapy for the Treatment of Eating Disorders (CBT-ED), designed specifically to address the underlying psychopathology of these disorders,” says Khazen, which trains professionals in these evidence-based treatments. by MEEDA.
Weeks after undergoing therapy, Abdul Rehman, 42 (name changed on request), who works in Dubai, says he was able to experience periods of relief from the bulimia he had for 20 years.
“Within two months of therapy, by addressing my self-esteem and related anxiety issues, I was able to stop the self-induced vomiting that started in adolescence. I see men suffering in silence , but they don’t have to. There is help available,” he says. CBT-ED typically involves 20 to 40 sessions, following a personalized treatment plan that addresses thought patterns unhealthy.
At Maudsley Health, Abu Dhabi, family therapy is offered specifically to young people with anorexia nervosa. First developed at Maudsley Hospital in London in 1985, intensive outpatient treatment involves working with the patient’s family to break their cycles of eating or excessive exercise.
Support groups and online platforms are equally inspiring for dialogue in bringing about change around these delicate issues.
Aakanksha Tangri, founder of Re:Set, an online mental wellness resource, is one such voice. “Re:Set provides a safe space where men can share their lived experiences, help them hear the stories of others, and access affordable mental health resources,” says Tangri. “We also need to eliminate the idea of toxic masculinity and normalize men seeking support.”
Overeaters Anonymous is a global community of people helping each other recover from compulsive eating behaviors. Through 6,500 groups in more than 75 countries, including a chapter in the United Arab Emirates, Overeaters Anonymous offers the 12-step method similar to a proven treatment endorsed by Alcoholics Anonymous.
“In OA, if I end my day eating only the foods I intend to eat, then I declare myself ‘abstinent’. says Joe, who has been a member for 18 years. “So just for today, I’m sober with gratitude and the world is a much better place because of it.”
Updated: July 27, 2021, 04:11