disordered eating is a male problem too
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for many men, an eating disorder might look more like an obsession with clean eating and developing muscle than "dieting." (getty)
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vacations were tricky for jason wood. exploring new neighbourhoods, once one of his favourite parts of traveling, was a major source of anxiety. spontaneity had become scary: it meant he couldn’t research the menu in advance. and that meant there might not be any foods that met his standards.
“i would spend hours, if not days, researching restaurants before we’d even leave for our trip,” says wood, an office events coordinator in denver, colorado. “i’d have everything planned out on a spreadsheet to ensure that whatever my diet looked like at that point in time, i had a plan down. vacations could easily be ruined if one of the vetted restaurants was unexpectedly closed, or if a menu item wasn’t available.”
though it took years to realize it, wood was struggling with orthorexia, a condition where a person’s focus on “healthy eating” becomes obsessive and debilitating.
it’s easy to think of eating disorders as a largely female problem, since we tend to learn about dieting, weight loss and food restriction in specifically gendered ways. and this can make it hard for men or non-binary people to recognize their own disordered eating habits.
the hidden struggle of male disordered eating
it’s something ary maharaj, outreach and education coordinator for the national eating disorder information centre (nedic), sees often in the outreach work that brings him to toronto-area schools. when he asks boys if they diet, they’ll always say no, he says.
“but as soon as i’m talking about dieting as in, watching what you eat, or cutting or bulking for muscularity, they’re like, ‘oh yeah, we’re doing those things.’”
he believes the number of men with eating disorders are much higher than the documented rates. “when we look at the research in the dsm-5 (the standard classification of mental disorders used by mental health professionals in the united states) around 20 per cent of people living with an eating disorder identify as boys and men,” says maharaj. “but as soon as you take away the diagnosis, when we talk about disordered eating more generally, those numbers really start to even out across genders.”
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about one million canadians have been diagnosed with eating disorders, according to the national initiative for eating disorders (nied) — but as maharaj points out, many cases go undiagnosed. nied also reports that eating disorders have the highest mortality rate of any mental illness.
the pandemic has only made a significant problem worse: eating disorders have spiralled out of control in the last year and a half.
“we know that eating disorders have a strong link to trauma,” claire mysko, ceo of the american group national eating disorders association (neda), told npr. “many people with eating disorders have past experiences with trauma, and this [pandemic era] is a collective trauma.” she added that between march and september 2020, calls to neda’s helpline were up by nearly 80 per cent.
in canada, the numbers are comparable, maharaj says — which means there aren’t enough resources for all the people who need help with eating disorders. “it was bad before covid,” he says. “people were already waiting six months to a year [for treatment]. then covid hit, it really exacerbated the problem.”
orthorexia can show up differently in men
terms like “optimization” or “biohacking” are more likely the words to come up in discussions around the restrictive food behaviours favoured by men. that’s how twitter ceo jack dorsey described his practice of eating one meal a day and skipping food entirely on the weekends.
“the first time i did it, like day three, i felt like i was hallucinating. it was a weird state to be in,” dorsey said on a podcast in 2019. “but as i did it the next two times, it just became so apparent to me how much of our days are centred around meals and how — the experience i had was when i was fasting for much longer, how time really slowed down.”
and while the focus for women tends to be on becoming as thin as possible, unrealistic body ideals for men often have a lot to do with large, defined muscles. just take a look at the way the media depicts men’s bodies — images that are getting less and less attainable for the average guy.
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bobby holland hanton, the stunt double for chris hemsworth’s titular character in “thor,” told muscle and fitness that he worked out for 90 minutes twice a day to get and maintain that enormous, hulking torso. his diet was equally strict. he ate small amounts of lean protein every two hours: “no sugar, no salt, nothing was grilled in sauces.” he also commented on how difficult the diet was to maintain.
“it made me kind of unsociable in a way because you can’t go out with friends or family because you’re picking what you can and can’t in the menu,” he said.
and then there are the financial costs of building a body. when actor and comedian kumail nanjiani posted a photo on instagram of his physical transformation after being cast in a marvel movie, he made explicit reference to how long, time-consuming and expensive those changes were.
“i would not have been able to do this if i didn’t have a full year with the best trainers and nutritionists paid for by the biggest studio in the world,” he wrote. “i’m glad i look like this, but i also understand why i never did before. it would have been impossible without these resources and time.”
but bulking up isn’t the only route men take to change their bodies — sometimes it’s just about losing weight. in a look-obsessed society, where weight loss is praised so relentlessly that even north korean dictator kim jong-un was celebrated for losing an estimated 20 pounds, it can be easy for something that starts healthily enough to gradually become obsessive. even the definition of wood’s condition, orthorexia — “an unhealthy focus on eating in a healthy way” — depicts how an intense focus on “health” can get distorted.
being healthy is what wood thought he was doing for a long time, he says. growing up, he was regularly picked on for being overweight. “i felt like as soon as i walked into a room, i was labeled because of my appearance,” he says. “i didn’t have a chance to really introduce myself, because i was already just ‘the fat kid.’”
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he joined weight watchers as a teenager, and was able to lose a lot of weight quickly. that’s when his restrictive behaviour started to escalate, he says “the problem for me was that the overachiever kind of came out,” he says. “if you could eat 28 points a day, i’d be like, i can eat only 25 and i’ll lose the weight even faster.”
the validation he got for losing weight this way was intoxicating. he started getting respect and praise from the same people who used to mock him. friends wanted to take him shopping; many people told him they were proud of his progress.
“in my head, i was like, ‘this is my crowning achievement,’” says wood. being a formerly overweight person became a big part of his identity: “i used to be fat” was the story he would tell when he met someone new and needed an icebreaker.
but that newfound approval also gave him a new fear. he was terrified of the possibility of gaining the weight back — he remembered how the world had treated him before he got thin.
“the thing that scared me the most was looking like a failure to my friends and family,” he says. “they were so proud of me for losing the weight in the first place. if i screw this up, if i revert back to the old jason, what are they going to be proud of? i’m just going to be a disappointment.”
wood began developing more anxiety about food, and would exercise more if he ate something unhealthy — eating stopped being a pleasurable or a social experience. “it was more about restriction and punishment,” he says. “there was a lot of shame and guilt around food.”
the stress of social eating
and then there was the stress that eating with other people brought with it. “i didn’t want to be tempted by the bad foods,” he says. “i didn’t want to look like a failure in front of them for eating, or feel bad about myself if i broke my food rules.”
one night he went out to dinner for a friend’s birthday, and the only food on the menu that felt healthy enough for him was a vegetable dish. but when it arrived, the vegetables were coated in parmesan. “i freaked out, because at that point, parmesan cheese was off limits for me,” he says. “i went to the bathroom, i tried to pull myself together. but i left the party early.” he went to bed hungry that night.
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the pain of asking for help as a man
disordered eating can be hard for anyone to talk about, but maharaj says many men find the descriptor humiliating. “i think there’s extra shame for men with eating disorders, maybe around having a quote-unquote girl’s [disease],” he says. “both say a lot about patriarchy, and the way that we see girls’ issues as being not as serious.”
and then there’s the fact that many men are taught to be strong when it comes to health and well-being — and for many, “strong” can translate to suffering in silence.
“men typically don’t seek support for issues around health in general,” paul gallant, a vancouver-based independent consultant who’s run men’s health groups through his company gallant healthworks and associates, told cbc news in 2018. “but especially health when it comes to issues of self-esteem, mental health and body image issues.”
for wood, what finally helped was a short weekend away with his husband, when he became upset that there wasn’t anything “healthy” enough for him to eat at a restaurant.
“[my husband] had seen me over the course of the pandemic, how it kept getting worse and worse, and he acknowledged that he was concerned about the way i was eating,” says wood. “i think hearing him say that kind of opened my eyes to what was going on, and i realized that i needed to talk to someone.”
but getting help wasn’t easy or fast — his doctor diagnosed him with an unspecified eating disorder, but didn’t provide referrals to any specialists. plus, most of the research that wood found online was specific to women with eating disorders, and didn’t apply to his situation. but his research finally led him to a therapist and a nutritionist, and together they made what he calls “an amazing team.”
wood’s therapist helped him understand some of the underlying issues that led to the obsessive way he thought about eating, like his anxiety and unprocessed trauma from a difficult childhood.
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“it was a huge reminder that eating disorders are about a lot more than food, because we didn’t even talk about food [when i started therapy],” he says. “we just talked about my life and the insecurities and the anxieties that were going on.”
and then came the difficult task of deconstructing his complex relationship with food.
when his nutritionist created a meal plan that included bread, wood was terrified. he started by eating tiny amounts of whole-grain wheat bread, and now he says he can go into a bakery and pick up any loaf he wants. and while he still has setbacks — wood once left brunch when he saw the calorie counts listed on the restaurant’s menu — he knows that slowly, he’s getting healthier.
“that’s kind of how i’ve made it as far as i have in recovery,” wood says, “just taking it one day at a time.”
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