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Eating Disorders Happen to Men, Too – Especially Binge Eating Disorder

Especially Binge Eating Disorder

Although most people think of anorexia nervosa or bulimia nervosa when they hear the term “eating disorder,” the National Eating Disorders Association shows that binge eating disorder (BED) is the most common eating disorder in the United States.  Binge eating disorder symptoms are defined by binge eating episodes (in which a person eats a large amount of food in a short period), feelings of shame or and guilt following the episode, and a compulsion to repeat these behaviors repeatedly.  This and other eating disorders can result in severe health risks – in the case of BED mostly relating to obesity, and mental health complications such as depression, OCD, and even suicide.

The stereotype that eating disorders only happen to women has some small relationship to the truth; they do occur more often in women than in men. Recently, though, therapists at eating disorder treatment centers have seen an increase in men receiving treatment – largely because of changes in traditional gender roles as they apply to therapy.

While women have more commonly been diagnosed with eating disorders at a much higher rate than men, binge eating disorder is much more even in terms of its gender distribution. According to Psycom, 40 percent of binge eating cases are observed in men. Because men are less likely to report mental health issues than women, there is cause to think the number of binge eating disorder cases in men is higher than it seems.

How Is Binge Eating Disorder Different for Men?

The most important factor in the previous underreporting of binge eating disorder in men is a cultural one. For centuries and even to this day, men are less likely than women to express emotional distress or admit to mental health issues. Sadly, cultural influences lead many men to think that this would be a sign of weakness or failure. This reticence to admit that there may be a problem can lead to other difficulties unique to men with binge eating disorder:

  • Refusing to ask for help–As with other types of mental health or behavioral health disorder, men tend to try and “tough out” the situation rather than asking for help from a family member or even a professional. There is a societal impulse for men to seem tough and independent that can lead to treatable conditions left unattended.
  • Taking part in “avoidance behaviors”–An “avoidance behavior” is like closing your eyes and putting your fingers in your ears– ignoring a problem rather than addressing it. This can manifest as avoiding using the scale or seeing a doctor and instead just hoping the problem will go away on its own.
  • Anger at confrontation – Certainly, many women are angry at being confronted by friends or family about their disordered eating. However, studies have shown that men reply more frequently to these situations with anger than women do. This reaction leads to more difficulty in intervention situations or even simple conversations about the possibility of getting help for eating disorders.

What Are the Causes and Triggers for Binge Eating Disorder?

Causes

Binge eating disorder is a mental health issue and as such, there is no single cause that can always be identified, unlike, for example, a disease caused by a single virus. It’s usually caused by a combination of factors, which culminate in disordered eating behaviors. These might include:

  • Genetic factors – Many studies have shown that if a family member has binge eating disorder, it’s much more likely to happen. There may even be a specific gene sequence linked to binge eating disorder. It’s not the only causative factor, but genetics certainly play a role.
  • Body dysmorphia – Also known as body dysmorphic disorder (BDD), this occurs when a person either becomes extremely dissatisfied with their body’s size or shape, or they begin to have a distorted perception of their body. For example, an underweight person might perceive themselves as fat. Or, in the case of binge eating disorder, a person of normal weight might think they need to lose weight and subsequently engage in dieting or excessive exercise.
  • Co-occurring mental health disorders – Disordered eating behaviors such as binge eating are often a coping response to another mental health disorder. Both depression and OCD are linked with binge eating disorder; depression causes low self-esteem and negative emotions that are alleviated by binge eating, and OCD spurs a tendency toward compulsive behavior that matches the compulsive nature of binge eating disorder.

A “trigger” in eating disorder treatment terms is a situation or feeling that impels a person to engage in one or more binge eating sessions. Although binge eating episodes can occur without a specific trigger, stressful or emotionally fraught situations can make them more likely to happen. These triggers are common in men, although not exclusive to them in the least:

  • Frequent dieting and calorie restrictions–Men who feel they are overweight will sometimes go on crash diets to lose weight, leaving them underfed and hungry. This can lead to secretive “cheat days” or other kinds of binge eating episodes. In a similar vein, men who are trying to increase muscle mass often engage in high-calorie eating sessions as fuel for extensive workouts, which can lead to compulsive binge eating.
  • Trauma and PTSD–Just as with women, binge eating episodes are often related to past trauma – binge eating releases dopamine into the brain which alleviates anxiety and depression temporarily. Just as with depression, symptoms of PTSD can trigger BED-associated behaviors as a coping mechanism. This can cause a “cycle” almost like an addiction, in which the disordered behaviors provide a temporary reprieve from negative emotions.
  • Suppressing Feelings–Men are culturally influenced to have more difficulty expressing how they are feeling. Males that are not able to communicate effectively may internalize their emotions, causing them to turn to food for comfort. This also influences the likelihood of them asking for help, since they might feel men can’t have an eating disorder.

How Can I Spot Symptoms of Binge Eating Disorder in a Loved One?

Some symptoms may require the help of a doctor or mental health professional to identify, but several are noticeable by the people closest to the individual in question:

  • They often eat even if they’re not hungry.
  • Eating past the point of being full.
  • Stockpiles of junk food, hidden away, or lots of food wrappers being found suddenly in the trash.
  • Feelings of guilt or shame after eating.
  • They may experience extreme changes in weight.
  • Frequent criticism of their body or weight.
  • Frequently commenting on other people’s body weight.
  • Making comparisons between their appearance and others’, including celebrities and people they don’t know.
  • Discomfort at meals with others.
  • Frequently dieting or trying to lose weight without any weight loss.
  • High blood pressure, cholesterol, and other health conditions associated with obesity

A few sessions with a psychologist or psychiatrist who specializes in eating disorders will typically be enough to positively identify binge eating disorder in an individual. While most doctors aren’t experts in eating disorder diagnosis, they generally can provide a referral to a specialist. When the need for treatment has been confirmed, there are several options.

Treatment for Binge Eating Disorder

Although the basics of binge eating disorder recovery are the same for men and women, traditionally eating disorder treatment has been geared towards an all-female setting. Thankfully, this is changing to a large extent in modern eating disorder treatment centers. Most are now ready to treat clients of all genders with programs tailored to their specific needs.

Binge eating disorder treatment is a combination of behavior modification, emotional regulation, and nutritional education. The main goals, after medical stabilization, are helping the client understand how their emotions drive disordered eating behaviors and how to replace those behaviors with more regular eating habits. Some Therapy techniques include:

  • Cognitive behavioral therapy – This technique includes a dialogue between client and therapist that helps both identify the thoughts and emotions that drive binge eating behaviors. Over time, these emotions can be experienced without being acted upon, leading to a stoppage of binge eating behaviors.
  • Mindfulness – This is the core of CBT. Mindfulness is the state of experiencing life in the moment without judgment and without action. It’s often implemented in the form of mediation. Being mindful of one’s disordered thoughts allows them to pass through without causing the urge to binge eat.
  • Exposure therapy – In this form of therapy, stressors that once might have caused a person to binge eat are faced in controlled circumstances. Learning to face difficult or triggering situations without resorting to disordered eating behaviors is key to long-term recovery. This kind of therapy is usually introduced gradually, starting with small triggers and moving on to more difficult ones.

Binge Eating Disordered Treatment Is Available for Men, Too

Although the term “eating disorder” is more often associated with women than men, people of all genders find themselves in need of treatment. If you or a loved one is struggling, don’t let societal expectations or gender roles stop you from seeking help. Binge eating disorder is quite treatable no matter your gender, and professionals are ready to help get you started on the path to recovery. Reach out today to begin a healthier, happier life free from binge eating disorder.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.
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