By Stuart B. Murray, DClinPsych, Ph.D.
Why do I focus my work on eating disorders in males? Shouldn’t I focus my work on something more worthwhile? Something more prevalent? Something less obscure? If you’re planning to study eating disorders in males, won’t it take you 10 years to finish any meaningful study because of how few of these guys there actually are? Why haven’t I decided to step into ‘mainstream’ eating disorder research, because surely no funding body will throw their money away and fund eating disorder research in males, which by default will only apply to so very few people?
Sadly, these are questions I’ve fielded all too many times from colleagues working within the field of eating disorders, at conferences, meetings, and even in casual hallway conversations. Our field is pervasively biased against eating disorders in males. This is reflected in our diagnostic system, which is set up to measure concerns more predominantly reported in female eating disorders. This is reflected in the measurement tools we use to track eating disorder symptom severity, which are often geared towards questions which don’t apply to males, like satisfaction with one’s hips or bust. This is reflected at a clinical institutional level, where many eating disorder residential treatment facilities don’t accept male patients, or when family doctors tell male eating disorder patient to toughen up, forcing them to live unassisted with a horrendous disease burden. This is reflected at an academic institutional level during casual conversations with mentors when junior colleagues are dissuaded away from a career in research relating to male eating disorders. As a result of this longstanding bias, far too many boys and men with an eating disorder are falling through the cracks into an abyss of stigma and marginalization. It is time for our field to change the goalposts.
When I made the decision to study to become a clinical psychologist, knowing it would be an arduous road of many years’ of study and sacrifice, I did so with the primary motivation of wanting to help people. Before I entered into the world of clinical psychology, I had envisioned it to be a panacea of warmth, nourishment and encyclopedic expertise, where all comers are welcomed with compassion and assisted in equal measure. However, as I ventured further into the world of clinical psychology, I realized that this was an illusion. It soon occurred to me that there were distinct subgroups of patients who were deeply marginalized, within an already marginalized population of those suffering from a mental illness.
Few illnesses carry the same stigma as eating disorders, where sufferers are often conceived of as narcissistic, controlling, or even attention seeking. These stigma are profoundly damaging, and can delay treatment seeking and cause far greater suffering. It was with deep sadness that I realized that mental health professionals, my own kind, the world I had conceived of as a panacea, contributed to and propagated this stigma. It was then and there that I decided to devote my therapeutic and research efforts to the male experience of disordered eating. I hoped, and still hope, to help as many males as possible who are struggling with an eating disorder. This takes me back to the origin of my decision to become a clinical psychologist; to help people.
In my journey in working with male eating disorders, I very quickly learned that these disorders do not discriminate along gender lines. Moreover, I learned of the incredible strength many male eating disorder patients carry within them, in navigating a brutally difficult illness, and the disabling stigma attached to it, while stepping forward to seek treatment. Further still, many recovered patients I worked with have gone even further, and have volunteered their own time to help overturn the stigma attached to eating disorders in males, or share their story in helping to connect other males to treatment.
If we can’t stand as a field, together, and advocate for the inclusion of males in eating disorder services, how can we defend the values that drove us all towards the profession of caring for people marginalized by mental illness? Surely we can all see the incredible strength of man who has taken the step to come forward and seek treatment for a life threatening eating disorder, despite society, and even health professionals, telling him that he has a female disease? Then why can we not match our patients’ strength in making our own voice heard in the Ivory Towers, or in treatment centers?
The National Association for Males with Eating Disorders serves as an important platform to share our collective voice in supporting males with eating disorders. One must recognize the paradox of needing to establish a male association for a disorder which profoundly impacts all gender orientations, and it is our hope that all eating disorder organizations and institutions will one day be as inclusive of male patients as they are to female patients. Until that day, we will continue to work towards greater recognition of male eating disorders, and improved treatment options, and reduced stigma.