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Tackling the stigma of eating disorders in men and boys

Alison Bloomer 19 November 2019
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The actor Chris Eccleston made the headlines last month when he admitted that he has battled with anorexia for decades and at one point considered suicide.

In his new book, I Love the Bones of You, the actor described himself as a "lifelong body-hater", saying he was "very ill" with the condition while filming Doctor Who. He said he never revealed his struggle before because it's not what working class northern males do.

At the time, a spokesperson for the eating disorder charity Beat said it took courage to speak about having anorexia.“Doing so helps to combat the stigma and misunderstanding that exists around these serious mental illnesses, especially for men and boys,” they said.

Often seen as a 'female problem', eating disorders in men are frequently under reported, but recent research shows that disordered eating practices may, for the first time, be increasing at a faster rate in males than in females.1

In addition, studies suggest that risk of mortality for males with eating disorders is higher than it is for females so early intervention is critical.2

Body image is believed to be a big factor. One study found that roughly 90% of teenage boys exercise with the purpose of bulking up.Psychological, genetic, and family influences can also play a role.2 

Eating disorders - such as anorexia nervosa, bulimia nervosa and binge eating disorder - affect an estimated 1.6 million people in the UK, though the true figure may be higher as many people do not seek help.

Lack of understanding of eating disorders among doctors

Despite the scale of the problem, resources to treat eating disorders are scarce. There are very few specialised treatment centres. People affected are often young and vulnerable, and may avoid detection. However, the earlier a disorder can be diagnosed, the better the likely outcome for the patient.

recent report from the Public Administration and Constitutional Affairs Committee on the care of people with eating disorders found that there is a lack of understanding of eating disorders among doctors resulting in avoidable deaths.

It found that medical staff and GPs, in particular, need significantly more training on the nature of anorexia nervosa and the behaviours that sufferers may display. The report also identifies a series of failings from the NHS to act on recommendations for improving care for patients with eating disorders to avoid unnecessary deaths.

Can GPs intervene earlier in eating disorders?

A study in the British Journal of Psychiatry by the Royal College of Psychiatrists looked at early warning signs of a possible eating disorder in general practice.

The research team, from Swansea University Medical School, examined anonymised electronic health records from GPs and hospital admissions in Wales. 15,558 people in Wales were diagnosed as having eating disorders between 1990 and 2017.

In the two years before their diagnosis, data shows that these 15,558 people had:

  • Higher levels of other mental disorders such as personality or alcohol disorders and depression
  • Higher levels of accidents, injuries and self-harm
  • Higher rate of prescription for central nervous system drugs such as antipsychotics and antidepressants
  • Higher rate of prescriptions for gastrointestinal drugs (eg. for constipation and upset stomach) and for dietetic supplements (eg. multivitamins, iron).

Therefore, looking out for one or a combination of these factors can help GPs identify eating disorders early.

Dr Jacinta Tan, associate professor of psychiatry at Swansea University and the Welsh representative of the Eating Disorder Faculty in the Royal College of Psychiatrists, said: "I cannot emphasise enough the importance of detection and early intervention for eating disorders. Delays in receiving diagnosis and treatment are sadly common and also associated with poorer outcomes and great suffering.

"The increased prescriptions by GPs both before and after diagnosis indicates that these patients, even if not known to specialist services, have significantly more difficulties or are struggling. This underlines the clinical need for earlier intervention for these patients and the need to support GPs in their important role in this."

  1. Mitchison D, et al. The epidemiology of eating disorders: genetic, environmental, and societal factors. Clin Epidemiol. 2014; 6: 89–97
  2. https://www.nationaleatingdisorders.org/learn/general-information/research-on-males
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507247/

An educational/awareness event raising event will take place on November 26 2019 at St Pancras Hospital, London, at 6.30pm. It is open to all professionals caring for children, sufferers of eating disorders, survivors, their families and carers.

The event will involve key professionals leading a panel discussion on eating disorders, focusing in particular on addressing the stigma of mental health conditions in certain communities. it will be looking at the evidence regarding different cultural attitudes to food, the impact on sufferers  and management options.

Certificates confirming this training as an annual update in level 3 safeguarding children will be provided.

Tickets are £15 pounds, and £10 concessions. Booking is via Eventbrite or text 07780813409 to confirm your place and pay at the door.