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Eating disorders among men, hiding in plain sight

The rise of eating disorders among men
Posted at 12:24 AM, Feb 26, 2022
and last updated 2022-02-26 10:23:11-05

COLORADO SPRINGS — According to NASA humans need just four basic things to survive, water, air, shelter, and food. However, out of all of the basic needs, our relationship with food is by far the most complex. Food can be cultural and an art form, but for some of us in society, food can be a battle.

National Eating Disorder Awareness (NEDA) Week runs from Feb. 20 - 27. According to NEDA's website, the week is a yearly "campaign to educate the public about the realities of eating disorders and to provide hope, support, and visibility to individuals and families affected by eating disorders."

According to NEDA 28.8 million Americans have experienced an eating disorder at some point in their lives.

According to the Eating Recovery Center, Anorexia has the second-highest mortality rate of any mental health disorder, with opiate overdoses surpassing it.

According to NEDA, men "represent 25 percent of individuals with Anorexia Nervosa, and they are at a higher risk of dying, in part because they are often diagnosed later since many people assume males don’t have eating disorders." However, eating disorders are not limited to Anorexia, with Binge Eating Disorder being the most common among men as well as Bulimia.

"I think the research would show that disordered eating is prevalent in males and females kind of at the same rates," said Dr. Barbara Kessel, a psychiatrist at the Eating Recovery Center. "And then eating disorders are grossly underdiagnosed in men and people of color."

News 5 looked into this issue within our own community and learned about the often untold story of men with eating disorders.

Ryan's Story

Ryan walker eating disorder
Ryan Walker is an accomplished choreographer who now lives in Los Angeles.

Ryan Walker's story is just one of many that men in his situation have had to go through. He grew up in the south and was into sports and athletics, but in his case playing sports was more than just an activity.

"There was like a big positive aspect being in sports and it also had an ulterior motive of like staying closeted," said Walker who is openly gay. "I definitely was like that kid on in the court that was, um, getting penalties and like I would break racks and there was just all of this free-floating arousal, meaning just like adrenaline and all this energy that I didn't really have a place to put."

He said when one of the older kids took a dance class as a joke, he felt like "if he could do it I could do it." He quickly fell in love with dance and applied for a "rigorous" dance conservatory when he was in high school, however this new direction in life would come with a dangerous struggle.

Ryan said he was about 14-15 years old when he started showing symptoms of an eating disorder. He began to lose weight from the rigorous activity and began receiving praise for it which he would later call "traumatizing."

"Having grown up as a bullied, looked-over, queer kid, enter into this performer profile where suddenly I'm like celebrated and sexualized and desired, sort of all under the pretense of what my body is doing," said Ryan.

Ryan then began to explore ways to manipulate his weight, and it quickly became self-destructive. When he was 16 his heart rate had dropped down to about 26 beats per minute and he became medically compromised and had to leave the dance conservatory.

However, because he was a man in 2006 he said there was not a lot of precedent on how to treat men with his condition. He said at the time there were no co-ed eating disorder inpatient facilities, so he had to be treated in a pediatric oncology wing at a hospital. He would later be treated at the Eating Recovery Center in Denver, and it would take him about six years to recover.

Ryan was also was able to re-vamp his career as a dancer. Since then he has worked with names like Lil Nas X, Christina Aguilera, Nicole Kidman, Red Hot Chili Peppers, and Demi Lovato. Ryan also says that while we've made great strides since 2006, there is still a lot of misunderstandings when it comes to eating disorders in men.

"Men have been hiding in plain sight. There's always been really systemic, conditions that have predisposed men to disordered eating and sports and this obsession with muscle composition," said Ryan."We think we tend to like reduce eating disorders to like a drive for thinness, and that is like one branch of a very big tree, and obviously, that is just the limbs of a deeper-rooted issue."

What is an eating disorder, and what leads to an eating disorder in men?

While eating disorders manifest physically and take a toll on the body, NEDA describes an eating disorder as both a mental and physical illness. News 5 spoke to Stephanie Hill, a licensed professional counselor in Colorado Springs who specializes in eating disorders, she says while there are different types of eating disorders it is ultimately a drive for inner peace by changing one's outward appearance through various behaviors.

According to NEDA, an eating disorder can be caused by biological, environmental, and societal factors. Research suggests there is a likely genetic component to eating disorders, and some members of the population might be more susceptible to this disease than others.

"Eating disorders only develop when genetics and the right environmental conditions combine, you know, like somebody who goes through a trauma, let's say, but doesn't have the genetic predisposition for an eating disorder isn't going to turn to that to cope," said Hill.

Hill says she has treated many men for eating disorders, and the driving force behind what triggers them is different for everyone. She says certain male populations could be more at risk including those who have experienced trauma, the LGBTQ+ community, semi and professional athletes, and even the military.

Hill referenced a study that showed an increase in eating disorders, specifically Bulimia, among veterans and men in the military. She said it's not surprising due to the combination of a focus on physical standards and the traumatic environments many of these men are exposed to.

Men in the LGBTQ+ community are also at a high risk, according to Hill over 50 percent of LGBTQ+ individuals develop eating disorders.

"You think of the microaggressions and, LGBTQ+ hatred that they faced in the day to day and discrimination that they face in the day of the day it just puts them at higher risk for any kind of mental health issue," said Dr. Kessel. "When you are dealing with a higher level of stress, you need to find ways to cope, and sometimes those coping mechanisms are gonna be unhealthy."

Ryan Walker also told News 5 that body image pressure on the LGTBQ+ community could even be traced back to the 90s when there was a stigma about gay men and HIV-AIDS.

"Thinness was associated with AIDS wasting," said Ryan. "So there was like a big social push to develop muscle composition to offset the stigma of AIDS wasting. So that really like lives in our collective unconscious."

When it comes to athletics, according to a study published in the Journal of Clinical Sports Psychology, up to 45 percent of female athletes, and 19 percent of male athletes, struggle with an eating disorder. In addition to the strenuous and body-focused environment, Hill also says she believes a competitive athlete's mindset could also predispose them to eating disorder behaviors.

Bryan Bixler, who was a collegiate track star and suffered from Anorexia, could perhaps be an example, he says he can attribute his disease partially due to his "perfectionist mindset."

However, no matter the cause of an eating disorder one of the biggest hurdles when it comes to men is seeking treatment which requires breaking through societal, cultural, and systemic walls.

The long journey to get help

Bryan Bixler's battle to seek treatment for his Anorexia is one that highlights the struggles men face when seeking treatment in our current system. The first hurdle he struggled with was just getting properly diagnosed.

Bixler said he fell onto the eating disorder path when he began to focus on nutrition and track. He said he became a vegan, a diet he says in retrospect was not ideal for an endurance athlete. He said post-grad he began to realize he may have a problem but didn't think it could be categorized as an eating disorder since he considered himself healthy and an athlete.

He said a doctor once pointed out that the "looked kind of thin," but never even thought to put two-and-two together, a man with an eating disorder.

Bixler said, at first, he was misdiagnosed with an autoimmune disease and other ailments before it was recognized as "secondary-anorexia," which he says was not exactly an accurate diagnosis.

Dr. Kessel says she sees this problem of misdiagnosing eating disorders within the medical community, and it's not just between men and women.

"You know, there's a lot of research... patients presenting to their primary care office with symptoms of eating disorders, and they could have the same symptoms of an eating disorder and a white female would be diagnosed with an eating disorder and a black female would not be diagnosed with the same eating disorder," said Dr. Kessel.

Bixler's battle for treatment continued, he told News 5 back in the early 2000's mental health and eating disorders were not being treated like biological illnesses. He said had to go through court battles to prove his condition, with doctors testifying that if he didn't get treatment soon he would die.

Eventually, his story caught the attention of the Dr. Oz Show, and he said he got treatment through the television show in exchange for sharing his story.

Today he runs a business that helps people with mental health disorders like addiction and eating disorders. Bixler says now being on the other side it's still a struggle to help people get the help they need, between battles with insurance companies and cultural stigmas surrounding men and mental health.

Dr. Kessel says men are less likely to seek help for an eating disorder, and even if they do recognize an issue, she says asking for help can be very intimidating given the stigmas. However, she says while more needs to be done there are lots of recovery options.

"There's many different levels of care, including, you know, outpatient seeing a therapist or a dietitian.," said Dr. Kessel. "A dietitian can be key in helping patients, you know, learn how to, you know relearn how to nourish their bodies, um, how to confront, maybe some biases or misconceptions about food or nutrition that they have developed."

When it comes to seeking help, Stephanie Hill also recommends finding someone who specializes in your particular situation or disorder.

"Someone who maybe is transgender doesn't wanna go to just a traditional eating disorder clinician, without knowing, 'do you have the ability to help me with that piece of my body image stuff?' You know, if the answer is no keep looking," said Hill.

When it comes to recovery both Hill and Ryan also emphasized the importance of human connection and support groups, especially when it comes to men who may think they are all alone.

"For a lot of us [recovery] is a really patient, sobering process," said Ryan, "So I think the elements that treatment really gave me was just exposure to so many people that based on my own sort of demographic profile, I would've written off, as like 'they're this way and I'm this way,' and all of these sort of divides, you're with a real grab bag of people and treatment coming from all walks of life... And that contact and sense of belonging is something I've forever internalized and been such a quiet engine of my recovery."


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