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If we ask you to picture a person with an eating disorder, you're almost always going to imagine a young white woman. That's just how the media portrays it, as a disease that makes thin females purge their salads so they can fit into their new dress. But while males make up only an estimated 5 to 15 percent of anorexics and bulimics, that's exactly 5 to 15 percent more than the culture at large expects.

We talked to Alex and Steven, who have eating disorders, and Brian Pollack, a therapist who specializes in them. All three have struggled to convince the world that this is even a thing.

6
Eating Disorders Come Out Of Nowhere

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So, why do guys develop eating disorders? There's no answer that is going to make perfect sense to you, since voluntary starvation is about the least logical thing an otherwise healthy organism can do. In Alex's case, his disorder developed in the summer before sixth grade, thanks to a mixture of stress and daytime TV.

"I started going through puberty, so there were body issues. The trigger was such a strange thing. I was outside playing and had the TV on in the garage. [Maury] had kids who were 5 years old and over 100 pounds. I remember being fascinated and disgusted. I hate to use that word now, but as a kid you're grossed out. I also remember being super hungry that day. I ate too much. The next day I wasn't hungry. I figured, well, I ate a shit-ton yesterday. And then the day after, I wasn't hungry again. And the day after that. And then I started getting hungry but I didn't want to eat. The next thing I knew, I had barely eaten anything for a week, and it snowballed from there," he says.

NBCUniversal Television Distribution
At least it wasn't a paternity episode. Testing your dad's DNA every day sounds incredibly expensive.

Steven, meanwhile, doesn't remember a specific trigger. It just sort of happened, like that summer you got really into ska. "When I graduated high school, I went off the deep end dieting," he says. "I went from 185 to 120 pounds. I was down to just drinking a cup of coffee and maybe snacking on a few almonds throughout the day. I thought I looked really good, and everyone at work was like, 'Oh, wow, you're really doing a good job!'"

Yeah, that's the other thing. Even when Steven's own doctor told him he had a problem (after he collapsed at work), all his friends were saying, "Hell yeah, you have a problem. You've gotten dangerously attractive." He says, "Everyone saw me as the fat kid. So all my friends were just like, 'Wow, you look great!' When I joined a gym, I was like 120 pounds. And I told this trainer [about my weight loss] and he was immediately like, 'Oh, way to go, good job!' So there's a lot of negative reinforcement."

Goir / iStock
"Let's work on eliminating those pesky almonds, bro. Double-digits, here we come!"

Therapist Brian Pollack says it's common for men to get this kind of feedback: "[Some men] utilize the gym as a bulimic behavior. A 'lean' or 'muscular' male may gain the attention and respect of the people around him, but what they often don't know is that this individual is restricting their [food] intake, spending enormous amounts of time in the gym, and eating in such a controlled manner that it causes them to become further obsessive about their body and more isolative due to the demands of the lifestyle. All signs of bulimia, but oddly seen as healthy in our society."

It's interesting how Alex and Steven's own stories almost downplay the causes -- after all, who didn't have body issues at that age or lose their appetite after an episode of Maury? But these guys didn't stop dieting once they reached what society says is a sexy weight -- they kept starving themselves to the point of system failure. If you find that behavior baffling, well, you are not alone.

5
When The Patient Is Male, They'll Try Every Other Diagnosis First

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We're not saying eating disorders are easier for women to deal with (it's not a competition!), but there is at least some awareness of eating disorders in females. Somewhere out there is a mother who started worrying her daughter had an eating disorder the first time she skipped lunch. But if you're a guy, you'll have better luck convincing people that you're skipping meals because you're a Kryptonian who feeds directly from the Sun.

DC Comics
Which is bullshit, because for some Kryptonians, the exact opposite is true.

Alex barely ate for months, but his parents never considered the possibility that he had an eating disorder. "It wasn't like I was hiding it," he says. "But no one ever thought to discuss it in terms of 'Your son has an eating disorder.' And looking back, I can't believe all the hoops we jumped through just to avoid that."

Instead, Alex, his parents, and his many doctors all thought it was a physical condition, he says. "I would tell people that it felt like I was choking, like there was something stuck in my throat. The doctor even said my throat was red and raw, but they think it happened retroactively -- my stomach started digesting itself and having flare-ups. So it was a self-fulfilling prophecy: my body broke down and it became real."

Kim Traynor / Wiki Commons
The only time you should ever eat stomach is when it's haggis, and even then only when you're too hammered to know better.

Everyone went all-out to avoid the mere suggestion of an eating disorder, to the point where it cost his parents serious money. "My parents and doctors were willing to bend themselves backwards to give me more and more expensive tests, consider weirder and weirder conditions, instead of just broaching the topic. And this was over three months, when I was eating the bare minimum I needed to function," he says.

According to Pollack, it's common for doctors to assume it's a physical issue in men. Because what man doesn't love chowing down on a steak? "It isn't on their radar, and the resources and education isn't readily available. When a man has trouble with his gastrointestinal tract, they don't take into consideration the patterns of eating -- they just want their constipation to go away. The reported difficulty is not the eating or the thinking surrounding the intake of food; it's the fact that they are having stomach problems. Specialists are called in and tests are done. The process gets distorted."

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4
Your First Instinct Is To Lie

nito100 / iStock

Even though Alex was trying to convince himself and everyone else that his problem was physical, he still didn't want to be known as the Weird Non-Eating Kid. So immediately he was forced to spin an elaborate web of lies: "I'd say, 'Oh, I'll meet you [at your house later], but my parents said I have to have dinner at home tonight.' And I'd just not eat at home. A few times, I'd throw away food."

Sometimes he took measures that were equal parts desperate and ridiculous, like a sitcom character trying to get out of a bad date. "When I couldn't avoid having to eat, I used to chew the food up and put it in my cheeks. And then I'd go to the bathroom and spit it in the toilet," he says. "Or I'd grab a bunch of paper napkins and spit into them while wiping my face. When I went out with my family to restaurants, I'd do that because I didn't want to be the freak not eating. That eventually led to my dad escorting me to the bathroom. And they'd watch me to make sure I didn't spit it out or grab a napkin. Or I'd cover food in a pile of fries and say, 'Oh, I just didn't want to eat all those fries,' and there'd be like an entire chicken leg under it. It's funny looking back, because it was so obvious."

Wow_Pho / pixabay
"We're at a sushi restaurant; where did you even get those?"

Steven also did whatever he could to avoid eating. It all comes back to that sense of shame -- we tell men they should feel weird for having an eating disorder (since that's something for frail female supermodels), so they do. "I would take extra shifts; I worked retail. Work thought I was a real go-getter, but I was just wanting to avoid having to go home and eat dinner," Steven says. "I also had a co-worker who was taking diet supplement pills that are basically just over-the-counter speed. She gave me some, and I was like, 'Oh man, these are awesome!' It was an appetite suppressant -- you're supposed to use it in conjunction with normal diet and exercise, but I just used it as my primary source of energy."

MelSi / pixabay
A pile of starvation pills: the one thing worse than a pile of cover-up fries.

Anyone who's ever worked retail now realizes how serious these disorders are -- Steven voluntarily spent more time with annoying customers to avoid eating. He even lied to his doctor. He couldn't tell a helpful medical professional the truth of his eating habits, because that's how deep the uncomfortable feelings surrounding these disorders run. "[My doctor] asked me what I eat throughout a day, and I started lying. I was like, 'Oh, I'm eating fruit and vegetables.' I just started spouting all the 'correct' foods the typical normal healthy person should be eating. And about halfway through, she called me out on it and said, 'I don't think you're eating anything.' I was ashamed. I knew I was unhealthy."

3
No One Understands Why You Can't Just Shove Some Damned Food In Your Mouth

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Right about now, we have a whole bunch of readers saying, "This is nuts! All they have to do to cure this 'disorder' is eat a fucking hamburger! I'd kill to have just one life problem I could solve that way!"

Zhenikeyev / iStock
As opposed to the many, many problems we only pretend to solve this way.

OK, stop and think of all the mental barriers you've built up in your life purely due to social pressure. If you don't know what we mean: Imagine you moved to a place where it's considered normal and healthy to, say, let strangers lick your eyeball. A place where the food is squirming lizards and where you're forced to defecate in the middle of a busy street while 50 strangers watch. Then imagine that, when you try to avoid those activities, everyone acts like you're the crazy one ("If you didn't want to do those things, why did you move to Florida?").

There's nothing logical about your aversion to those things, yet some of you wouldn't do them even if your lives were at stake. Well, these guys have developed equally strong aversions to eating food. When asked to explain themselves, what can they say other than, "I just don't want to"? The fact that it's illogical doesn't make it go away.

JanMika / iStock
They'd probably prefer the lizard, since it'll immediately run away and that's a perfect excuse to skip lunch.

Because Alex's parents weren't terrible or wolves, they were obviously worried when he stopped eating, but they also had no idea what to do. "They went back and forth between frustration and concern," he says. "My dad told me he would go into my room when I was sleeping and cry, because he didn't know what to do. But there were other times where they would yell at me because they didn't know why I was taking two hours to eat three bites."

Steven's eating disorder also strained his relationship with his father, he says. "There was a point where I had come home at 3 or 4 in the morning, and I had to be up for work the next day. And he just lost it. 'What's wrong with you? You don't eat dinner anymore, what's going on?' He told me to stop going out, and he would watch me eat. He encouraged me to go to the doctor. But like any teen who kind of lost their way, I just resented and ignored him."

Oh, and there was another factor involved ...

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2
Gay Men Are Much More Prone To Eating Disorders

Nicolas McComber / iStock

Eating disorders are seen as a feminine problem and, if you're already shopping for stereotypes, assuming gay men are a bunch of girly-boys obsessed with being pretty is a two-for-one combo. But Steven noted that the ugly stereotypes don't always come from ignorant yokels: "Being a gay man, people are very quick to judge and say this is a self-imposed sickness, or that I'm just making things up. In the gay world, a lot of people want to be either really skinny or really muscular, and you can't get muscles without eating. So you have one side telling you to eat and become muscular and another side telling you to not eat and become skinny."

diego cervo / iStock
The waist is not the area most people think would be receiving the most size judgment, but there you are.

Research has found that 42 percent of men with an eating disorder identify as gay or bisexual, and that 15 percent of gay and bisexual guys will face an eating disorder. As a group, they simply face a different array of body-image issues. "Gay men generally report lower body satisfaction than heterosexual men," Pollack says. "The research states they are also more likely to agree that they experienced objectification and pressure from the media to be attractive. We also hear more concern regarding gay culture and the nicknames the community utilizes to stereotype themselves by the way they speak, act, feel and look. ... For some, trying to fit in a community after not fitting in with family or heterosexual community stereotypes can often create pressure that is confusing."

BrianAJackson / iStock
Skipping food for another week will not earn you your Sexy Twink Badge, because Sexy Twink Badges are not real.

The good news is that Pollack also noted that research on this subject is starting to become more prevalent. Given that we've (mostly) come a long way from the days when homosexuality was considered a mental illness, you'd like to think that awareness alone will make a huge difference -- sufferers shouldn't be put into a situation where they have to "come out" a second time.

1
You Have To Retrain Yourself To Eat ... Over And Over Again

Halfpoint / iStock

For Alex, there was no sudden inspirational moment of clarity where he came to terms with his body and started eating again. A doctor just tricked him, because sometimes medical science uses the same techniques as a devious babysitter. "What helped me was the placebo effect. One of the doctors just told us what we wanted to hear, that this medication would help," he says. "Only looking back did I realize that all this dude gave me was a slightly stronger antacid and told me it would fix the problem. And it did."

Mightnightcomm / Wiki Commons
From Tums to yums.

The recovery was unpleasant -- a process of begrudgingly relearning a task he'd fought to put behind him, like if you had to go back to crawling everywhere you went. "It didn't feel natural. I had to force myself to eat. Three meals a day took three hours. I had to mentally walk myself through chewing and swallowing," he says. "I had to sit and be like, 'OK, I'm going to take this bite on this fork, I'm going to put the fork in my mouth, I'm going to chew, I'll swallow ...'"

Steven, meanwhile, finally just saw his body run down like a battery. "I would drive myself to the point of utter exhaustion. I wouldn't sleep for two or three days because I was hopped-up on pills and caffeine. I would try to up my energy, when what I really needed was food. But there were times I would just crash. My brother told me one time I slept for a day and a half straight." After passing out on the job, he says, he was ordered to the doctor (and even then only got help after said doctor saw through his bullshit insistence that everything was fine).

Daizuoxin / iStock
"If you were truly fine, you would've told the customers to fuck off and die, like a normal worker."

So, happy ending, right? One quick eating montage and they're happy, healthy adults? Yeah, not quite.

When Alex went to college, stress brought his eating disorder right back: "I would get so stressed out with projects that I would all of a sudden realize, 'Oh, it's midnight and I haven't eaten since 8 a.m.' I would have to force myself to go make a sandwich. It's interesting how quickly and unexpectedly it can come back. Because if I don't cook dinner, that's an hour I can use to work. I'd have to catch myself and be like, 'No, that doesn't help.' That would happen several times a week."

These days, he's fine most of the time. But like a recovering addict, bad urges will pop up in the back of his mind. "I like food. I still don't necessarily like how I look on any given day; there's still that mental stuff," he says. "But I know not eating isn't the solution. It's background noise. Every once and a while, you have to address it."

Kanawa Studio / iStock
Treat this as a rehab session.

Steven, meanwhile, still isn't doing so great. "I still have extreme body issues," he says. "The moment I gain two or three pounds, I feel like I'm really fat and I start to hate my body. I have to force myself to eat. I can still go days without eating and be totally happy doing that." And that, of course, takes its toll. "I have hypoglycemia; I'm borderline diabetic. I have major mood swings. I use my eating disorder as a coping mechanism, something that I can control. I gain a weird sense of self-worth from restricting my food intake. [It's] the one thing I have control over."

And let's face it: In our culture, men are trained not to talk about their problems -- especially "girly" problems like body-image issues and eating disorders. "If there is one thing an eating disorder loves to do," Pollack says, "it's take control when a person doesn't want to speak up. We have to change the conversation. Change the actual language of the experience for men so they can relate more in their terms."

So, maybe instead of "anorexia" and "bulimia" we should go with "destructively successful food vendetta," or perhaps "excessive diet dominance." Feel free to make up your own -- it just has to be something dudes aren't afraid to say out loud, because if there's one thing we've learned today it's this: Shame is a fucking killer.

Brian Pollack has a website and works for the National Association For Males With Eating Disorders. Mark is on Twitter and has a story collection.

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For more insider perspectives, check out 5 Unexpected Things I Learned From Having An Eating Disorder and My Eating Disorder That Ruins Thanksgiving: 4 Realities.

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