June 22, 2017

Men and Binge Eating: What You Need to Know - Dr. Julie Friedman

binge eating disorder and menJim, a 39-year-old married male*, sought treatment in our program last year.

He told me that he had suffered with Binge Eating Disorder for ten years. He shared that when he finally "got up the nerve to tell my doctor" about the binge eating, the doctor’s response was "Maybe you should follow a ketogenic diet. You don't have an eating disorder – you are obese! You just eat too much."

Sadly, this scenario is all too common.
Many people, including health care providers, assume that men (higher weight men at that) are not as vulnerable to eating disorders as women. Therefore, they often do not bother to screen male patients for eating disorders in the same way they might screen women. The assumption can be that men simply lack discipline and willpower and need to be instructed to "diet differently" or be "better at dieting."
Often, providers focus on the fact that their patient is gaining weight while ignoring clinically significant eating disorder symptoms. To make matters worse, restrictive diets — that can exacerbate binge eating — are often prescribed as the recommended “cure."
Many men that seek help in our eating disorder clinic struggle with binge eating for many years before seeking treatment. Our male patients tend to wait to seek help until they start experiencing serious health issues or significant functional impairments. 
  1. Men tend to wait to seek help many years after eating disorder symptoms appear.
Men tend to seek help for binge eating disorder because they are concerned about serious health issues that stem from binge eating habits and the associated weight gain (examples: diabetes, risk of limb amputation, high blood pressure and more). Conversely, women tend to seek treatment for binge eating earlier — often primarily due to concerns about weight and appearance.
  1. Men struggle with body image, too.
Like women, men also have body image issues. But this body image disturbance can look different. Men tend to focus on having a healthier body. They might want a more muscular physique while women want to be much slimmer. Men can also be less compulsive with body image disturbance related behaviors than women are. Women might weigh themselves multiple times over the course of 24 hours, check their body appearance and measurements frequently, and compare their body to other women. Men might practice more avoidance behaviors more frequently, such as avoiding weighing themselves or avoiding situations where they will be weighed. Men might also to avoid clothes shopping and wear clothes that are too big or avoid mirrors and reflective surfaces in which they would see their shape.
  1. Eating disorders in men are underdiagnosed.
Not only are men seriously underdiagnosed with eating disorders, but they are less likely to seek specialized binge eating disorder treatment from experienced clinicians. One of the problems that I see is that many primary care doctors and other providers are just not expecting male patients to have an eating disorder. Thus, they do not look for or screen for eating disorder behaviors.
  1. Binge eating can reduce sexual functioning.
I see many men with binge eating disorder struggle a great deal with sexual functioning. In fact, many of our male patients come to us for help because they want to improve their intimate lives with their partners. Concerns about intimacy can be related to body image issues, mood issues, behavior patterns, and/or medical issues associated with BED. In treatment, men can address these issues behaviorally and medically.
  1. Men struggle emotionally, too, and benefit from therapy.
Many male patients come to treatment and recognize that they have been struggling with comorbid depression, anxiety, and or addictive/compulsive behaviors for years. Men are not always socialized to sit and talk about their feelings in any setting let alone a group setting, but I’ve seen many of them discover the power and value of vulnerability and connection in a therapeutic setting.
  1. Men might have different views about exercise.
Since movement is often an important part of living a balanced life, it’s important to incorporate joyful movement into the binge eating disorder treatment setting. Men and women might focus on different things when it comes to exercise. In our treatment center, every patient in our treatment program works with an exercise physiologist and participates in daily movement groups. We sometimes see a man’s exercise goals looking very different from woman’s. Men might be very goal and performance driven when it comes to exercising. They will make goals regarding exercise: to run a 5K, to walk a mile without stopping or to be able to walk to work.

Read more about movement therapy in binge eating disorder treatment.
Many patients come in to see us for binge eating only after their loved ones have told them to seek help — or because they finally realize that they need help. It takes a great deal of support from friends, health care providers, and/or family members to help a patient identify the need for treatment and to seek specialized eating disorder care. Let us know how we can help you and your family members move forward in recovery.
*This patient’s name has been changed for privacy reasons.

About the Author:
Julie Kabat Friedman, PhD is Vice President of the Binge Eating Treatment and Recovery Program (BETR) at Eating Recovery Center. She is also Assistant Professor in the Department of Psychiatry at Northwestern University Feinberg School of Medicine.

June is Men's Health Month.

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