This post is part of a series of guest posts on GPS by the graduate students in my Psychopathology course during Spring 2014. As part of their work for the course, each student had to demonstrate mastery of the skill of “Educating the Public about Mental Health.” To that end, each student has to prepare two 1,000ish word posts on a particular class of mental disorders, with one of those focusing on evidence-based treatments for those disorders and the other focused on a particular myth or misunderstanding about mental illness.
Who Actually has Eating Disorders? by Holli Norris
When you think of the term “eating disorder” what comes to mind? Usually the mental image that is conjured by this term is a young, white, female. This can be seen via a simple Google image search for the term “anorexia,” where only one gender and skin color is represented on the first 1000 images. Eating disorders are commonly thought to only effect these people. This is because the cause of eating disorders are considered by many to be the proliferation of the ideals of beauty portrayed by the western media. Most women depicted as beautiful in movies, television, and print would in fact be considered underweight. The link between the media and eating disorders has led to many advertisers and companies to come under fire. This mindset that the only way that a young, white, woman one can be beautiful is to be unhealthy may have a dangerous effect on the level of body dissatisfaction of these individuals. Most of the focus on combating eating disorders has been against changing the images in the media of young, white, women. Although eating disorders are more prevalent in this population, despite what most people believe it is not only these people that are affected by them.
Eating disorders are found in many populations, including males. It has been found that approximately 1 in 10 people with an eating disorder is male. Like eating disorders in the female population, eating disorders in the male population may be linked to the unattainable ideal male body image portrayed in the media. While females strive to be thin, males are more concerned with getting bigger. The masculine ideal of physical attractiveness is generally shown as extremely muscular. Males tend to focus on gaining muscle mass while keeping their body fat percentage low. As a result of this males are more likely to use over exercising as a compensatory behavior to combat weight gain as opposed to the purging behaviors more often seen in females.
As eating disorders are usually seen as a more feminine problem there appears to be little to no public outcry regarding the idealistic images of men in the media. Like those images that represent an unrealistic ideal for females this masculine ideal can be just as dangerous for males. Eating disorders come with a myriad of severe health effects ranging from dry skin and hair to death. However for males there appears to be less objection to males straining to meet the criteria of the ideal male form. In some instances it is even encouraged. For example in the culture of high school and college wrestling it is common for coaches and team mates to encourage wrestlers to “make weight” many times through the use of dangerous methods. Adolescents and young adults are pressured to lose weight rapidly in order to fall within a certain weight class. In order to do this wrestlers will often utilize extreme methods to lose weight quickly such as using running or saunas to quickly sweat out any excess water. This is extremely dangerous and can quickly lead to kidney failure and possibly death.
Eating disorders are generally considered by the public to be a “female” disease. Because of this and societal pressures for males to internalize their emotions the prevalence of eating disorders in males may be under reported. The view that eating disorders are only for women is so prevalent that even the Diagnostic and Statistical Manual of Mental Disorders (DSM) endorsed it up until the latest edition. The criteria for diagnosing Anorexia Nervosa required the individual to have amenorrhea for a diagnosis to be made. Amenorrhea which is the cessation of the menstrual cycle clearly cannot be a symptom for a male. Although the DSM-IV contained guidelines for diagnosing those without a menstrual cycle the criterion was eventually removed with the release of the DSM-5 in 2013.
Eating disorders have been considered to be “culture bound” syndromes for a long while now. This means that they were thought to occur mostly occur within in only one culture. This is often attributed to the view that many other cultures around the world have a beauty standard that allows woman to be larger. However, some studies have shown that even in populations where it is acceptable for women to be overweight the prevalence rate of eating disorders is similar to that of the United States.
Furthermore eating disorders are often thought to only effect white women within western culture. The reasoning behind this is that minorities are less acculturated to mainstream western society. Acculturation being the level at which an individual accepts the values and standards of a specific culture. The exact statistics and prevalence rates of eating disorders for minority women living in western society are unknown. This is in part due to the view that eating disorders only effect white women leading to a trend where research regarding the subject has been very limited within other populations. As most people, including some clinicians, eating disorders are likely to be misdiagnosed or overlooked with minorities.
It may be true that the prevalence rates of eating disorders are higher in the young, white, female populations, it is far from the truth that these are the only people that are affected by them. Eating disorders can affect anyone regardless of gender, ethnicity, culture, or even age. Eating disorders are among the most dangerous mental disorders with extremely harmful and potentially deadly side effects. Because of this it is extremely important that we change the way we think about these disorders and further research for males and minorities. The more that is known about eating disorders and their effects on minority and male populations the more effectively that they will be diagnosed and treated. Through education and awareness we can better understand and remove the stigma associated with these disorders and save the lives of those that suffer from them.