Purging Stigma
Cases are thought to have doubled among boys and men in recent years. But with the illness too often dismissed as a ‘women’s issue’, thousands are missing out on treatment – or are reluctant to seek it. For many, it remains a secret source of shame. MH spoke to four men who want to break the stigma
Browse any number of articles on the ‘alarming rise of eating disorders’ recorded in recent years, and you’ll notice a common theme.
Almost invariably the images are of thin, pale young women, who sit hugging their knees or with their heads in their hands.
Despite the fact that an estimated quarter of those affected by eating disorders are male (and that rates are just as high among ethnic minority groups), the old stereotypes are hard to shake. This becomes doubly complicated with bulimia, an eating disorder characterised by recurrent episodes of binge eating followed by compensatory behaviours, such as self-induced vomiting, misuse of laxatives or excessive exercise.
Historically, bulimia has attracted less media attention than anorexia. It’s less understood and more difficult to spot, even among women. Bulimic men, then, can seem near invisible.
Caroline Mayor is a helpline adviser for the UK’s leading eating-disorder charity, Beat. The number of calls she and her colleagues receive annually increased by 218% between the year before the pandemic and the year to March 2022. According to Mayor, calls from male sufferers have soared, particularly among those with bulimia and binge-eating disorders (BED).
‘There’s been a rise in bulimiarelated calls from men in the fitness and bodybuilding spaces,’ Mayor notes. One of her colleagues recounts a recent interaction with a bodybuilder who described how bulking and cutting had destroyed his relationship with food, and how difficult it became to avoid binge eating during the restrictive phase. ‘The guilt and shame from that binge eating lead to compensatory behaviours like purging,’ she explains, keeping him stuck in a cycle of harm.
Of the 96,473 support sessions Beat provided between April 2022 and March 2023, 10,612 calls were from men – double the number recorded between 2019 and 2020, when just 5,001 callers were male. This is consistent with data from the Royal College of Psychiatrists, whose analysis of hospital figures in 2015/16, compared with 2020/21, showed that the number of boys and men being admitted for eating disorders increased by 128%.
These numbers only reflect those who feel able to come forwards. The very nature of bulimia – a disorder that doesn’t necessarily lead to weight loss – makes it hard to spot. ‘Bulimia is probably the most secretive eating disorder, which makes it notoriously difficult to diagnose,’ says Chukwuemeka Nwuba (aka Dr Chuks), autho
