More men now suffer from eating disorders - but the stigma attached means many suffer in silence, writes Ciarán Brennan
HE WAS the archetypal political heavyweight in more ways than one - an overweight, thickset, battling deputy prime minister who once punched a protestor. So when Britain's John Prescott admitted to having suffered for many years from bulimia, a disease normally associated with young women trying to control their weight, it surprised many people.
"Which is what makes John Prescott coming forward so significant - it challenges a lot of stereotypes of an eating disorder all at once. He is 69 years old, he's male, he was in a very powerful position and he wasn't the typical image of a vulnerable adolescent girl," explains Ruth Ní Eidhin, communications and advocacy officer at Bodywhys, the eating disorder association of Ireland.
"There are certainly issues around men coming forward because they probably don't want to admit to themselves or to others they are being affected by something that is considered can't happen to men or wouldn't happen to men."
But as Prescott's case demonstrates, girls and women aren't the only ones with body image issues.
"Men are presenting more with eating disorders which 20 years ago was unheard of," says clinical psychologist Armien Abrahams. "But because of media and an emphasis on the six-pack and looking good, men are now presenting more with disorders usually associated with women."
According to Ní Eidhin, one in every 10 people now contacting Bodywhys is a man. Surveys and anecdotal evidence show that increasing numbers of men and boys are also feeling unhappy with their bodies and are under pressure - real or imagined - to achieve a certain image. The ideal male look today, as shown on TV, in film and in advertising, has become increasingly lean and muscular.
"I think society, western society more so, is becoming more image-focused and appearance focused," says Suzanne Kelly of the Eating Disorder Resource Centre of Ireland.
"Society is suggesting to men that if you look a certain way you get the package, you get happy, you get the woman, you get the job, you get the money, you get the car and, therefore, people who are vulnerable and predisposed to developing these problems are then adopting the behaviours to actually get that package and most times those behaviours are really unsustainable and dangerous."
While some of these behaviours can manifest themselves in disorders such as bulimia or anorexia, for many men there is another side - a preoccupation and obsession with bulking up and building muscle.
"The difference is you will see females wanting to get smaller so they start to slim down but the men want a metamorphic shape, they want to bulk up so they head to the gym," says Kelly.
"You find a lot of male body image dissatisfaction in the gym, and the difference between a male just exercising to look and feel good and one who has psychological issues could possibly be the male who bulks up but who still sees himself as being really small and he then tends to want to try to bulk up more, do more exercise, possibly take steroids, possibly start to address food and while his shape has changed physically, he wouldn't see a difference.
"This would be very similar to the person who suffers from anorexia and has lost lots of weight but still looks at themselves in the mirror and sees themselves as being heavy," says Kelly.
The key issue with eating disorders is to get people to admit that they have a problem.
"People see eating disorders as the answer to their problems because in some cases it makes them feel special, it makes them feel different, they stand out and it gives them something. As such, they believe it's the answer to their problems," says Kelly.
But Prescott's experience may underline why many men do not seek help for eating disorders. He talked about feeling like a "right twerp" when he found that he was the only man in a waiting room full of women seeking help from an eating disorder consultant.
Many males do not seek help as they feel stigmatised by the illness, or they feel it is a sign of weakness or fear to show their feelings, says Kelly. Many suffer in silence or are not diagnosed early enough. Many feel uncomfortable in a group setting and feel discomfort with women issues being discussed openly.
And it is not only because it was always regarded as a female disorder, says Kelly, who says that there may be a homophobic element attached to the stigmatisation of the disease.
"There is also a stigma attached to it which is suggesting that maybe if you have this disease you could be gay," she says. "Because the research suggests that if you are a gay male you are more likely to be caught up with your appearance and how you look."
Ní Eidhin agrees that many men have a problem admitting that they suffer from the disorder but says that John Prescott's experience may provide the spur for men to seek help.
"There is a reluctance to seek help because in many ways it is giving up your mechanism for coping but once you start the process, treatment recovery is possible. John Prescott has recovered a year now after a 20-year stint."
Men and body image: the stats
Twenty years ago, for every 10-15 females who suffered from anorexia or bulimia there was only one male. Today, research shows that for every four females with anorexia there is one male, and for every eight to 11 females with bulimia there is one male.
Binge-eating disorder occurs equally in males and females, although many males are not as likely to feel guilty or anxious after a binge as women do.
RISK FACTORS FOR MALES
Being fat or overweight as a child; starting to diet; participating in a sport that demands thinness - running, horse-racing, football, weightlifting; doing a job that demands thinness - models, entertainers, dancer.
If you are gay then you are judged on physical attractiveness by the gay community, hence you are more prone to development of an eating disorder due to body image preoccupation.
POSSIBLE CAUSES
Males are more likely to have a specific trigger. Examples include: being bullied/teased in childhood; being bullied/ teased for being overweight; low self-esteem; genetics; starting a body-building programme and becoming preoccupied with body image; having a specific occupation/sport that creates an unhealthy preoccupation with the body.
• Source: Eating Disorder Resource Centre of Ireland