Anorexia Nervosa in Men - Stigmatised, Even in South Africa

Anorexia nervosa affects between 2% to 5% of adolescents and adults; it is the third most common disease amongst adolescents in the United States of America, second to obesity and asthma. The disorder is generally considered uncommon in men, with reported prevalence numbers between women and men of 10:1. It is estimated that roughly 1 in 250 women and 1 in 2000 men in the United Kingdom have been diagnosed with anorexia nervosa. In South Africa, men constituted 3.5% of all patients diagnosed with anorexia nervosa at a psychiatric facility across a nine year period. However, other studies propose that up to 25% of people diagnosed with anorexia nervosa are men.

Despite the growing number of published studies and incidents of male eating disorders in the past three decades, anorexia nervosa in men remains poorly understood, with most studies focusing exclusively on women. Epidemiological studies have also demonstrated that anorexia is more prevalent in women than in men. However, these reports are considered inconclusive - possible reasons for the low reported cases of anorexia nervosa amongst men include the false belief that eating disorders are limited to females, the lack of familiarity amongst health professionals, and/or the late treatment and resulting increased risk of other medical complications that may mask the underlying eating disorder.

It is estimated that only 10% of men with anorexia nervosa receive the required treatment. Amongst men, there is the added stigma of having a disorder that is mostly associated with the female population. Whereas a preoccupation with being thin is seen as socially acceptable for a woman, men who obsess with their bodies are often seen as abnormally identifying with female characteristics, which may result in men not seeking help. This is further highlighted by treatment being largely aimed at women. Consideration for the most gender-appropriate treatment of anorexia nervosa in men may therefore be needed, especially considering that the typical treatment options of anorexia nervosa in men fail to address the various social or cultural problems surrounding their symptoms. As an example, men with anorexia nervosa often suffer from other psychiatric disorders, such as depression. Men suffer from the added stigma of going against various cultural norms that prescribe that they should conceal their emotional vulnerabilities.

In extreme cases, anorexia nervosa may lead to premature death, with studies suggesting that it has the highest death rate of the specified mental disorders. This suggests that anorexia nervosa is a major health problem, and that it is important that both men and women diagnosed with anorexia nervosa find an effective and appropriate treatment option. In my view, special attention should be given to men with anorexia nervosa, considering the unique perceptions and issues affecting this population of patients. Time will tell whether this becomes a reality.

If you suspect someone may have anorexia, please seek the help of a professional.