The number of adult men being admitted to hospital with an eating disorder has risen by 70% over the past six years – the same rate of increase as among women.
NHS Digital data analysed by the Guardian shows the number of hospital diagnoses in male over-19s rose from 480 in 2010-2011 to 818 between April 2015 and March 2016.
The rate of increase was slightly higher among older men, at 70% for the 41-60 age group, compared with 67% in the 26-40 category and 63% among 19- to 25-year-olds. In the same period, there was a 61% increase among women aged 19 to 25 and a 76% rise among middle-aged women.
The figures come after it was revealed that steroid use among young people quadrupled in the past year. The Home Office’s crime survey found the biggest rise in anabolic steroid use was among 16- to 24-year-olds, with an extra 19,000 taking the drug.
Medical leaders and health experts have put the growing numbers down to pressure from popular culture and social media. But more awareness about eating disorders may be encouraging life-long sufferers to come forward and talk about their problems, they believe.
Dr William Rhys Jones, of the Royal College of Psychiatrists’ eating disorders faculty, said: “Pressure for body perfection is on the rise for men of all ages, which is a risk factor for developing an eating disorder. Images of unhealthy male body ideals in the media place unnecessary pressure on vulnerable people who strive for acceptance through the way they look.”
He said a continued lack of understanding and sometimes sympathy for men suffering from eating disorders remained a barrier for some who needed help. “We must continue to address the ongoing gender bias around eating disorders so every man who is suffering feels comfortable to get help when they need it.”
Prof Helen Stokes-Lampard, chair of the Royal College of GPs, said the rise was not surprising “when you consider the unrelenting pressures placed on people by popular culture and social media”.
She called for schools, universities and employers to be more aware of the danger signs. “[These] can include excessive dieting or daily trips to the gym, eating large amounts of food, the inappropriate use of laxatives and obsessions around weight and appearance,” she said.
Stokes-Lampard said there was a growing awareness that eating disorders affected both men and women. “Increased awareness among sufferers and health professionals has likely meant that men are starting to recognise their symptoms more and are being diagnosed more, meaning that they are more likely to be referred to eating disorders services,” she said.
The eating disorder charity Beat said increases in hospital admissions may be a positive sign. Tom Quinn, its director of external affairs, said: “It’s possible [the increase] indicates an increasing awareness that these illnesses affect people regardless of gender.”
Earlier diagnosis and treatment would lower the chance of an illness developing to the point when they required hospital treatment, he added. “There is still a long way to go to ensure that all sufferers get the treatment they need as quickly as possible.”
Figures released last year showed people with eating disorders in England could wait for up to 182 days for treatment. Patients surveyed by Beat expressed concern about GPs who were failing to refer people for specialist assistance. Half of those with some experience of an eating disorder rated GP care as poor or very poor, and 30% said they were not referred to mental health services after their appointment.
Sam Thomas, the founder of the charity Men Get Eating Disorders Too, said the UK had no dedicated facilities for male patients. “Usually places will have two separate rooms they prioritise for men but that can reinforce any sense of isolation, and eating disorders thrive on that,” he said. “Some services literally cannot admit men. One guy I know has been waiting months and months. He has had a heart attack and is desperately unwell and he is still waiting for a referral. He is on about seven waiting lists.”
Data shows that men still account for a small proportion of the total patients diagnosed in hospital, with 1,098 male adults and children admitted in 2015-16 and 12,054 female adults and children. More than 300 boys and girls aged 12 or under were admitted to hospital with an eating disorder in 2015-16.
The fastest rate of change among all ages over the six-year period was in 13- to 15-year-olds. Diagnosis numbers over the period more than doubled, from 565 to 1,383.
Rhiannon Lambert, a Harley Street nutritionist, said: “One key marker between men and women is that women tend to be more honest in their symptoms whereas men typically suggest they are on a physique transformation journey.
“There is a stereotype that eating disorders still only apply to privileged, appearance-obsessed women. This huge misconception exists which pushes the harmful notion that a great many others are not at risk. I have met people of every race, gender, sexuality and personality with disordered eating patterns. Eating disorders do not discriminate, they are a complex mental health illness that can affect everyone.”
Case study: Dave Chawner, 28, from London
When I was 17, I got a role in a play and I had to appear topless. It was the only time I had ever really thought about my body and so I lost a bit of weight. People started saying “you look good” and that made me feel great. Losing weight gave me approval and meant “being good” in my mind.
It came at a time when I had a lot of other stuff going on – including applications, exams and deadlines. Everything felt intense and my grades were not good but losing weight was.
Eventually the people around me picked up on it, and took me aside for a quiet word. But I didn’t acknowledge I had a problem. It was only when I was 21 that I first said that I had anorexia. I got a job over the summer in a boarding school which was completely catered for. It really affected me how little control I had over the food. I started exercising during the night, binging and purging. One of the teachers, who had experienced bulimia herself, asked me if I was anorexic. I thought: “I do have anorexia.”
At my worst I was weighing myself four or five times a day, coffee loading, exercising during the night. I would have mood swings and constantly feel thirsty because when you’re not eating your brain thinks you must need a drink. I was also constantly freezing.
Over the years, it faded in and out of prevalence. How bad things were depended on how much I wanted to escape life and numb myself. I am a comedian and I started doing shows about my illness when I was about 23. It went better than I thought but people said “you don’t look anorexic” and that made me feel like a fraud. So I had a relapse and ended up needing outpatient treatment at the Maudsley hospital in London. I was treated there for two and a half years and finished therapy about three or four months ago. I found it really helpful.
It is still an open book in terms of what will happen in terms of my eating disorder, but I feel the furthest away from anorexia that I ever have.
As a man, I never found it hard to get help because I am very open and can talk about what is going on. I could go to my GP and explain what was on my mind and they did take me seriously. I know not everyone can be so open.
Although it’s awful to see more men suffering from eating disorders it’s great that more are having the balls to stand up and come forward, saying they don’t feel stigma anymore. If a man came into the doctor with cancer or heart disease, would we treat them differently to a woman? It’s easy to create a barrier that doesn’t need to be there.
I think it’s lazy to blame social media for the rise in eating disorders – they existed before Facebook. However, now it’s like people have someone looking over their shoulder as everything is documented. It’s not helpful that people Photoshop their photos and present an unrealistic image to the world that is unobtainable.
Having an eating disorder is like a constant background noise, a hum that is never completely there but also never ever taken away. It’s not that I didn’t like food. I was always thinking about how I could eat and feel full without having any calories. It is like being an alcoholic, it’s not something that ever goes away. It’s a kind of colour to your existence but it makes life so unstable.
For hundreds of thousands anorexia isn’t sexy, interesting or exciting – it’s just a shit, boring, mundane, anxiety-ridden hell for them. I am trying to help make that clear, to present a more authentic portrayal of it.
