Anorexia Nervosa in Men
Anorexia nervosa (AN) is an eating disorder that is the exact opposite of obesity. In this condition, the individual starves himself, sometimes to death. It is typically characterized by a very low body weight, a distorted body image and an intense fear of gaining weight. No matter how thin the individual is, there is a perception that the individual is still fat. The disorder is more common in females but in the past 2 decades, it has been increasingly recognized in males. Two decades ago, it was found that for every 15 females with anorexia, there was one male with the same disorder.
Today, ratio is 4 females to one male. It is estimated that males generally account for 5-10% of reported cases of anorexia nervosa but this number is an under estimate because the disorder is under diagnosed and under reported. Anorexia nervosa among females has its peak onset during the adolescent years, with the vast majority developing the disorder between the ages of 13 and 20. Relative age of onset of anorexia nervosa in males is still unclear. In the decades past, it was believed that eating disorder was only common in homosexuals, bisexuals or transvestites, but this is only folklore. Today, men in every societal class have been found to be affected with this disorder, regardless of sexual orientation.
According to criteria in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-IV), individuals with anorexia nervosa are less than 85% of expected weight, have an intense fear of gaining weight or becoming fat, and exhibit a significant disturbance in the perception of body weight or size. Another additional criterion for anorexia in postmenarchal females is amenorrhea for at least 3 consecutive menstrual cycles. Unfortunately, males with anorexia do not have amenorrhea and this may be the reason why the disorder is frequently under diagnosed. However, there are many other features of anorexia in males which are similar to females and should lead to a suspicion of anorexia. Males with anorexia have similar mental problems as females. This may include depression, obsessive compulsive or extremely anxious. The biggest difficulty for male anorexics is coming out in the open with the disorder. The reason for hiding in the closet is because society as well as many physicians believe that only females can have anorexia. In addition, men take even more care in hiding their disorder and frequently present much later than the females. As a result, when men are diagnosed with the disorder, the symptoms are quite severe and the disorder is more difficult to treat.
The literature on causes of anorexia and bulimia (another eating disorder) is abound with theories and explanation. Even though the condition was first reported many decades ago, only recently are physicians becoming aware that it is also a problem in males. Why males develop anorexia is unknown but n...