Why We Don’t Talk About The 10 Million Men With Eating Disorders

British Olympic diver Tom Daley shocked the world when he admitted that he used to purge and that he weighed himself nearly every day. This athlete — this male athlete — was coming out about his eating disorder. The truth is, most men hide their struggles with disordered eating. As Daley told The Guardian, “It’s hard to talk about it, but I would consider myself to be someone that has very much struggled with body image, and eating, and feeling guilty and shameful of the things that I eat.”

He’s not the only one — not by a long shot. A third of the 30 million people who suffer from eating disorders are male, a fact we rarely hear about it because of the stigma and shame surrounding eating disorders in men, says therapist Brian Pollack, clinical director of the treatment center Hilltop Behavioral Health.

This shame has to do with “gender role conflict,” Pollack says, because admitting to having an eating disorder isn’t considered masculine. Men have been socialized to be in control, and admitting to an eating disorder can make a man feel like he’s losing that control.

And unlike women, who are more likely to turn to other women when there’s a problem, men are more likely to have trouble opening up to each other about disordered eating. “Men tend to have trouble communicating and emotionally connecting with other men,” Pollack says. This not only keeps male eating disorders in the dark as a whole, but it also means individual guys don’t have a support system for dealing with this mental illness.

Since men are socialized to believe that they don’t get eating disorders, they may not realize that they need help. As a result, they’re more likely to bury their pain. Often that means their doctor doesn’t find out about their eating disorder until the disease has progressed to a dangerous degree and is much more difficult to treat.

Staying quiet and delaying treatment can even be deadly, says Terri Griffith, Psy.D., clinical coordinator of The Center for Eating Disorders at Sheppard Pratt. “When men are engaging in these behaviors, they’re also suffering emotionally and having a hard time expressing what’s going on. As a result, we see more men that are suicidal in conjunction with their eating disorders. And more often they end up completing that suicide compared to women.”

Of course, the eating disorder itself can also lead to death. Research has shown that someone dies from an eating disorder every 62 seconds.

Oftentimes, Griffith says, men struggle with an eating disorder for years before they get the help they need. Beyond their own reluctance to admit to the condition, family, friends and even care providers might miss the signs because of assumptions that men don’t get eating disorders, as well as societal prejudices. For example, in the past in order to be diagnosed with anorexia, a person had to miss their period, which made it impossible for cisgender men to receive proper care.

Although diagnosis has changed, some of the stigma remains. “Care providers need to become aware of their own biases so they ask the right questions to uncover potential eating disorders earlier on,” Griffith says.

Disordered eating in men is also more difficult to spot because it may present differently than it does in women. According to Griffith, men are more likely to binge and purge than women, who are more prone to anorexia and bulimia. However, eating disorders don’t discriminate by gender, says Lauren Smolar, senior director of programs at the National Association for Eating Disorders, and men can suffer from a wide variety of them, from anorexia to binge eating disorder, bulimia, and more.

When men binge, they may consume a large amount of food in a small amount of time, often to stuff their feelings. “If you’re a male who has a hard time expressing yourself and it feels like you don’t have people to support you, it makes sense that you would use food to cope,” Griffith says. Eating can be soothing, so when men binge, they’re often doing it to block and numb their feelings. Some men may purge afterwards to feel like they have a sense of control.

What’s more, men who have eating disorders may not be identifiable just by how they look. Typically, people think of people with eating disorders as appearing very thin. But unlike most women, when men engage in disordered eating, they might not be doing it to change their bodies, but rather because of the emotional component.

That’s not to say that body image doesn’t play an important role. The media has targeted men of late, which makes the issue worse, for example, with muscular superheroes and tall, lean movie stars in the spotlight. “It’s hard to compare to these idealized bodies, which can lead to a lot of insecurities. Men are going to drastic measures to adhere to these types of bodies,” Griffith says.

Because of this, sometimes the symptoms men have may look different than “typical” eating disorder symptoms because body ideals for men aren’t the same as for women. “A lot of people still think that eating disorders only happen to affluent, young, white women, so anyone who doesn’t meet that stereotype is typically under-diagnosed and under-recognized, even if they’re experiencing similar symptoms,” Smolar says. “Additionally, men that don’t meet these stereotypes might not think that they deserve the help they need.”

Athletics can also trigger eating disorders in men. Boys and men in high school and college are bombarded by idealized images of athletes in the sports they play. This is especially true of wrestling, swimming, gymnastics, and bodybuilding.

The bottom line? Men can and do suffer from eating disorders at a similar rate to women, but society seems to have trouble grasping the severity of the issue. Stereotypes run so deep that men have trouble admitting to themselves and their loved ones that they have a problem, even when all signs point to an eating disorder. And the longer they go without a diagnosis, the more likely they are to die at the hands of this painful, albeit treatable, mental illness.