‘Being male is a barrier to an eating disorder diagnosis, and to getting well’
Some suffering illnesses like anorexia go‘under the radar’
Simon* was aged 12 and on the cusp of puberty when he fell into the dieting culture that was gripping his group of female school friends.
When some of them commented on how jealous they were of his seeming “success”in the weight-loss stakes, it gave him a sense of accomplishment and a feeling that he was“better at it than them.”
But then, envy turned to concern among some of the girls, who feared that Simon“was taking it too far.”
There was, he remembers, a lack of education about mental health when he was growing up. Yet, his school was the first to challenge him when his weight loss and fainting spells began to ring alarm bells.
“School first asked if I had any eating disorder behaviours,”he recalls.
“They asked about self-induced vomiting. I had never struggled with that. I did not have those behaviours. I didn’t relate to those questions, and so conversations stopped there.”
Simon, who had, like many of his peers, issues with low self-esteem, started to cut out food, skip lunch and became vegetarian.
As he focused increasingly on restricting calories and fluids, he began in late adolescence to take diet pills.
“I had social anxiety, poor concentration. It really impacted school performance and friendships. It was quite isolating,”he explained.
“If friends were wanting to do something like go out for food, I would always not do it. My body had quite a strong reaction to not eating great. I had dizziness and blackouts.
“For me, there was that surface level fear of becoming overweight. But I was masking a lot of deeper core beliefs. It’s about so much more than weight. There is so much more under the surface.”
With some of Simon’s relatives putting his fainting episodes down to low blood pressure, which ran in the family, he was 17 years of age before his concerned aunt persuaded him to consult his GP.
“By that point, my BMI was low,”he said.“once it did come to the attention of health professionals, the treatment was comprehensive and happened quite quickly. My body was in such a crappy state that they threw everything but the kitchen sink at me.”
Simon’s case had become so acute that he was fast-tracked through the system and received a CAMHS (Child and Adolescent Mental Health) appointment two weeks later.
Between the ages of 17 and 18, he attended hospital as both an outpatient and in-patient. But because his family refused to accept his anorexia diagnosis, so too did he.
“My mum had quite a black and white understanding of what eating disorders were,”explained Simon, of Lothian.
“She thought people with anorexia just didn’t eat. I did eat. So, she did not put two and two together.
“I had struggled to accept the diagnosis because my family struggled to accept it. I did come round to it after a couple of months of seeing a psychologist. The symptoms started to resonate with me.”
The real work, says Simon, started after weight recovery, when he had a tremendous psychological hurdle to overcome in order to challenge years of behaviours. It’s at that point, he says, that people who are battling an eating disorders are at risk of“getting stuck in the cycle of relapsing.”
Now 29, Simon is fit and well. He took part in the Beat focus group that helped to shape this month’s awareness week’s focus on eating disorders in men.
He firmly believes that“being male is a particular barrier to an eating disorder diagnosis”and that he“went under the radar”because of his gender.
On film and on TV, says Simon, it is portrayed“as a girl’s illness”affecting girls and young women“who don’t eat at all.”
And he points out:“the reality of people with an eating disorder is they still eat 500 calories a day – until they are really, really unwell.”
Although he wasn’t diagnosed until the age of 17, his experience of the health system when he finally accessed it was so positive that he’s now working as a mental health nurse in the hospital departments in which he was treated as a teenager.
“I try to give people the same positive experience I had,”said Simon, whose lasting consequences of delayed treatment include developing the bone weakening condition, osteoporosis.
“Despite my positive experience, I do feel the delay in my diagnosis and thus treatment was related to my gender.”
Sharing Simon’s experience of being “praised for unhealthy behaviours until it was too late”is Shalhavit Simcha Cohen, who is 40 years old, is nonbinary, and has recovered from anorexia and“other specified feeding or eating disorder”(osfed).
Keen to share“childhood perceptions of perfection,”they said:“being aware of one’s eating disorder is the opposite of shameful – but rather an opening to normalising struggles, feeling stronger about one’s own journey and getting support.
“It’s about the possibility of growth, and that change is possible beyond your best dreams. And that this is not a linear process.”
For 29-year-old Alanna Goddard, it was her dad’s patience and encouragement that set her on the journey to recovery from anorexia, OSFED and orthorexia – an unhealthy obsession with eating“pure”food.
“I first began to struggle and start experimenting with dieting and restricting certain foods and having food rules around first and second year at school,”she explained.
“I was 23 when I was first diagnosed and I would say I faced the worst of my struggles between then and the age of 27 or 28.”
During this time, she stopped menstruating due to a condition known as hypothalamic amenorrhea, which is associated with poor nutrition.
Through Alanna’s determination to beat her eating disorder, she gained the weight she needed – and more – for her periods to return.
Her message is to never give up – because every day, she insists, is a step closer to recovery.
“It’s an on-going thing and you will constantly have to challenge and keep yourself well,”she said.
“Be aware of your mind, your thoughts and behaviours.
“One thing about recovery is that I’ve learned to become really aware of my own thoughts, behaviours and triggers.
“I know my own triggers and the things I can do to keep me well. I call it my own psychological toolbox.
“You learn so much about yourself in recovery. There will be ups, followed by the downs.
“Know that you are human and this is likely to happen in recovery.
“The main thing is to keep going. Ride the wave, and you will get there.
“If it’s hard and you are finding it challenging, you are doing the right thing.”
Alanna, of the Highlands, continued:“reach out to those you trust. My dad was the main reason I recovered.
“He was always just there – not necessarily to give me advice, but just to sit and listen to me, to be there, supporting and encouraging me to keep me going, my rock.
“Be kind to yourself. Showing compassion to yourself is really hard, but has such a powerful impact.
“Just keep going, lean on those who are around you, people you trust. And reach out to those, like myself, if possible.”
She added:“i never would have believed you at the beginning of my recovery if you showed me a video of the way I live my life now. If I can do it, then so can you.”
* Not his real name