The Invisible Man: Recognizing and Supporting Men with Eating Disorders in Melbourne

When we think of eating disorders, the cultural stereotype is often of a young woman. This pervasive image can make it incredibly difficult to recognise these serious illnesses in men and, even harder, for men to seek help. The reality is that men and boys account for a significant portion of those with eating disorders, and they face a unique set of challenges, including different societal pressures and heightened stigma.

At Shaw Psychology, our Melbourne general and clinical psychologists are committed to providing a safe, understanding space for men to address these issues. This guide aims to shed light on how eating disorders can present differently in men and how to find effective, tailored support.

True strength is not about rigidity; it's about the resilience to break through hard expectations and find a way to grow.

How Eating Disorders Can Look Different in Men

While men can experience Anorexia, Bulimia, and Binge Eating Disorder, the underlying drivers and behaviours can differ from those typically seen in women.

• The Focus on Muscularity, Not Thinness: Many men are driven by a desire to be lean and muscular, rather than purely thin. This can lead to what is sometimes called "muscle dysmorphia" or "bigorexia" – a preoccupation with the idea that one's body is not muscular enough.

• Compulsive Exercise as the Primary Behaviour: Instead of or alongside food restriction, the primary behaviour may be obsessive, rigid, and excessive exercise. This often flies under the radar, as dedication to fitness is typically praised in men. The key difference is the compulsive, punitive nature and the intense anxiety that occurs if a workout is missed.

• Different Bingeing Patterns: Binge eating might be framed as a "cheat meal" that spirals out of control, followed by periods of extreme "clean eating" or restriction to compensate.

• Substance Use: There can be a higher co-occurrence of substance use, particularly with steroids or supplements aimed at altering body composition.

The Double Bind of Stigma

Men face a powerful double stigma. Firstly, the general stigma associated with having a mental health condition. Secondly, the stigma of having what is incorrectly perceived as a "woman's illness." This can lead to:

• Delayed Recognition: Friends, family, and even healthcare professionals may be less likely to recognise the signs.

• Intense Shame and Secrecy: Men may feel profound shame, believing their struggles are a sign of weakness or a failure of masculinity, making it incredibly difficult to open up.

• Reluctance to Seek Help: As a result, men often wait until the disorder is more severe and deeply entrenched before they seek support.

Evidence-Based Treatment for Men

The core therapeutic approaches, like Cognitive Behavioural Therapy - Enhanced (CBT-E), are just as effective for men. However, the application of the therapy must be tailored to the male experience. At Shaw Psychology, therapy for men with eating disorders involves:

• Creating a Safe Space: Acknowledging the courage it takes for a man to seek help and providing a non-judgmental space is the first priority.

• Exploring Masculinity and Body Image: Directly addressing societal pressures on men regarding strength, muscularity, and control.

• Adapting the Model: Applying the principles of CBT-E to address behaviours like compulsive exercise and the specific thought patterns related to muscle dysmorphia.

Find how to create a peaceful shift in focus from inward self-scrutiny to the wider world and future possibilities

A First Step You Can Take Today: Questioning the "Rules"

A core feature of many eating disorders in men is a rigid set of rules, often around exercise and diet. A first step, drawn from CBT, is to simply start identifying these rules without judgment.

1. Take out a piece of paper or open a note on your phone.

2. Over the next day, try to notice and write down any rigid "rules" that pop into your head regarding food or exercise. They might sound like: "I must go to the gym for at least an hour," "I am not allowed to eat carbs after 6 pm," or "If I eat a 'bad' food, I have to run 10k to burn it off."

3. Just observe and write them down. You don't have to change them yet. The simple act of externalising these rules is the first step in seeing them for what they are – the eating disorder's rules, not your own.

   
   

An Example:

Michael, a young construction worker in Melbourne, was admired by his mates for his dedication to the gym and his strict diet. But secretly, he was miserable. He was obsessed with his physique, living in constant fear of losing muscle mass, and would experience intense anxiety if he missed a workout. After a minor injury forced him to take a week off from the gym, and his anxiety spiralled, he realised his "dedication" was actually a prison. He found Shaw Psychology online and booked an appointment, a step he later described as the hardest but most important he'd ever taken. Therapy helped him see how his self-worth had become entirely fused with his workout routine and gave him the tools to build a healthier, more flexible approach to fitness and life.

(Please note: This is a fictional vignette created for illustrative purposes only.)

Support for the Invisible Man

If you are a man struggling with an eating disorder, body image issues, or compulsive exercise, please know that you are not alone. Your struggle is real, valid, and deserving of expert, compassionate support.

Contact us today on (03) 9969 2190, visit our website at www.shawpsychology.com to learn more, or book an initial consultation directly online here: https://bit.ly/bookshawpsychology.