Suffering in silence... when does a fitness regime tip over into an obsession?
When it comes to the self-loathing Olympics that are body image issues, many people perceive it to be a women-only event.
But while healthcare professionals are often trained to detect eating disorders such as anorexia and bulimia, they admit it can be much harder to tell when a male fitness regime tips over into an obsession.
So while considerable attention is focused on helping women overcome the eating and exercise disorders that often result from such insecurities, scant consideration is being paid to the effects felt by the men currently battling similar issues.
“Most body image experts agree that some men with body image problems or eating disorders don't get help due to the shame and self-imposed silence that goes with experiencing a so-called women's illness,” said Eating Disorders Victoria's communications and media officer, Megan O'Connor.
“There is a perception in society that it is normal for women to be concerned about their bodies but for a man to be concerned is egotistical.”
Statistics suggest that one in ten individuals with an eating disorder is male, but many experts suspect the true prevalence to be much higher due to the fact that men are less likely to report.
Defined by training at least two hours a day unrelated to a career in sport, individuals affected by exercise disorder feel they can't live without it. They exercise when they're sick, injured or tired, and often do it in place of normal social activities to the point where it interferes with their lives.
“I had one young man, a lovely young man, with low self-esteem. He'd spent years going to the gym every night only to feel more and more unsatisfied, and in his mid-thirties he desperately wanted to have a relationship and a partner but… he'd never developed social skills,” said Professor Jennifer O'Dea of The University of Sydney, who specialises in health, nutrition and body image.
For every pert, slender woman gracing a billboard or peering out from the advertising pages of magazines there is a rippling, Thor-like specimen held up as the masculine ideal which is largely unattainable for many young men regardless of how many bench presses they do or protein shakes they drink.
“Women can spend their whole lives dieting and exercising to be slim, and men can waste a lot of their lives trying to having muscular bodies to fit the masculine ideal but they'll often end up with very little,” said O'Dea.
“Men who are carrying a bit of fat these days in Australia, particularly young men, feel bad about it. They think they should have no fat and all muscle, but physiologically that's impossible,” she said. “If there is a young man concerned about his weight, losing weight, exercising excessively and is unhappy, then he probably has an eating disorder. Or, more likely, he has an exercise disorder.”
Dr Elizabeth Celi, a psychologist, author and former personal trainer specialising in men's health, said many of her patients discounted their obsession as a healthy hobby while combining exercise with more readily understood disordered behaviours such as binge eating and bulimia.
“It's easy to hide your body image and self-image anxieties in the gym because few people will tell you off for choosing a healthy lifestyle choice like exercise and fitness,” she said. “However the way men work out with their weights overworks some muscles at the expense of others, which throws out their muscle, joint and body balance. The overuse of protein drinks and supplements at the expense of a balanced, nutritional eating plan then adds to internal damage and that's before we start talking about steroids and their medical dangers.”
The factors that can lead an individual to overexercise can be divided into two camps, according to Celi. The first is internal and has to do with self-esteem. A lack of confidence can lead to anxiety over body image that then manifests as obsessive behaviour. The other is external and relates to the constant messages young men are fed by a society that equates masculinity with muscularity.
“Outside sources certainly influence the internal pressure men feel – cut up bodies on magazine covers, the quick-fix ab workout – compounded by erroneous mixed messages about what being a man is and telling them to 'man up,'” said Celi. “The added social scrutiny men have cuts to the core of their own masculine identity.”
Twenty-five per cent of children diagnosed with anorexia nervosa are male and a recent a study by Harvard University Medical School found that, in the US, 25 per cent of adults with eating disorders were also men. Research shows that when it comes to binge eating, there is equal representation of both genders.
“Males can be affected by any type of eating disorder and engage in any type of eating disorder behaviour so it is difficult to generalise,” added O'Connor. “Dieting is less common and severe in males as an eating disorder characteristic, whereby they are equally as likely to use physical activity to lose weight or change body shape.”
There have been recent attempts to publicly address the issue. Last month, Noah Brand, editor-in-chief of The Good Men Project, appeared naked on his site - the results of which can be seen here - in a bid to confront his own body shame and spark discussion on the complexities of self-acceptance.
“Men are conditioned from childhood not to talk about these issues,” he said. “I knew that if we were going to get anyone seriously talking about them somebody would have to do something really confrontational. And I was raised to believe that when you think someone ought to do something your next thought should be, Hey, I'm someone.”
Admitting that he's never been happy with his body, Brand said he wanted to lose weight for his health but was tired of wanting to take it off because of self-hatred.
Though it took a couple of fingers of whisky to get the courage to take his gear off and expose what he describes as his “just over the line where overweight turns into obese” frame to the world, the overwhelmingly positive response has left him without regret.
“There have been a few haters but mainly people have seen what I was getting at, that this is about a radical act of self-acceptance,” he said.
“What's been most encouraging is seeing dialogues opening up. Seeing men say, 'I've felt the same way for a long time, I just don't know how to talk about it,' and women say, 'I never realised men struggled with these issues too.' That's where real progress comes from, getting people to talk about what nobody talks about.”