As a man, I struggled getting help for an eating disorder all my life

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“Boys don’t get eating disorders.”

That was what my doctor told me when I was 12. It had taken me a year to pluck up the courage to tell him that I was engaging in self-induced vomiting, food restriction and laxative and diuretic abuse.

After a physical examination, he noted my weight and calculated my body mass index (BMI), which was still within the normal range at the time. My BMI number — a deeply flawed tool used by global health-care providers — determined that I wasn’t sick enough for treatment.

He recommended an exercise regime to lift me out of what he assumed was a phase of adolescent depression. “It’ll help you feel better,” he told me.

His uneducated decision was one that led to years of compulsive exercise behaviors and seeking out illegal substances to aid with weight loss.

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In recent years, a number of male celebrities have opened up about their eating disorders to raise awareness — including Ed Sheeran, Tom Daley and Zayn Malik. However, there are still millions of us harboring a life-threatening illness that thrives in secrecy.

Today, 1 in 3 eating disorder patients are men, and 10 million American men are at risk. Men are also at a higher risk of not being diagnosed, in part because of the belief people hold that we don’t have eating disorders — just like my doctor thought when I was 12.

As I came into my teenage years in the early 2000s, I turned to dieting to maintain my physique as a competitive dancer. But I was also struggling with coming out as gay in a repressed Catholic environment, and I found solace in online pro-anorexia forums, which were trending on the news at the time.

When I reached adulthood, I was in deep; I had become completely consumed. Bingeing and purging was my drug of choice, and I would engage in it like a sport, from morning until night. I was spending upward of $200 a day on food. Outside of that, I would exercise three hours daily and fast for long periods.

After 15 years, my body signaled that it had reached its limit. Along with increased anxiety, physical pain and gastrointestinal symptoms, test results showed signs of electrolyte imbalances and a low heart rate.

In September 2019, I was admitted to the Columbia Center for Eating Disorders and diagnosed with anorexia nervosa. When I entered the inpatient program, I was the only man in the ward and felt more alone than I had ever been. While the women discussed losing their periods, experiencing infertility and having been hospitalized as kids, I couldn’t relate.

It was the first time I could speak openly about the problem that had haunted me for the majority of my life. And yet I still felt I shouldn’t be there.

Upon discharge after three months of intensive treatment, I returned to Vancouver and relapsed immediately. My eating disorder convinced me I wasn’t sick enough. This time, I refused food almost entirely, and my treatment team referred me for another inpatient admission.

At the beginning of last year, no longer able to work or see friends while in treatment, I reached a breaking point. After an attempt to end my life, I was diagnosed with bipolar disorder and C-PTSD (complex post-traumatic stress disorder).

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During the height of the pandemic, I spent most of the year in the hospital for psychiatric evaluations, medical stabilization and re-feeding. Despite many stays, I have never met another man in treatment with an eating disorder.

Contrary to what people might believe, my symptoms don’t differ much from the stereotype. On the outside, I’m striving for thinness, perfection and control. Inside, I’m using my eating disorder as a way to cope with insecurities, anxiety, C-PTSD. I can simply engage in symptoms and dissociate.

The eating disorder voice is relentless, obsessing about calories, weight, activity levels and specific food rituals that I must carry out in order to eat.

It’s important to note that eating disorders present differently in everyone. While I spent my teenage years restricting my intake, some men are doing the opposite — using supplements and steroids to increase their body size.

I’ve since learned that social media is playing a huge part in how we see and judge our bodies, and not just for teen girls: A 2020 study found that men are faced with social media trends that have given rise to a desire for a muscular and lean body. The influx of “health” and “fitness” influencers are potentially harmful to men’s body image, the study found.

Deborah Glasofer, associate professor of clinical medical psychology in psychiatry at the Columbia Center for Eating Disorders, told me that “men are also less likely to disclose their symptoms and seek treatment than their female counterparts.” Some of the reasons include stigma, shame and being perceived as effeminate.

Glasofer also said there’s a link between sexual and gender-minority groups and disordered eating: “Some research also suggests that individuals who are members of marginalized groups may face higher rates of eating disorders,” she said.

When it comes to treating men, James Greenblatt, chief medical officer and vice president of medical services at Walden Behavioral Care, a treatment center specializing in eating disorders, told me that there are “unique psychological and medical concerns.”

“The medical and nutritional deficiencies in males, including low testosterone and often low vitamin D, are rarely addressed in current treatment programs,” he said.

A harsh reality set in when I was admitted to the hospital at the end of last year with critical lab results. As I stood outside the emergency room, every part of my body shaking, I turned to my partner and said, “This has to end.”

My advocacy work started shortly after. I enrolled myself in a college course while in the hospital and earned a mental health worker certificate. I learned a lot about my illness and how low self-esteem, trauma and perfectionism had increased my risk.

By advocating for men, and speaking openly about my experiences with anorexia and bipolar disorder, I’m learning to empower myself and others. Regardless of the research, I’ve found many people unwilling to accept that we exist. It sends me spiraling back into my 12-year-old body, to that horrifying day I sat, ashamed, in my doctor’s office.

Men account for about one-third of the 70 million people worldwide with eating disorders. We deserve to be seen, heard and treated the same as our female peers.

Sean Loughran is working on his memoir. Find him online at @sean_writes.