"Men can also have anorexia, but its invisibility means that we often don't ask for help"

Anorexia nervosa has accompanied me for more than half of my life, in a hidden and subtly acting way. Eating disorders in men are not always treated as they should be. They are talked about very little, if not almost not at all, and this accentuates the stigma that exists around this disease and causes that there are surely more men or boys who have a disorder of this type, but from silence, out of fear or ignorance.

Even as a child, I was a very shy child, who found it difficult to ask for anything, and conformed to what others said, especially adults. I had a clear hierarchy (family, teachers), but perhaps I misunderstood it, in the sense that I was always afraid of disappointing. This belief was also accompanied by a fear of abandonment. Although I was a child who liked to play alone and who had no problems creating his own games, in reality, the fact that no one paid attention to me always haunted my mind. As a teenager, I received criticism and contempt from classmates... In other words, bullying in drops. And these comments were starting to sink in.

No one had taught me how to ask for help, and on the other hand, I was afraid of the reprisals that could come with doing so, or that they wouldn't give importance to how I felt, remembering the phrases I had always heard like "don't cry", "it's not that big of a deal", "be a man", "in life you have to be strong". These phrases made me believe that I would be "less of a man" if I told what was happening to me, and I was afraid that the comments from my peers would grow. They were beliefs. Simply beliefs that I created on my own based on the entire context that surrounded me. When I was 14 years old I reached the limit.

The situation was untenable. That imaginary backpack that we all say we carry, weighed a lot, too much. I only put things in it, but I didn't take anything out. This was added to a progressive distrust of the rest of the world, and of myself. I felt like a worthless person. In short, I had low self-esteem and a very negative self-concept. So the time came when I had to ask for help, whether I wanted to or not. However, how would I do it? One day, I noticed that in the school cafeteria, if I didn't eat something, the monitor would control me so that I would finish it. It was at that moment that I found the way I would use to get attention and to ask for help. The solution (or bad solution) was to devote all my attention to food. To choosing what I ate and what I didn't, when and where.

After a year, it worked. The school contacted my family and I received mental health treatment. Well, treatment for about two or three days, since the conclusion the psychiatrist came to was that we shouldn't worry, that it was just an age thing. From then on, and until 2019 (about twenty years apart), the relationship with the disorder was unconscious and subliminal.

Male anorexia, an invisible disorder

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Male anorexia, a stigmatized disorder

Maintaining a food restriction over time is very difficult, so during the year there were periods of everything: restriction, less restriction or, on the contrary, even binges. The problem, however, was the behavior, the cognitive: the internal thought. A thought that accumulated many fears, insecurities, obsessions, self-contempt...

The disorder did not start with anything related to the physical. However, coinciding with the age when I started going out at night, I realized "the importance of the physical" and "the importance of people's opinions (what they will say)". It was then that what has marked me the most throughout the years began, unconsciously: the obsession with physical appearance. This has been accompanied by specific restrictions, obsessions with certain foods that I labeled as bad, behind which, without realizing it, like a fine rain, there was a self-attack, guilt and contempt. I had lost control of my life. I didn't see it. I simply considered that getting irritated by anything, thinking that everything they said to me was an attack, having a high degree of self-demand and an obsession with perfectionism were my personality. I defended myself by saying: "everyone is the way they are".

I have lived and continue to live with a disorder that has taken root in me and has become increasingly severe.

My experience led me to go 20 years without seeking help. First, because I didn't think I needed it: it was very difficult to differentiate who I was and who the disorder was. Second, the vast majority of the information I read about anorexia was written in feminine terms and, if there was any reference to men, there was always the word minority. I automatically thought: I doubt I'm part of this minority. In short, stigmas and more stigmas. Now, I often see a contradiction in all the information I read: "EDs don't understand race, age and gender, but they affect women more". This "but" is synonymous with what I was reading before: minority. It's as if the impact on men who have this disorder is minimized, which prevents its visibility and makes it difficult to know about it.

Eating disorder treatment, a road full of twists and turns

Two years ago, my physical and mental health was hanging by a thread. I was lucky to have someone by my side who convinced me to ask for help. I was admitted to the day hospital and have been in treatment ever since. The process, or the path as I call it, is long. It is a path that is not straight. It is full of twists and turns, with stones that make you stumble. At first, it is very difficult to get up, very difficult. As I fall, I know that I will get up. Interdisciplinary help is essential: psychological, psychiatric, nutritional therapy... I realize the fears, not only about food, that I have created over time and that the disorder has reinforced. It is key to do self-esteem and self-compassion exercises and the reintroduction of those foods that I consider "forbidden".

I realize the fears, not just about food, that I have developed over time and that the disorder has reinforced.

In my case, it was very good for me to rewrite my life, from childhood to the moment I asked for help. I managed to see what had led me to have an eating disorder: guilt, fear of rejection, insecurities, low self-esteem, pretending who I really am for fear of acceptance... and the only thing I could control was what I ate and stopped eating. I had the false belief that permanently having an 18-year-old body would make me happy. Lie. Accepting things as they are, and above all seeing the qualities that we all have, are the key to accepting that we are valid people, beyond what the scale shows and the hours in the gym. An interesting path to walk little by little. A path that without help is very difficult to do. A path full of stigma and ignorance on the part of those who walk it and society in general.

Not being afraid to ask for help, the basis of recovery

On this path, after the day hospital, in the same Eating Disorders Unit (UTCA), I continued the therapies in a group only of boys who have EAD. And that's where I'm currently staying. We meet and share how the week has gone and each one has their own space to express themselves. The psychologist acts as a guide, but we help each other, we support each other from our experience. This group is totally necessary because we realize that men have to re-educate our emotional and eating part and that the disorder has distanced us from reality.

Despite the stigma and lack of information about EDC in men, it is essential to detect when we need help and not be afraid to ask for it. This is the basis of recovery. Once in treatment, it is necessary to follow the guidelines established by nutritionists and the psychotherapeutic team. The keys to recovery first lead to food stabilization, that is, achieving a healthy weight. To do this, you need to fight against many fears (and not only food-related). When I restricted my food and lost weight, I thought I was looking for happiness, well-being. Now, if I remember those moments, was I really? No. The disorder had me blinded, and it took a while to remove this blindfold. Even now there are foods that still scare me, but I know that everything is the result of a false belief and the only way to overcome this fear is to face it. The process is very long, but by working on self-esteem, self-compassion and above all a positive attitude (which is different from always having good days, because that is not the case) little by little there are small improvements.

When I restricted my diet and lost weight, I thought I was looking for happiness, well-being. Now, if I think back to those moments, was that really the case? No.

The important thing is to be aware of it. Discover what the disorder is telling us and do the opposite. As I say, this requires time, patience, constant work, allowing yourself to have bad days, allowing yourself to make mistakes. To get here, of course, the brain must have energy and we get this energy by eating all the meals and with the necessary nutrients. Thus, once stabilized, we will gain the strength to be able to deconstruct what we have learned and learn again. In fact, we will be able to truly know ourselves.