“A society concerned with shalom will care for the most marginalized among them.”
Randy S. Woodley, Author, Activist
“The individual has always had to struggle to keep from being overwhelmed by the tribe.”
Fredrick Nietzsche, Philosopher
July was National Minority Mental Health Awareness Month. It was first established in 2008 by the National Alliance on Mental Illness (“NAMI”). It largely went unrecognized, unacknowledged and unremarkable.
And it should not be surprising that the eating disorder industry is a microcosm of that reality. The eating disorder industry is at a dysfunctional crossroads as it continues to plummet down a rocky path of chaos, silo mentality, voodoo treatment regiments and parochialism.
Nonetheless, in recognition of the month of July and National Minority Mental Health Awareness, let us shine a beacon of light on the largest group of marginalized members in the eating disorder industry, for they are in the greatest need of understanding, support and assistance. Those marginalized members who are overlooked, misunderstood and trampled upon … and sometimes whose existence is not even acknowledged.
I speak of course … of boys and men.
According to the British eating disorders charity “BEAT,” about twenty-five percent (25%) of people diagnosed with an eating disorder are male. According to Eating Disorders Hope, a US based eating disorders organization, forty percent (40%) of those who suffer from Binge Eating Disorder are male. According to the National Institute of Mental Health, 1.2% of all United States adult citizens suffer from binge eating. If this number is accurate, that translates to approximately 3,024,000 adults who suffer from Binge Eating Disorder. Of these, approximately 1,210,000 are adult men. Of course, this does not take into account the many adolescent boys suffering from this disease.
According to the National Eating Disorder Association (“NEDA”) an often quoted statistic states that approximately 30 million people in the United States suffer or will suffer from eating disorders – 10 million of whom are male.
Ten (10) million souls. Equal to the combined populations of Los Angeles, Chicago and Houston. With this many boys and men suffering from eating disorders, one would naturally think the eating disorder industry has rushed to include boys and men in the treatment of eating disorders especially with the unique cultural and societal stigma encountered by males with eating disorders.
Outside Societal and Cultural Issues Encountered by Boys and Men
Boys and men with eating disorders face unique societal and cultural challenges, beginning with the factually incorrect, but widely held misconception that eating disorders are a “rich, white girl’s illness.” That “real men” do not get eating disorders. And young men are supposed to be able to overcome adversity through shear strength of will and determination. Treatment and counseling are for women folk!
And yet, if men do not enter treatment programs, they do not give researchers the chance to understand their stories, their risks, and their successes. Dr. Ralph Carson, a doctor specializing in eating disorders stated: “ … leaning on published statistics does not always tell the whole story of men with eating disorders. Since eating disorders are not typically associated with being male, and since there are not many published articles about how these disorders impact men, those males who do have eating disorders could be struggling in silence.”
The cultural expectation of beauty for men involves a body that is well-defined and muscular. A V-shape, packed with muscles in the shoulders, well defined arms and a torso tapering to slim, yet muscular legs is society’s definition of beauty for men. And it goes back thousands of years. One need only to look to Michelangelo’s masterpiece, “David” and you realize that he captured the quintessential expression of what “a man” is supposed to embody.
Men who participate in sports like wrestling, ice skating, swimming, boxing and gymnastics are particularly susceptible to eating disorders to become stronger with more endurance.
Even still, body dysmorphia impacts a large percentage of males. A male with this condition wants to gain muscle mass so he looks stronger and more virile. The modern day version of “David.”
Dr. Carson goes on to state, “For so long, eating disorders have been considered a female condition, so males shy away from it. They aren’t females, so they think it can’t happen to them, or they don’t want to be given a female label or a female disease.”
Even clinicians may overlook signs of eating disorders in men. Dr. Carson relates, “In the past, the clinical reference books didn’t even mention men. Up until recently, the DSM defined anorexia with a lack of menstrual periods. Men were just invisible.”
With these societal and cultural views to fight and with the number of males impacted, one could presume that the treatment of boys and men with eating disorders would be of paramount importance. And yet, if one held those views, they would be wrong.
Lack of Treatment Options
Treatment has been overwhelmingly and almost universally focused on girls and women. In fact, there are numerous treatment centers which do not admit boys or men suffering from eating disorders. Timberline Knolls in Lemont, Illinois; Clearview Women’s Center in Los Angeles; Center for Hope of the Sierras in Nevada; Magnolia Creek Treatment Center in Alabama; Oliver-Pyatt Center in Florida; Princeton Center for Eating Disorders in New Jersey; The Renfrew Center in Pennsylvania; Carolina House (*Correction. Thank you to Leanne Raiford who contacted me and pointed out that Carolina House opened a gender inclusive house in September 2017) in North Carolina, and; Montecatini Treatment Center in California, to name just a few.
With regard to treatment, Dr. Carson related, “I’m in the field and there’s not that many places to get treatment. I’ve heard that the number of facilities is increasing, but the facilities are not specific. It’s hard to even find a place to refer men with eating disorders. And finding the right place is so important. Men can feel shame in asking for help, and sometimes, they can even feel shame while in treatment. In some facilities there are 35 women and two men, so those men can feel really disconnected.”
And if a male is self-aware enough to understand he has a life-threatening illness and turns to the eating disorder industry for help, he is likely to find bias, treatment designed for girls and women and very few answers.
Bias Encountered by Males from Eating Disorder Professionals
The International Association of Eating Disorder Professionals (“iaedp”) holds itself out as: “Established in 1985, the International Association of Eating Disorders Professionals (iaedp) is today well recognized for its excellence in providing first-quality education and high-level training standards to an international multidisciplinary group of various healthcare treatment providers and helping professions, who treat the full spectrum of eating disorder problems.”
It also states, “Clearly iaedp has become more than just an organization. It is representative of leadership in the field. The value of the overall iaedp program is perhaps best seen in its annual Symposium. [emphasis added] The conference draws attendees from all corners of the globe…”
Let’s review the iaedp Symposiums from 2015 through 2019 to determine the value of iaedp’s programs with regard to boys and men.
At the 2015 Symposium, which lasted 4 ½ days, there were 48 educational sessions conducted. Only one (1) session addressed men. The topic? It was entitled, “Bringing Men to the Table: Reaching and Training Male Loved Ones to Support Treatment and Recovery.”
At the 2016 Symposium, which lasted 4 ½ days, there were 54 educational sessions and poster presentations. And whereas, there was one session on music therapy and one session on art therapy, there were a grand total of ZERO sessions regarding boys and men.
At the 2017 Symposium, which lasted 4 ½ days, there were 55 educational sessions. The former male owner of Castlewood, who had been the subject of four lawsuits for allegedly implanting false memories and other improprieties conducted a session on, “Eating Disorders … Sexuality and Intimacy.” However, what you would not learn about is the manner in which boys and men are suffering and dying from eating disorders and how best to treat them because once again, there were no sessions concerning boys and men.
At the 2018 Symposium, which lasted 4 ½ days, there were 58 educational sessions. And YES! There was ONE SESSION entitled, “Dominant, Logical, Unemotional: Deconstructing Male Eating Disorders.” This 90 minute session received the same amount of time as “E.D.ucation through Musical Theater.” However, it received one fewer hour than the session: “Giving Voice to the Hidden Emotions: The Use of Sand Play Therapy in the Treatment of Eating Disorders with Adolescents.” Who could have guessed that “sand play therapy” was of greater importance and needed more attention than boys and men suffering from eating disorders.
At the 2019 Symposium, which lasted 4 1/2 days, there were 60 educational sessions. You could learn about Veganism but you could not learn anything about boys and men with eating disorders.
So, in a five (5) year time frame, at iaedp’s largest annual international conference, attended presumably by thousands of professionals, there were a total of 275 educational sessions. 1 session was addressed to training men to be supportive partners. There was 1 session deconstructing male eating disorders. And that is the totality. On the other hand, you could learn about sand play therapy, musical theater, art therapy and veganism!
If, as iaedp says on its own website, it is representative of leadership in the field and the value of iaedp is best seen in its annual Symposium, then boys and men are in grave peril and not just from this insidious disease.
Perhaps NEDA would prove to be more understanding and would embrace boys and men. But, as pointed out in the last article, we addressed the manner in which NEDA turned its back on boys and men long ago. We outlined that a bold, new program, a “Dad’s Initiative” was brought to NEDA nine (9) years ago. In 2012, NEDA was allegedly going to embrace dads and kick off this program. And then … NEDA did nothing.
To add fuel to the fire, in a controversial post that appeared on NEDA’s Facebook page which took place on Tuesday, July 23, 2019, men who were fighting eating disorders were singled out, bullied and abused:
“John Doe: I don’t dispute the veracity of the post at all, what I would say as a man who lives with ED is we are very underrepresented in discourse, advocacy, and services. Not to take anything away from women who suffer, but we need more visibility about this topic among men so men can learn to talk about it safely too. Thanks.
Jane Doe: This post has to do with men, too.
John Doe: Jane Doe I didn’t say it didn’t. NEDA asked how people reacted to it and that is my personal reaction.
Jane Doe: dude, you’re full of shit. Just listen to yourself. You’re literally saying your reaction to this post is that we need to talk more about men. Though this post has to do with men, then you say you didn’t say it didn’t, but you reacted to it as such. You’re trying to fucking derail and take over when this didn’t even mention gender.
John Doe: Who are you to try to and silence me? I’m a man who has lived with this crippling disease for decades,. I wouldn’t wish it on anyone, ever I’m talking about my own experience Ever go to a NEDA event? Almost all women. [remaining message lost]
Jim Doe: John Doe I am in the same boat as you John and I am very disappointed with NEDA. Jane has some serious issues of wanting/needing to divide people. I am very sad and disappointed with NEDA. They made me realize there really is no hope [emphasis added]
Kate Doe: Okay, so I thought this was a safe place. I can see politics is in their agenda. I’m out … I’ll recover with my local EDA.”
After a storm of complaints, NEDA took down the post. But, it reappeared on the personal Facebook page of an officer of NEDA that very same day.
Given the harm and discord NEDA’s post caused, one would naturally assume that NEDA would act like any responsible organization and issue an apology.
The next day, NEDA did issue a statement. But, this statement in no way accepted responsibility for its short-sighted and harmful conduct. Instead, in a brazen act of arrogance and intransigence, NEDA did not even apologize … that is to the persons who were harmed. It did however, reaffirm its commitment to social injustice. The post in material part said, “Removing yesterday’s post was in no way a retraction of NEDA’s commitment to important social justice issues, rather it was a response to the harmful discourse in the comments section.”
In fact, the only apology came from an officer of NEDA and was directed toward a closed Health at Every Size (“HAES”) group on Facebook wherein that officer stated: “Folks, I want to apologize for the labor many of you provided that was erased tonight. [emphasis added] I’m disappointed about it being taken down …” And then, “We won’t be deterred in our social justice work, but there is a long way to go – a lot of learning to do to navigate the vitriol that this team [NEDA] is not familiar with.”
No apology to the men on the NEDA thread who were bullied. No apology to the eating disorder community. A recommitment to the message of the Social Injustice Warriors. Perhaps it is time for NEDA to come out of the closet and speak its perceived truth, “No Men Are Allowed.”
As for foundations, Project HEAL is becoming a force in the community. And yet, even within Project HEAL, messages are being sent that boys and men are not included. Full disclosure requires me to state that I started the Project HEAL North Texas Chapter approximately two (2) years ago [but turned over the chapter to others to operate]. I spoke at a gala event in Dallas in May 2018 hosted by Project HEAL. Its founder, Kristina Saffran is nothing short of amazing, a powerful presence.
And yet, in late September, Project HEAL is hosting an enrichment camp celebrating self-care, body acceptance and empowerment. Camp HEAL is being held at the Angeles State Forest in Southern California. Its promotional literature lists 37 camp counselors, speakers and leaders. Of these 37 leaders, 36 are women. One (1) man. Thirty-Six (36) women.
Would There Even Be Interest in a Boys or Men Program?
Hard questions need to be asked all around. Assuming iaedp had promoted and presented sessions on boys and men, would there be any interest? Would anyone attend? The answer to these questions can perhaps be supplied by the Academy for Eating Disorders. (“AED”)
At AED’s 2018 international conference held in Chicago, there was an educational session entitled,”Unraveling the Enigma of Male Eating Disorders: Conceptualization, Assessment and Intervention.” It was presented by Stuart Murray and Jason Lavender. I was a bit late coming to the session. When I arrived, I saw the room was packed. Every seat was taken and people were standing against the walls. As people continued to arrive, I first offered my chair to them to sit outside of the room looking in through the doors. As even more people arrived, I walked over to a nearby dining table and chair set and started moving over chairs for them to be seated upon.
This session ran long because of the interest and questions asked. Now, would every breakout session involving boys and men be as well attended? Of course not. But, the professional interest is there when the opportunity is presented. This is also demonstrated by the fact that there were no less than eight (8) poster presentations with different topics focused on issues faced by boys and men.
Even still, more difficult questions have to be asked. How did we get to this place? How can as many as 10 million people suffering from this disease be relegated to worse than second class status? Where are the leaders of eating disorder organizations? Perhaps we should look at them as well.
Organizational and Industry Leadership Exclusion
It should come as no surprise that Men have been, as a matter of course, excluded from leadership positions in the eating disorder organizations.
If you look at NEDA’s primary officers, all four (4) are white women.
The Alliance for Eating Disorders Awareness lists a leadership team of thirteen (13) people, twelve (12) of whom are women and none of whom are African-American.
The National Association of Anorexia Nervosa and Associated Disorders lists five (5) staff members. All of whom are white women.
The International Association of Eating Disorder Professionals (“iaedp”) lists four (4) primary officers. Three (3) of the four (4) are white women.
The Academy for Eating Disorders (“AED”) lists five (5) persons on their Executive Committee, four (4) of whom are white women.
The Eating Disorders Coalition list five (5) officers, four (4) of whom are white women.
The Multi Service Eating Disorders Association (“MEDA”) lists five (5) officers, all of whom are white women.
As such, of the forty-one (41) positions listed, the tally is:
- Zero (0) African- American men;
- Zero (0) African-American women;
- Four (4) White men;
- Thirty-seven (37) White women.
Diversity at its finest? This lack of representation may also explain, given these statistics, why the industry as a whole is ignoring boys and men.
They may Be Forgotten but They will NOT be Victims
Where are boys and men afflicted with this deadly disease left to turn? Certain elements in the eating disorder community and the more militant advocates advance baseless messaging, social engineering, finger pointing, and victimization all in the name of bringing social injustice inside counseling rooms. Rallying cries of “white supremacy” and “white male privilege,” are being whispered across the eating disorder advocate community, which when extended to their most commonly defined meaning are pointing fingers of oppression and blame against the very people being excluded by the eating disorder industry, boys and men. It has already been demonstrated that if boys or men are hurt as a result of this militant advocacy, one need not apologize. Perhaps boys and men are merely meant to be the sacrifices laid on the altar of social engineering in the eating disorder industry.
To that militant sect who seek to strike back in furious anger against those whom they believe have belittled and stigmatized them, your wait is over. The eating disorder industry is doing your job for you.
But, boys and men, fathers, husbands, brothers, sons, who are afflicted with this disease will not be forgotten. They will not be victims. They have a voice. A voice that should have been heard long ago … a voice which will be heard in the future.