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At 5 feet 9, Alan Baum has never topped 120 pounds. But during his freshman year of college, disappointment and frustration began to cat away at what little flesh he had. Baum, now 25, dropped out of Salem College in West Virginia and went back home to Macungie, Pa., to live with his parents and save money for a better school. Depressed by the derailment of his career plans and cut off from the friends he'd made at college, he decided to try to take control of his weight.
First he began skipping breakfast, then lunch, and eventually shrank his supper to a bowl of cereal. "Every time I ate, I felt like I had lost that feeling of control," he says. If he went off his diet, he'd force the food back up by vomiting. Hospitalized (for the first of 11 times) at 84 pounds, Baum has been near death more than once in the five years, at one point dwindling to 72 pounds. "I didn't realize anything was wrong." he says. "I didn't think I looked skinny. The more weight you lose, the more your mind becomes distorted and you can't see yourself clearly." After finally facing up to his problem and entering an eating-disorder program, Baum now works-paradoxically-as a waiter in a restaurant and weighs 102 pounds. "I still feel that if I try to eat normally," he admits, "I'm just going to balloon and get fat."
Baum is a classic case of anorexia-except that he's a man. Long considered "women's diseases" that afflict primarily young white females from privileged homes, eating disorders are now gaining recognition as equal-opportunities plunderers. Well, almost equal: according to one estimate, anorexia (self- starvation), bulimia (gorging and vomiting) and B.E.D. (binge eating disorders), characterized by unhappy, uncontrollable eating without purging, affect some 7 million American women and 1 million men. But the disparity may be partly due to under diagnosis. In a 1992 survey of 1982 Harvard graduates, eating disorders in women had dropped by half, but among men, they had doubled. And a study of 131 Cornell University light-weight football players, completed this spring, found that 40 percent engaged in "dysfunctional eating patterns" (mostly bingeing or purging), with 10 percent classified as having outright eating disorders.
Researchers don't know if there are more new cases of eating disorders in men-or simply more recognition. There are, they agree, both similarities and differences in how men and women are afflicted. In both genders, eating behavior is likely to go awry at key points of separation from family or reaching a new, adult stage in life, going away to college or graduate school or starting a new job appear to be trigger. So is puberty.
In girls, says University of Iowa psychiatrist Dr. Arnold Anderson who has treated more than 1,000 girls with eating disorders and about 120 men, the onset of anorexia in early adolescence is often partly a frightened retreat from sexuality. (Curves disappear, menstruation stops.) In males, who tend to develop anorexia symptoms a couple of years later-in late adolescence or their early 20s-anorexia sometimes signals confusion over sexual orientation. According to Andersen, about 22 percent of male anorexics are homosexual. "Being gay is a risk [for the disease] but not a requirement." he says.
Actors and Jockey
For women, the overwhelming social and cultural pressure to be slim can produce such ferocious fear of fatness that the result is anorexia. For men, says Andersen, such pressures are a significant cause of anorexia primarily in a subset that includes models, actors, gymnasts, wrestlers and jockeys. But for many males, nonprofessional sports training can lead down the road to an eating disorder. "When the season is over, they find themselves in an addictive pattern," says Anita Sinicrope of the Pennsylvania Educational Network for Eating Disorders. Tony Muno, now 27, who grew up in a Chicago suburb, got a gymnastics scholarship to college and found that when he began taking off weight for competition, he simply couldn't stop. "I just got obsessed with it;" he says. "It started to consume my thoughts." When he reached 113 pounds (at 5 feet 10), he dropped out of school and checked himself into hospital for three months, where he began a recovery process that took 2 1/2 years.
Men can also develop eating disorders in connection with what behavior experts call "obligatory running" and other endurance sports. In a world of deprivation chic, pain and hunger take a back seat to miles-per-day and body-fat percentage numbers. (For female compulsive athletes, the anorexia often precedes the exercise addiction.) "There is a certain social acceptance of [excessive] exercise," says Steven Zelicoff, a Pittsburgh-based exercise physiologist. "You would be frowned upon for being neurotic about the way you eat, but celebrated as a local legend for the way you exercise."
Chris Balser, 26, saw his weight bounce all over the scales when he went in for junior-high-school football (at 210 pounds) and wrestling (at 170 pounds) in northern New Jersey. Kicked out of school at 14 for drug and alcohol abuse, Balser was sent to Hazelden rehab center in Minnesota, where he picked up the habit of compulsive eating, purging and exercising. Between the ages of 16 and 19, he says, left pretty much on his own by divorced parents, he would alternately starve himself and binge. Intensely hungry, he craved cookies, cake and ice cream-and would often cram in huge quantities at one sitting. It took him a while to become adept at purging, but with a little practice, he could just lean over the toilet, flex his stomach muscles and throw up. "I wanted to get rid of a little bit of flab around my stomach," he says. "I looked in the mirror all the time. I didn't see that I was losing weight."
At 19, six feet tall and weighing 137 pounds, Balser was purging 40 times a day and spending $100 on food; sometimes he even stole to support his habit. "I felt ashamed," he says. "I felt like I was partaking in a woman's disease and that it wasn't very manly." Finally, Balser got help at a residential treatment program in Florida. He now lives in Branford, Conn, attends college nearby, has a girlfriend-and weighs a solid 185 pounds.
Perhaps the ultimate indignity for men with eating disorders has been that for years doctors failed to recognize the problem. Now there is growing awareness, says Andersen, that these illnesses can strike "males, matrons and minorities" as well as young white teenage girls. (They also affect some older men, driven to extreme dieting by fear of heart disease.) But men are still often reluctant to enter treatment programs where they may be the only males-and where the women sometimes resent and sneer at them. Without treatment, declares Andersen, the outlook for men and women with eating disorders can be ominous. With help, including group and family therapy, antidepressants and possibly male hormones for men, the recovery rate is 90 percent. And for someone who starts treatment now, there's the prospect of enjoying a normal Thanksgiving dinner, maybe even including a slice of pumpkin pie.
Reprinted with permission.
From Newsweek, May 2, 1994, Newsweek, Inc. All rights reserved.