Eating disorders know no gender lines. When most people think “eating disorder,” they think of a severely underweight female. The truth is that men are just as likely as women to be genetically predisposed to eating disorders, and neither gender is immune to societal and media pressures to conform to an unrealistic body type. “Eating disorders can kill men as well as women,” said Dr. Neeru Bakshi, medical director for the Eating Recovery Center of Washington. She said one misconception is that men tend to only develop binge-eating disorders and body dysmorphia. “I see men across the entire spectrum of eating disorders, including anorexia and bulimia.” Males account for at least 10 percent of diagnosed cases of eating disorders, but because men are less likely to get professional help, the actual percentage could be 25 to 40 percent. “We had a saying in medical school, ‘When you don’t look for zebras, you won’t find them. You’ll only see horses,’ ” Bakshi said. “If you don’t think that men develop eating disorders, you won’t look for them. You won’t ask the right questions.” This means some men don’t end up receiving help until a point when successful treatment and recovery is more difficult.

Chuck F., 28, of Chicago, said his struggle with anorexia started when he was an overweight freshman on his high school’s varsity football team. “I thought I would be faster if I lost weight,” he said. Through overexercising and extreme food restriction, he lost so much weight between seasons that “I was basically useless on the field.” Bakshi said both males and females with anorexia restrict calories and overexercise to change their body shape, but why and how they go about it might be different. Women usually want to be thin, whereas men are more likely to want to look muscular and defined. When Chuck was 17, he started to see a therapist and gained some weight for football. “Then I went off to college and was left to my own devices,” he said. He was working as a personal trainer when, “My boss finally called me out on my exercise habits.” Chuck gained some weight again, but it wasn’t until he received inpatient treatment through the Denver-based Eating Recovery Center that he gained insight into what was driving his eating-disorder behaviors. “What they showed me was that it wasn’t about food,” he said. “It was a way to be in control. It was a way to cope with loneliness. It was filling the void of things that were missing from my life.”

Chuck says his eating disorder was so evident to those around him that they couldn’t help but intervene. But he does agree with research showing that eating disorders are more likely to be missed in men. “I think it’s easier for a guy to mask an eating disorder because people think, ‘He’s just working out. He’s just being healthy.’ ” Although Chuck considers himself recovered, he still enjoys exercise. “For me, it’s about being much more aware of why I’m doing things.” For example, is he exercising to burn calories or exercising to improve athletic performance? “I’m also very cognizant of putting exercise before hanging out. It’s important for me to put friends and relationships before working out.” His message to other men? “If you find that food or exercise is taking over a part of your life and is starting to become all-consuming, it may be time to get help.”

This article first appeared The Seattle Times, 28 June 2015.