Bulimia nervosa is an eating disorder involving bingeing on food and then compensating for doing so (using various methods which I’ll explain below), in an attempt to avoid weight gain.
Boys and men today are subject to a lot of pressure around appearance. It’s no longer only women and girls affected by this.
We see images everywhere of hyper-muscular male body ideals, routinely presented as healthy, strong and desirable.
If a boy is having trouble with his self-esteem, he may distract himself from uncomfortable feelings, by aiming for a ‘perfect’ body, in the hope of feeling better about himself. But these body shapes are often only achievable through methods such as steroid use, restrictive eating and extreme exercise regimes. So, if a boy or young man falls short of his ideal and continues to feel poorly about himself, bulimia can develop as an attempt to exert increasing control over body size and shape. Over time, this can become an entrenched behaviour. Bulimia is a dangerous condition, with serious consequences, and if left untreated can be fatal.
What are the signs to look for in boys?
Early signs are when a boy or young man starts focusing heavily on his body and what he eats. He may start swinging between eating in a very ‘healthy’ and controlled way, to eating large amounts of high fat, high salt, high sugar foods – perhaps in secret. His weight may start to go up and down in response.
Gym-going can be a red flag too, especially if exercise activity appears intense, rather than about wellbeing. For example, if a young man is starting to go to the gym more than once a day or spending hours there at a time. Perhaps he is focusing not on how his body feels, but only on the appearance of muscularity and percentage of body fat. Maybe he is starting to engage in the process of bulking up followed by ‘shredding’ fat or weight to exaggerate muscle gain.
From the outside, there may not seem to be any specific sporting goal or reason for him to be doing this. Instead, it seems to be solely about changing his body shape, and this is starting to interfere with his social life, family mealtimes, school achievements, health or general levels of happiness.
What is a binge?
Bingeing is eating an amount of food within a two-hour period that can objectively be described as excessive. For example, a binge might look like eating one or more shopping bags full of high fat, high sugar foods in one sitting.
Why binge?
Someone with bulimia is using food to change the way they feel. A binge is not about satisfying hunger. Bingeing is accompanied by preceding thoughts that the food will taste good, bring comfort and make that person feel better. In reality, the opposite occurs: feelings of shame, regret and remorse follow a binge and this triggers the other part of the cycle – compensation.
Does everyone with bulimia vomit up the food they’ve binged on?
No, not at all. Bulimia involves compensating for excessive food consumption. That may mean vomiting for some, but compensating can take the form of fasting, restricting food intake (dieting), refusing to eat certain food groups, excessive exercising, taking diuretics and laxatives or using drugs and alcohol to reduce appetite.
Whilst lots of research, (my own included) has focused on bulimia in women and girls, relatively little has focused on men and boys. It used to be thought that bulimia was found only infrequently in men and boys. We now know that’s not the case and that the same underlying fear in girls who have bulimia also exists in boys: self-esteem is linked to body size, shape or weight and there is a fear of being out of control around food.
What should I do if I know a boy or man with bulimia?
Approach the issue gently. The problem isn’t the food, it’s self-esteem and confidence. Try telling him what you’ve noticed and what you think may be the problem. Offer to help him find help when he’s ready. Be the safe person he can go to. Then step back. No one benefits from being watched, controlled, lectured, nagged or judged.
What treatment works?
Bulimia is a problem of the mind, body and spirit, so good treatment addresses all three. There are a range of effective approaches, such as in-patient rehab, 12-Step programmes, support groups, specialist therapy, trauma-focused body work and more. Recovery is absolutely possible.
Do you want help?
If you’re ready for change, I’m ready to help you. So please contact me and we can start finding the freedom from bulimia you’re looking for.