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  • Dr. Jenna Daku

Person to person: does holistic eating disorder treatment need to be different for men?

I am a feminist. I believe in equal rights and opportunities for all. And as a woman, I am naturally drawn to helping other women heal from their disordered relationships with food and their bodies. Perhaps this is because I have an innate understanding of the struggles and injustices that woman face in the world because I have both witnessed and experienced many myself. But I don't believe that feminism is only about women empowering other women - although this is amazing and we should never EVER stop! I say this because I've also had the privilege of knowing some incredible men who, whether they choose to label themselves or not, could be described as feminists. These men firmly believe in equal opportunities for women and they embody this in how they interact with both men and women. If you can't think of any in your own life, just think of the male actors on "The Big Bang Theory" who gave up part of their salaries so the female actresses could receive more equal pay. There are plenty of men who fit the criteria for feminism and support equal opportunities for women, but when it comes to eating disorder treatment, does it go both ways? What are we doing to ensure that men are receiving equal opportunities for support with their disordered relationships with food?

At the end of July, Toby Symonds wrote in the Guardian about his experience of anorexia and his treatment at Seacroft. He started off by describing how perplexed he felt when he was diagnosed with an eating disorder because he is a "heterosexual, non-athletic male". This highlighted some prominent stereotypes around men with eating disorders - of which there are many more. For example, some statistics have shown that a large proportion of men with eating disorders identify as homosexual, which could be in part due to the heteronormative oppression that they continue to face. I understand eating disorders as a way of trying to cope with difficult emotions and experiences, so it makes sense that oppressed groups would experience higher rates of disordered eating in an attempt to self-soothe and cope. As always though, this is only one piece of the puzzle. Perhaps men who identify as homosexual are more likely to reach out for support, for a myriad of reasons, in term skewing these statistics. Maybe other stereotypes, like the belief that women are more emotional, prevent many heterosexual males from identifying a problem and reaching out for support. It is also possible that professionals don't think to look right away for eating disorders in men due to stereotypes suggesting that they predominantly affect adolescent girls. For example, Symonds described how the possibility of an eating disorder was only presented to him after a series of tests ruled out any medical reasons for his weight loss.

In reality though, according to NHS statistics gathered between 2010 and 2016, the number of men admitted to hospital with eating disorders has grown at the same rate as women. In terms of gender gaps, this one is closing at an alarming rate. And yet, according to B-eat there's still not enough support in place for men with eating disorders. This left me wondering about what I can do to support men with disordered eating, and whether I should change the way that I frame my therapeutic approach in order to be more welcoming to men.

My website is a gateway between myself as a practitioner and my clients - both current and potential. I've built it in a way that reflects who I am as a person and as a therapist, which includes being in touch with my identity as a woman. But do I need to change my website to be more gender neutral if I want to attract male clients as well? Or should I create a second website designed specifically for men with disordered eating? More importantly, do I need to change the way that I work with male clients?

As I thought about making these changes, I began to feel unsettled as they seemed to reflect the need to change the way that I am in order to attract a different client group. This in itself doesn't fit with my ethos as a therapist or as a person. I believe in empowering my clients to uncover who they are as humans, to embrace their vulnerabililty, and learn how to accept themselves for who they are. Given this, it would feel disingenuous of me to revamp how I work or how I present my work to the world in order to appeal to a wider range of clients. I am who I am, and I want you to be who you are. Furthermore, and this might be a bit controversial but, I question whether we actually need a seperate language if we want to better understand disordered eating in men , and here's why:

The dialogue about gender and eating disorders is widening, and Symonds' piece is just one example of how more men are bravely opening up about their struggles with food, body image, and eating disorders. Throughout my work ED sufferers, I've found that although the symptoms of eating disorders are all quite similar, they manifest in different ways depending on each individual. They also have a unique impact on people's lives, and they mean something different to each person. Within this context, I can't help but wonder if perhaps we need to look at this from a slightly different angle - and I certainly don't mean that gender doesn't matter. Maybe the language that we use around gender and eating disorders is contributing to difficulties in closing the gender gap and making it more challenging for men to reach out for support. Perhaps equality could be more easily reached by stripping back this language and focusing on what's most important...the person with the eating disorder.

Eating disorders are struggles that can affect anybody because they are symptoms of a struggle to try and cope with being in the world. They are fundamentally a human condition, not a woman's condition or a homosexual condition or an adolescent condition, and I believe they need to be treated as such. In addition, from a therapeutic perspective, I am interested in both context and meaning and thus my focus is on uncovering how my clients make sense of their world. This, of course, involves exploring how they create meaning from their internal and external contexts - one of which is gender. Every person that I've met embodies and makes sense of their gender in their own unique way, and my role is to support my clients to understand what their gender means for them in the context of disordered eating.

Fundamentally, I believe that the therapeutic treatment of eating disorders involves sitting, human to human, with my clients and supporting them to make sense of and create meaning from their past and present experiences with food, exercise, relationships, body image, spirituality, identity, and the world around them. I also believe that recovery is inherently a process of learning how to become the best possible version of yourself....

So, in the spirit of equality for all, why should this be different for men?

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