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27 Feb 2023

Anorexia and men: the hidden disease

Anorexia nervosa is a torturous and life-threatening disease, which affects people across all society demographics. But anorexia is still widely seen as a mental illness which solely affects women. James Knott tells SANE what it’s like to have anorexia as a man, and how far we have to go in battling stigma.

So, I fancied popping up this ‘Eating Disorder Awareness Week (EDAW)’, with the primary focus being eating disorder awareness in men. Yes, that’s us strong tough men, who hide our feelings. Hang on a minute, that’s not true…

Generally speaking, people often think that only women suffer with ‘eating disorders’, but this is far from the truth. It is estimated that 1 in 4 people with eating disorders are, in fact, men.

However, stigma can prevent us men seeking help, and a lack of understanding about the prevalence and presentation of eating disorders in the male population can mean that eating disorders are not identified or treated early enough.

With that said, it is possible that us males are particularly vulnerable to a lack of early intervention. One of the main reasons for this is likely to be the reduced likelihood of family, friends and medical professionals suspecting an eating disorder as early as they would do in a woman with the same symptoms.

Below I open to you how I fell victim to the deadly disease ‘anorexia nervosa’. Thankfully and luckily, I live to tell the tale. I am turning my wounds into wisdom and encouraging suffers to re-evaluate their thoughts and seek help no matter what type of eating disorder you may have.

Malnourished to manpower

For two years, I myself lived with anorexia but convinced myself that I was fine. Only when my weight dropped did I finally agree to get the help that I needed. Raising awareness of the illness helps me to help others.

I was a relatively chubby child and, as I’m sure you know, kids can be mean. Children bullied me at school for the way I looked and at one point I was even given the nickname ‘Bacon Boy.’

But looking back, it didn’t make me desperately unhappy, at least not at the time. It wasn’t like those unkind words made me want to change myself or fit in, triggering an eating disorder. Although, I suppose in some way that’s what did happen. It just crept up, surprising me years later when I was 22.

After leaving school I was happy. I was living at home in Milton Keynes, I studied horticulture and then ended up working for a local company. Everything felt pretty stable. As I got older, I did want to look good and feel better in my skin, so I signed up to the local gym and found that I actually really enjoyed it.

I fell into a good routine; making my own lunch in the morning, going to work and then the gym after that. I lost weight, felt good and my life as an 18-year-old seemed very normal. Then I got offered a secondment in London which meant being away from home and the familiarity of that entire routine; that’s when things began to change.

Over those few months I got used to the feeling of being empty and hungry and what’s more, I liked it.

Isolation and restriction

What also happened, as I began eating all of my meals alone and doing nothing but work and going to the gym, I began to isolate myself from other people. I didn’t feel comfortable being around anyone else, having people watch what I was (or wasn’t) eating, so I cut myself off. My work colleagues didn’t really know me, so they didn’t notice much difference, but when I went home after my secondment ended, my family saw that my behaviour had changed.

I kept telling them I was fine, and I thought I was. I just wanted to be left alone and the more they told me to eat, the less I wanted to. But I guess that deep, deep down I knew things weren’t fine. I remember at the same time thinking that I just wanted to fade away, to not exist, to be gone by the time my sister had her baby, six months later.

However, I pushed those thoughts and feelings down and carried on. There were moments during those months, before my diagnosis, where there was a lot of tension. When you’re malnourished, it plays havoc with your emotions.

“I kept telling them I was fine, and I thought I was. I just wanted to be left alone and the more they told me to eat, the less I wanted to.”

I was angry, snappy and volatile. My parents didn’t understand what was happening to me or how to help: how could they when I didn’t know what was happening myself? When I was at the doctor’s, they told me that I was severely underweight. You might think that at this point things would start to look up. But for me, this is where my mental health actually hit rock bottom.

The first thing that happened was that I was signed off work for eight weeks and had to declare my licence to the DVLA as I was considered a risk on the roads. It felt like being punished. In fact, worse, it felt like people had taken away my control and were trying to control me. I was told that I was entitled to 30 weeks of Cognitive Behavioural Therapy. Something that I really didn’t want.

It’s hard to explain, but with anorexia you can only start to accept help and get better when you hold your hands up and say, ‘I need help’. But I still couldn’t do that; I was in complete denial. My aim then was just to be healthy and for it all to be over; to be left alone. So, I went from being extremely anorexic, to binge eating.

People started saying that I looked good and how much ‘healthier’ I must be now that I was gaining weight. What they couldn’t see was the way I was crumbling inside.

Therapy and healing

It’s hard to pinpoint when, why or how the therapy started to help, it just did. I think when you start to feed yourself physically with food, and mentally with therapy, you get a better perspective and understanding. I learned to recognise the voice in my head – the one telling me that my weight needed to be as low as possible for me to be happy – and change it.

When the therapy ended, the hard work on myself really began, but the treatment had given me the tools to do that and what’s more, I wanted to. I show myself compassion and I can give myself a ‘talking to’ when I have thoughts that might not be healthy.

Of course, I’ve had setbacks but over the last eight years I’ve really managed to get myself back on track. I’m still very mindful and aware of what I eat, there’s no doubt about that, but I don’t restrict myself anymore. And on the days that I indulge, it doesn’t hurt as much as it used to.

They helped me see things differently, admit that I ‘did’ need help and recognise that I never want to be back in that painful place again. It’s why I’m now extremely passionate about raising awareness of male eating disorders and anorexia and talking about how to recognise it in friends and colleagues – and in yourself.

Luckily, CBT helped me, and I’ve turned things around. But I’m very aware that there are so many people convincing their friends, family – and themselves – that they’re fine. I hope that by talking about my experience, it might help them.

Things are changing for the better

Eating disorders, particularly anorexia, continue to have the highest mortality rates of ALL mental illnesses. Yes, all mental illnesses, shocking I know.  We need to see more accurate awareness of the early signs, symptoms and risks of eating disorders, and we need to see more prioritisation of early detection and treatment especially in men, before medical treatment becomes necessary.  

As a lived experience sufferer, I strongly believe these deaths are preventable if people receive the right care early enough. Recovery from eating disorders is possible, but accessing the right treatment early is key, not only for the sufferer but also for the increasing strain on our health care system. Eating disorders are a severe mental illness and shouldn’t be underestimated.

And if you could take anything away from this article it would be the following: “all the advice in the world won’t help, until you are willing to help yourself”. You can and will get better.


Further reading

Do men get eating disorders? – Beat (beateatingdisorders.org.uk) – Learn more about men and eating disorders.

Overview – Cognitive behavioural therapy (CBT) – NHS (www.nhs.uk) – Interested in CBT? Learn more about this type of therapy on the NHS website.

Emotional support – SANE – If you need someone to talk to, learn more about the emotional support SANE provides.


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