Nathan was a graduate student when he met his girlfriend in 2006. She was concerned about her weight and tracked every meal in a food diary. Nathan, (his name has been changed here), had always been naturally thin, but began cutting out certain sweets from his diet, then processed food. Soon, he was eating only fruits, vegetables and, on occasion, meat.
"It wasn't a vanity thing," he says. Nathan married his girlfriend, had three kids and continued his studies while searching for a job. As the pressures in his life mounted, his diet became increasingly restrictive. At the time, he says he would think to himself, "I can't control how my dissertation is going. I can't control that my kids are crying but I can control what I eat."
Soon Nathan had lost so much weight that he couldn't climb the stairs in his house without getting winded. He was 5'10" and less than 100 pounds, and his weight continued to drop.
"I was looking at myself deteriorating and hating it," he says. At the same time he felt this bizarre sense of accomplishment, almost like a rush. "I was somehow super human. I didn't need to eat."
Nathan is one of a million men in the U.S. who have eating disorders and that number appears to be growing. Boys as young as 8 have been diagnosed with eating disorders, according to the Eating Disorder Hope website.
In a recent study that surveyed 5,500 male teenagers over a decade, one in five subjects was very concerned about his weight and physique. While body image concerns don't automatically qualify someone as ill, because male eating disorders are so often overlooked according to experts, researchers have begun tracking these statistics.
Alison Field, the lead author of the study and an associate professor of Pediatrics and Epidemiology at Boston Children's Hospital Adolescent Medicine Division, said in her report that clinicians often fail to notice male patients who are using "unhealthy methods" to achieve their target weight and shape. "And parents are not aware that they should be as concerned about eating disorders and an excessive focus on weight and shape in their sons as in their daughters, "she added. The study was published by JAMA Pediatrics Nov. 4.
Light as Air
John Nolan, a pseudonym, shared his story in the book "Going Hungry: Writers on Desire, Self-Denial and Overcoming Anorexia,"edited by Kate Taylor, in which he reflected on his teenage battle with anorexia.
Like Nathan, he remembered the high he felt from starving himself-- feeling literally lighter. In this altered mental state a classical concert became a dreamlike experience. "I could hear the whisper of my blood in my ear and see the beat of my heart against my ribs. I was the air and the music," he wrote. More than 20 years later he reflects on that period of his life. "The moments of euphoria were wonderful. I just felt like I connected with the world in some strange way."
But his moods were erratic and the feelings of exhilaration were rare. Mostly, he felt anxious and isolated.
John remembered walking down the street comparing himself and his size to strangers. He also had a brother who was clinically obese. "It was more a fear of fatness than a desire to be thin," he says. He would even picture the food another person had eaten that day. He'd see it in a pile and pride himself on the mental image of his own tiny pile. "Even if I won that competition what was it that I was really winning? It was all about control," he says.
More Than a Woman's Disease
That society looks at men's behavior and women's differently is a given, but it's particularly true of eating disorders. "A woman orders a large pizza and goes for a five-mile run. People notice," says Dr. Mark Warren, medical director of the Cleveland Center for Eating Disorders. When a man does the same thing, he argues, people pay less attention. "The same disorder triggers different pictures for men than for women."