Mr. Smith is a 34-year-old transgender person. He struggled with his sexual identity as far back as he can remember. He often felt that he did not belong. He was disgusted with his foreign body and body parts. He started to engage in binge/purge behavior in his adolescence. He felt a sense of relief from vomiting. He soon began to lose weight and felt more accepting of his body. This was short-lived as he ran into numerous medical concerns, almost dying from his bulimia nervosa. He felt he failed again as he always had with life. He attempted suicide several times to escape from his agony. He then engaged in meeting an eating disorder therapist who helped him realize that he is a valued person. He continues to work on his recovery and has a hope for his future.
Male Eating Disorders are on the rise. A recent 2007 Harvard study of eating disorders demonstrated from a population of 3,000 adults, one-quarter of those with eating disorders in general and 40% of binge eaters were male (Hudson, 2007). No diagnosis of Binge Eating Disorder was formally recognized at that time; the DSM-V was not published yet. The general belief has been that approximately 10% of eating disorder patients are male.
According to Dr. Arnold Anderson, an expert/researcher on males with eating disorders from the University of Iowa, there are several differences between males and females with eating disorders. Males tend to fixate on the shape of their bodies, or a certain body type rather than their actual weight. Male patients tend to be more concerned with their torsos and arms and less concerned with their lower body appearance. Anderson also states that males tend to develop eating disorders in relation to athletic performance. They may develop food phobias based on what will and won’t give them a competitive edge in their athletic field (Mehler, Andersen, 2010).
Anderson states that approximately 20% of males with eating disorders have a gay orientation, approximately four to five times the population average. Homosexual males with eating disorders tend to obsess over their weight more than athletic performance. One theory for this is that there is an increased valuation of thinness in the gay culture rather than any intrinsic consequence of sexual orientation (Mehler, Andersen, 2010).
According to the Eating Disorder Coalition, suicide rates are 20% higher in eating disorder patients than in the general population. Additionally, the rates of death by suicide among individuals with eating disorders are elevated compared to other mental health disorders including depression, bipolar mood disorder, and schizophrenia. This means eating disorders have the highest mortality rates compared to all other psychiatric illnesses. In fact, the suicide mortality rate in people with anorexia nervosa is one of the highest of all psychiatric illnesses. Individuals with anorexia are 31 times more likely to make a fatal suicide attempt than the general population. The Eating Disorder Coalition notes that some studies indicate that suicide is a more likely cause of death in anorexia nervosa than are medical complications secondary to the disorder.
The Eating Disorder Coalition also points out that patients with bulimia nervosa according to some research have a more frequent history of suicidal ideation and suicide attempts as compared to patients with other eating disorders. Patients with bulimia nervosa are 7½ times more likely to die by suicide than the general population. Lifetime prevalence of suicide attempts is as high as 35% in individuals with bulimia nervosa.
The Eating Disorder Coalition also points out that patients with binge eating disorder have a higher suicide rate than the general population. Approximately 15% of adolescents with binge eating disorder have attempted suicide.
Suicide is a definite risk factor for all mental illness including eating disorders. This may be the reason that eating disorder patients who have a high comorbidity of other psychiatric illness (mood disorders such as major depression and bipolar mood disorder, anxiety disorders, chemical dependency disorders and personality disorders) have the highest mortality rates of any other psychiatric illness.
With a higher percentage of adult males with eating disorders being gay, their risk for attempting suicide may even be higher. According to Raevuoni (2014), various studies suggest that the risk of mortality for males with eating disorders is higher than it is for females. In a study by JP Paul-2002, Suicide Attempts Among Gay and Bisexual Men: Lifetime Prevalence and Antecedents, lifetime prevalence rates of serious suicidal ideation ranging from 24-41% have been reported, along with lifetime prevalence rates of suicide attempts ranging from 7 to 20% among adult gay men and lesbians.
In the article Suicide Prevention: 15 Resources That Could Help Save a Life, Shannon Braasch, MA an alumni coordinator for Eating Recovery Center has outlined several statements one can say to someone in crisis. Included are:
- Call a suicide hotline 1– 800 –SUICIDE (784-2433) and 1-800-273 – TALK (8255).
- Those who suffer with an eating disorder can call the Eating Recovery Center for support at (877) 711-1796.
- Other resources include educational material from the American Foundation of Suicide Prevention
- Knowing the warning signs and risk factors of suicide.
Encourage the at-risk to use available resources such as the suicide hotline or the eating disorder recovery support line. When we direct someone to seek treatment for their eating disorder and comorbid psychiatric conditions, our intervention increases the chance of preventing yet another suicide.
- “American Foundation for Suicide Prevention.” AFSP. N.p., n.d.
- Andersen, Arnold E. “Osteoporosis and Osteopenia in Men with Eating Disorders.” The Lancet 355.9219 (2000): 1967-968. Web.
- Braasch, Shannon. “Suicide Prevention: 15 Ways to Help Someone in Crisis.” Eating Recovery Center. N.p., 05 Sept. 2016.
- Hudson, James I.M.D., Sc.D., et al. “The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication.” Biological Psychiatry. February 2007.
- Mehler, Philip S., and Arnold E. Andersen. Eating Disorders: A Guide to Medical Care and Complications. Baltimore: Johns Hopkins UP, 1999.
- Paul, Jay P. “Suicide Attempts Among Gay and Bisexual Men: Lifetime Prevalence and Antecedents.” American Journal of Public Health 92.8 (2002): 1338-345.
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