One in four people with an eating disorder is male. We don’t hear about it or speak about it as often as we should.
"On average it takes nearly three times as long for men to get a referral after first visiting a GP as for women," says eating disorder charity Beat's Head of Communications Rebecca Willgress.
"Too often doctors do not spot the signs of eating disorders in men because they might not be underweight or because behaviours such as excessive exercise are seen as typically male activities. We need to challenge the stigma and misunderstanding that surround male eating disorders."
Eating disorders are harrowing and dangerous for the people who live with them. They are also traumatic for those people's loved ones – and we don’t hear about that much, either.
So what is it like to be in love with a man who lives with an eating disorder?
Chloe, 22, has been in a relationship with Aiden, 23, for two and a half years. She loves him because he’s funny and charming and sweet. She loves him because he makes her laugh – proper belly laughs. She loves him when he’s angry and she loves him when he’s miserable.
Not long after they first started dating, Aiden told Chloe that he had bulimia.
"We were laid in bed one night, and he said 'I’m a bit of a weirdo' and I said 'What you talking about?' and he said basically, 'I can’t eat anything without throwing it up'. At first, I didn’t really clock onto what it was, you know. But then I thought about it and I said to him, 'You need to get help, you need to get help'. I kept pushing him to go and see someone and finally he got to the point where he realised something's got to be done."
That was the first time Aiden had told anyone about what he does after he eats. His family and friends didn’t know about it at the time, which must have been terribly isolating. Thankfully, he felt safe enough with Chloe to tell her the truth, and she was able to encourage him to see his GP. From there, he got therapy and would come home with various exercises to do, like recording a food diary and writing about how eating made him feel.
For Chloe, Aiden’s revelation explained some of his behaviour. "When we’d go out, he’d always be watching what he was eating and after dinner, he’d vanish. He’d go to the bathroom and he’d be gone so long, I’d think 'Have I been stood up?' He wouldn’t come over to my house at the beginning and have something to eat. It was always 'Oh, I’ve already eaten'. He’d do a lot of calorie counting. When we first started going out, we’d do late night shopping trips to Tesco and I’d go straight for the crisps, as you do, and he’d be in the salad section, reading the backs of packets. I never really thought too much about it at the time, until I found out what was going on."
Even now, after Aiden has been through therapy, their relationship is affected by his fear of food. They don’t go on date nights to restaurants like other couples. Going out to dinner makes Aiden too anxious. "Every time we eat out, he thinks people are watching him. He gets petrified. It makes it quite difficult. It’s really rare now that we go out. I’ll suggest it and he’ll say 'It’s always food or the cinema with you' and I’ll say 'But that’s what people do for dates'. So we’re just in the house a lot of the time, or he doesn’t mind going for a long walk. Sometimes we put on a film and share a bag of popcorn, if we’re lucky. It’s had a massive effect on both of us, and on our relationship. I mean, we’ve never really had that honeymoon period."
Chloe says her body has changed since she’s been in a relationship with Aiden, but her attitude to eating really hasn’t. She’s always been pretty resilient and healthy in that regard. "I don’t stop eating," she says. "I’ve put on weight in the past 18 months but I think that’s because I’ve been comfortable, you know." Aiden has got to a healthier weight but he’s requested that Chloe and his family members not comment on it. "He talks about wanting to lose weight but when he weighs himself, he’s asked us not to congratulate him or say anything either way, so it’s about finding that balance and just saying, 'Okay then, alright' instead."
Aiden says he’s in recovery, but he still struggles. He has good days and bad days. He and Chloe argue quite a lot. Like a lot of men, Aiden’s depression and anxiety tend to manifest in anger. She’s loving and patient, but she’s also had to be straight with Aiden about how his illness affects other people. It affects her enormously; of course it does. She worries about him all the time.
"I ask him daily, 'Are you okay, are you alright?' and it really winds him up, but I think that’s just me being anxious and making sure he’s alright. I don’t like to mollycoddle him; I more go for tough love. I say it how it is. I’ve said to him, 'If you carry on like this, you’re going to kill yourself. You’ve got to think of your family.' That happened one night when we had an argument and I just said what needed to be said. I have to be honest with him because I know what he’s going through is tough but I have to be tough with him to love him, you know."
Aiden has been ashamed and secretive about what he goes through, partly because we so often think of eating disorders as illnesses that belong to women.
Loving a man with bulimia is difficult. Being a man with bulimia is difficult. It’s all achingly difficult. Aiden has been ashamed and secretive about what he goes through, partly because we so often think of eating disorders as illnesses that belong to women. "We’d have rows and I think part of that was because he is a male with an eating disorder," says Chloe. "I think he felt like he’s lost some of his masculinity, and I had to say to him, 'This makes you no less of a man. You are still a man.' I wanted him to know that it’s fine for him to be going through this. I think that’s the reason he didn’t ask for help until we spoke about it."
Chloe wants Aiden to get more treatment, go back into therapy and further repair his relationship with food, and himself.
"I want that for him, I want him to be better. But selfishly, I also want it for me. This has had a huge impact on us, of course it has. He still struggles, I can see that. It’s not something that’s going to be fixed overnight, I know that, and I’ll be here. But while he’s like this, I’m affected. I don’t talk to him about how I feel because I don’t want to ever be a burden, or too much for him. I don’t open up to him."
Aiden has told his friends and family about his bulimia, which means he has a proper support network. He knows he’s got Chloe, he knows he’s got other people around him who love him. This time, when he goes back into treatment, that could make all the difference.
"Men with eating disorders face particular challenges, but help is available and recovery is possible," says Rebecca from Beat.
Taking care of someone with an eating disorder can be physically and emotionally exhausting, especially as your loved one may become withdrawn or have emotional outbursts. It can be helpful to bear in mind some strategies to avoid escalating situations, such as waiting to talk once everyone involved has calmed down, while still remembering that you do not need to feel guilty yourself. The eating disorder is not your or anyone’s fault.
"Remember that eating disorders are isolating and secretive illnesses, and often cause feelings of low self-esteem and a distorted perception of body size and shape," says Rebecca. "Your partner may not want to be physically or emotionally intimate while they’re ill. This is not them rejecting you, but the eating disorder speaking. Try to understand things from their point of view, but communicate your feelings too. Try to keep doing things together as a couple and as a family."
"Beat’s helpline service is open every day of the year, and runs support groups where men can speak to their peers about their problems and their recovery."
If you or someone you know is living with an eating disorder, visit Beat or call their helpline on 0808 801 0677 for information and support