At first, people didn’t notice anything was wrong with Thomas Pickerton. Friends and family thought he was slim, nothing more. Even Pickerton ignored his symptoms. He thought the control he inflicted on his diet was just a part of who he was. A way of coping with the world.
For several years, Pickerton battled with anorexia in silence. He couldn’t possibly have an eating disorder, he told himself. Those were for teenage girls: they definitely weren’t for adult men.
Still, the illness gnawed away at him. “I was having a screaming match with my mum over eating a single grape,” he says. “I didn’t even recognise it as an eating disorder at that point. It was just so all-encompassing and overwhelming. I honestly thought it was just my life.”
By the time he was 21, things started to become unmanageable. When Pickerton went on a year abroad to Spain in his second year of university, all the distractions from his usual life had gone: he no longer had university work to throw himself into. “Up until that point I think I had been trying to avoid my real underlying difficulties through overworking,” he says.
Pickerton, now 27, lost weight rapidly. But it was never enough. Eventually, his eating disorder became so severe he was unable to complete university and his parents decided to intervene. For the next 10 months he would live in an inpatient hospital for people with eating disorders.
It wasn’t easy finding a hospital nearby that would take him: most only had space for women. Eventually, he found a hospital that was a few hours from his family home in Derbyshire. This referral unit had beds for 20 people, but only two were for men. “I made some great friends while I was there, but I felt very isolated,” he says.
Then there was the therapy. As part of the cognitive behavioural work (CBT) he did on the programme, he was routinely asked to point to a picture of a woman’s body when describing his own body image issues. “Every part of the programme was designed to help the female body,” he reflects.
The therapy was life-changing but these details, although small, only reinforced the shame Pickerton felt for being a man and struggling with what he still saw – wrongly – as a female disease.
Eating disorders in men are under-researched, according to Beat, the UK’s leading eating disorder charity, which says estimates based on the existing research suggest around one in four (25 per cent) of those with an eating disorder are male. It points out that the fact men may face extra stigma around eating disorders, and that most research has focused mainly on white cisgender men, means the true number might be much higher.
While all who suffer from eating disorders experience stigma, as a man this felt more intense, says Pickerton. “It’s almost seen as vain for a man to think about his appearance in that way,” he says. “One of the biggest challenges I had in accepting the illness and the need for treatment was understanding that it’s not really about how you look. It’s about how you feel.”
It is estimated that over half of the men suffering eating disorders have never sought out treatment. While therapy looks similar for both men and women, Lauren Muhlheim, a clinical therapist at Eating Disorder Therapy LA and a certified eating disorder specialist, says that working with men has to be gender sensitive. Men’s disordered behaviour may be different from women’s. While food is often the most significant focus for female sufferers, “exercise is more likely to be part of the disorder for men,” she says. “Therapy often needs to focus on addressing exercise and what it means to be male and how their body reflects that.”
Like all mental illnesses, eating disorders are not simple to explain. “The cause across the genders is complex and not caused by a single issue, but an interaction of genetic and environmental factors. Body image plays a role in eating disorders for many but definitely not all.” One thing can be generalised: “Men do take longer to seek help,” says Muhlheim.
Increasingly though, some men are beginning to speak out. In March, Ed Sheeran revealed that, in the early years of his career, he secretly struggled with “a real eating problem”. “You do songs with Justin Bieber and Shawn Mendes. All these people have fantastic figures. And I was always like, “Well, why am I so … fat?” he told Rolling Stone magazine. “There’s certain things that, as a man talking about them, I feel mad uncomfortable,” Sheeran said. He added: “It’s good to be honest… because so many [men] do the same thing and hide it.”
Dave Chawner, 33, hid his illness for years. It dominated his teens. “I wanted to starve out the things I didn’t want to deal with,” he says. “Anxiety, or my sex drive. Sexuality was a big thing for me, as that was something I was struggling with as a teenager,” he says. It was also a coping mechanism for academic pressure, he says. “When you are starving yourself, your brain can’t focus on much else. I couldn’t be bothered if I didn’t get an A in my exams if all I was focused on was exercise; calories, weighing myself.”
Throughout school, Chawner had managed to keep his illness – from his perspective – under control. “Everyone always said, ‘oh you have anorexia,’ but no one ever really asked me if I had it. It was never really discussed,” he says. “It had just become an ingrained and accepted part of my life for years at that point.”
The turning point came when Chawner got a job at a boarding school in Somerset. “All the food was pizza, chips. There was nowhere to buy your own food. There was no calorie count. That was the first time that I’d been completely beholden on someone else for my food. It amazed me how much I freaked out.”
Chawner started having nightmares about food. In an attempt to control his calorie count, he was setting his alarm to wake him in the middle of the night to do extra exercises. He started bingeing food and then throwing it up. “It was only when one of the teachers turned around to me and said, ‘look, I’ve been in therapy for bulimia. I find this a really tough environment. Have you ever thought you might be anorexic?’ That was the first time someone asked me rather than just telling me. I felt like I had been given some power back,” he says. Not long after that, Chawner was diagnosed as severely clinically anorexic and fast tracked for treatment at a specialist hospital, He would spend the next two-and-a-half years there recovering.
Chawner is now fully recovered from his illness and runs a comedy group, Comedy for Coping, for other men who have experienced eating disorders. “A lot of men want to talk about it but they don’t have the emotional language,” he says. “Which is why we set up the club.”
The number of men seeking out the help of Beat is still small. “We did the biggest survey of men that’s ever been done in the UK, and over half didn’t recognise that they had any real issues, as they didn’t think it was an illness men could suffer from,” says Sandie Barton, deputy director of services at Beat. “Then over 40 per cent were worried about how other people would react if they knew they were suffering from an eating disorder. There is very much a perception still around it being a female illness.”
Danny Bowman, now 28, was just 15 when he started struggling. He believed that he looked like a monster. “I was spending 10 hours a day looking in the mirror, scrutinising my image. I stopped going out sometimes because I just felt I didn’t look a certain way,” says Bowman. Then he started to purge his food. “It got to the point where I didn’t leave the house for six months. I was so engaged in what I was doing, I didn’t want to interact with anyone,” he recalls.
Bowman was diagnosed with body dysmorphic disorder: a disorder that focuses on image rather than weight. This also involved disordered eating. “I felt like I couldn’t possibly be suffering from a psychological illness or a mental illness because, you know, only women experienced these sorts of difficulties. There was this denial of, well, I’m a man, I shouldn’t be experiencing these things. It stopped me from getting the help I needed earlier, I think.”
Bowman is now fully recovered, as is Pickerton. In the years since his recovery, Pickerton has learnt a lot. If there is one message he wants to tell other men, it’s this: “The earlier you get help, the more likely you are to make a full recovery,” he says.
“You know, none of the people around me questioned me in the way I think they perhaps would have done if I’d been female. It took longer to recognise that something was wrong,” he says. “But you can recover.”
Beat helplines are open all year for those with or without a diagnosis, from 9am to midnight on weekdays and from 4pm to midnight on weekends and holidays. It also offers one to one webchats
