1 in 10 Men Are Binge Eaters, Once a Women's Disorder
The first time Ron Saxen discovered the numbing effects of food, he was 11 and nervously anticipating a beating by his strict father -- a punishing military man who often burst into his son's bedroom to beat him after work. Terrified, the boy devoured a bag of chocolates that lay by his bedside.
"My mother used to keep a note pad if we did things wrong," said Saxen, now 48. "My father would come home late at night and I would wait with my sweaty feet and palms. I had 15 pounds of chocolate candy from a sale at school. I ate one and it took me away."
"I learned at an early age that food erases anxiety," said Saxon, a former model who wrote about how binge eating destroyed his career in his 2007 book, "The Good Eater."
Now, a new study reveals that men like Saxen are overlooked when it comes to diagnosing and treating binge eating, a disorder that affects 4 million Americans and has been historically associated with women.
The study, published today in the International Journal of Eating Disorders, reveals that the condition is just as damaging to men, and yet they seek treatment less often.
Saxen, now married and living in Berkeley, Calif., said after that incident, food was an escape. "If I ate a bunch of food, it would calm me down," he said. "It became the way I dealt with things."
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He'd go to McDonald's and order a couple of Big Macs, large fries, a cheeseburger and a chocolate shake, then go on to Taco Bell for more and follow that with several king-sized candy bars.
Afterwards, horrified by his out-of-control eating, Saxen would run 30 miles. But as he got fatter, he couldn't run and burn off the weight, and he permanently damaged his knees.
When 6-foot, 1-inch tall Saxen ballooned from 180 to nearly 300 pounds, he dodged his modeling agent out of embarrassment and sabotaged his career.
Saxen began to realize he had a problem, but it took years to get help, mostly because of the shame. That, say researchers is one of the reasons male binge eating is largely unrecognized.
"It doesn't surprise me -- it's thought of as a women's disease," said Keith Ayoob, a registered dietitian at Albert Einstein College of Medicine in New York City. "Guys are reluctant to seek help. Eating disorders of all types are socially less acceptable than other addictive behaviors. If you drink or smoke, it may be an addiction, but if it's an eating disorder, you are crazy in society's mind."
Binge eating disorder (BED) is defined as having at least one episode a month of overeating with "a sense of loss of control," according to the study's lead author Ruth Striegel, professor of psychology at Wesleyan University in Middletown, Conn.
Her team used cross-sectional data from a sample of 21,743 men and 24,608 women who participated in a health risk self-assessment screening. They found that 1,630 men (about 7.5 percent) and 2,754 women (11 percent) binge eat.
"Anytime we exclude a population, we are not learning about them," she said. "In a way, we are inadvertently giving the message that men don't have the problem, and they do."
"Data suggests that the impairment is basically just as bad in men as it is in women. Yet we focus only on women."
She estimates anywhere from 5 to 10 percent of all men experience the symptoms of binge eating. "It's not a rare phenomenon."
More women than men, however, report psychiatric symptoms like the "purging" associated with bulimia, according to Striegel.
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Binge eating takes an obvious toll on a man's physical health: obesity and associated cardiovascular disease. But it also has a psychiatric side -- depression, anxiety and sleep problems.
"The problem is they travel together as an expression of distress," said Striegel. "It's way of coping with highly averse emotional states."
She said she hopes doctors and employee assistance programs will recognize this behavioral risk factor in men so they can be properly treated.
Because BED is associated with women, men admit to Striegel anecdotally, "there is a double layer of shame."
Such was the case with Saxen.
"I kept telling myself to buck up and be strong -- to man up," he said. "I didn't want to be part of a therapy group because they would think I was crazy or weak. All I had ever seen were women with eating disorders."
By the time he was 18 or 19 Saxen's weight was beginning to pack on and he was still a virgin. Thinking he was undesirable to women triggered a roller coaster of binge eating and dieting.
"I had unrealistic expectations about being a Joe six-pack," he said.
At one point, he went on a 700-calorie a day diet and dropped 100 pounds. At 21, an agent noticed Saxen's physique and asked him to do some modeling.
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"I was thinking I wasn't worthy of women, and the next thing you know I signed a contract on TV," he said.
But Saxen still hadn't dealt with his eating disorder and the "cognitive distortion" that goes with it.
"I thought through modeling, I would get the girl and get rid of the virginity problem," he said. But six months into the career, his eating went out of control again.
"I tried out for an underwear fashion show and all I had to do was lose five pounds," he said. But the anxiety paralyzed him.
"I had a large pizza, four or five king-size candy bars, ice cream -- 10,000 calories," he said. "Oh my God, I shot myself in the foot."
He called in sick to modeling gigs, refused to answer the phone calls and "basically ran away." For more than a decade he took itinerant jobs, had failed relationships and dabbled in drugs.
As his weight approached 300 pounds, Saxen happened across a book with a photo of his old, svelte body on the cover.
"What's wrong me me? Am I insane?" he said he thought, and knew something had to change.
He read books on the subject, learning that BED was not "gluttony," but a psychological condition listed in the DSM4. "All of a sudden I say, 'Wow, I have something with a name. I am not alone.'"
But his shame persisted, even following him into a therapist's office looking for help.
"I put on a sport coat, tie and carried a clipboard so if someone saw me in the waiting room they would think I was another therapist [and not a patient]," he said.
Through counseling, he learned to handle his stress and throughout recovery he decided to write his own book on the subject. Today, he is writing a novel that has elements of his own story.
"I am doing great now," he said at a healthier 210 pounds. "I am happy...My hope is that by telling my story, people will say, 'Here's a regular Joe.' An eating disorder took me out of modeling."