At the age of 43 I have found out that I am a man with an eating disorder. A bit late isn't it?
Eating disorders in men go undiagnosed and untreated according to statistical research. Eating disorders in women have been extensively studied, as well as the reasons such as unrealistic body images peddled in media and entertainment, being most of the time, part of the cause. But very little narrative exists on how men experience male body image in the media and very little is done with the fact that it is estimated that 10 million boys and men will have an eating disorder in their lifetime in the United States alone, let alone worldwide.
According to a study by the University of Malta's Faculty of Social Wellbeing (2021) we may have an estimated between 1500 to 2000 young people aged 10 to 16 diagnosed with an eating disorder, which is considered to be a figure that raises concern. I can tell you dear reader, that I would have been part of that cohort back in my teens in the 1990's when Haddaway's "What is Love" was played incessantly on every 2000 watt sound system in Fiat Uno's. But my generation had little education about eating disorders. PSE (today PSCD) was a novel subject with no syllabus, mostly a niche in which low-loaded teachers of other random subjects were transferred to, in order not to end up redundant. Psychosocial services at my school were in the form of a rare moment of kindness by an otherwise very strict prefect of discipline, and a Mars chocolate bar from his desk drawer.
I had no idea until the past year that I have an eating disorder. I may have been in denial of course, but only recently was when I faced facts, because nobody EVER pointed it out to me and it was only through self-reflection and personal research that I came to the conclusion - eating disorders, we are conditioned to think, are a "girl problem". This misconception among men, educators and healthcare professionals is the reason why we miss diagnoses and treatment. So, thankyou toxic masculinity and patriarchy for more damage done to men from your backfiring, culturally oppressive strategies.
There are different brands of eating disorders but mine is in the form of Binge Eating Disorder (BED). The DSM-5, which is the manual of what is a disorder, or mental illness, for mental healthcare professionals. BED was not considered a disorder in the previous DSM-4. There are 5 principles, or criteria, that describe behaviours to be considered for a possible BED diagnosis, and well....I check them all:
Criterion 1
Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: eating, in a discrete period of time (for example, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances; a sense of lack of control over eating during the episode (for example, a feeling that one cannot stop eating or control what or how much one is eating).
Criterion 2
The binge-eating episodes are associated with three (or more) of the following: eating much more rapidly than normal; eating until feeling uncomfortably full; eating large amounts of food when not feeling physically hungry; eating alone because of feeling embarrassed by how much one is eating; feeling disgusted with oneself, depressed, or very guilty afterwards.
Criterion 3
Marked distress regarding binge eating is present.
Criterion 4
The binge eating occurs, on average, at least once a week for three months.
Criterion 5
The binge eating is not associated with the recurrent use of inappropriate compensatory behavior (for example, purging) and does not occur exclusively during the course Anorexia Nervosa, Bulimia Nervosa, or Avoidant/Restrictive Food Intake Disorder
(American Psychiatric Association 2013).
I really have nothing much to add to describe what I do because the DSM-5 outlines it all, very accurately. The shame and stigma is very real, which only serves to compound the need to binge. It is very much similar to a self-harming cycle, in which the stuffing session offers a temporary relief, only to result in more shame that triggers even more bingeing.
But many might say "we have seen you in performances and you were fit". I would answer that they are completely right. I won't go all the way back to 2002, but in 2010 I lost around 20Kg in just a few months using the Atkins diet, which was to me, a quick weight loss remedy, but had a big impact on my health and I ended up gaining more weight afterwards. I do not recommend Keto diets from my personal experience. Take 2017 for instance, when I played Phantom: in 8 months I shed almost 30Kg of weight for the role with a healthy, balanced diet and exercise. It was a special year and that role is not only special for me because of the nature of it, but because it was the main motivator behind a healthy change in my life. But alas, the weight returned by 2019, and one can see the weight back in my role of Gomez Addams in Addams Family - A new musical. I tried intermittent fasting and I realised I wasn't lucid in my mental processes during the day to sustain such a long fasting period, and of course I failed miserably.
Come 2021 I discovered 'The Sixpack Revolution', which I believe to be the best weight-loss programme out there, and in 75 days I lost again around 25 Kilos, with a healthy balanced diet and exercise. I took it very seriously and did not derail once in those 75 days. Not only that, but I also improved my mental clarity and practically had never been healthier in terms of blood pressure, asthma, etc. SPR has a great team of professionals and it is built and devised by great coaches and mental health professionals. I trust it fully and it is that programme that I kept up longest after having completed it.
I kept this up for quite some time all the way till the end of 2022. It's 2023 and I have never been heavier than I am today. So the weight came back and brought more uninvited friends for the party, due to the metabolic decline that these up-and-down trends can do as well as worsening conditions of the disorder.
This is called Yo-yoing, which is very closely linked to Binge Eating Disorder. We gravitate to fads, diets and programmes because we feel the pressure to change, especially if we work in entertainment or show business. Many think that by losing weight they will be more accepted, more popular, or they will hate themselves less. They might think that their relationships will be better or simply that they will be happier and less depressed. In this vulnerable state we may think that losing weight (or gaining weight for people with anorexia for instance) will be the answer to our problems. But since the real reason behind the eating disorder is not worked on, the weight will inevitably return and usually bring more of itself.
If you have BED and you're obese, the weight loss needs to be a self-caring act for the sake of one's own health. It will not eliminate the trauma or family history and other reasons behind the bingeing.
What am I doing about it?
I am back with a weight loss programme and of course, it had to be the already tried and tested 'Sixpack Revolution'. I know I am going to succeed as I have done before, in terms of weight loss, but I am also seeing a therapist because losing weight is not the cure for Binge Eating Disorder.
I am also writing this blog - it is cathartic for me, and as an educator I am hoping that someone might read it and understand themselves a bit better through it and feel they are not alone in this. In 40 years, I did not have the opportunity of someone pointing out to me "Hey you might actually have an eating disorder - find some help." I was told I'm fat and need to lose weight, and I was told "well done" when I did. But that's it. I hope someone out there who might be going through similar stuff can read this and feel less apathy. It can be fixed.
It is the first time that I have opened up about such mental health issues, both with my friends and to the public. Mental health is still taboo in Malta, and even more so in Asian countries where I also have sense of belonging to, due to my Filipino heritage. The shame and stigma need to go.
What would I like to see happen around me?
We definitely need more awareness on eating disorders in Malta, especially BED, since it is something that is more recently explained than other disorders. After all, Malta is the most obese country in the European Union. Could it be the case that we are affected by high rates of undiagnosed and untreated eating disorders, especially BED? If so, Why is there not enough awareness and material about these issues in schools? Why aren't people more aware of help services such as Dar Kenn Għal Saħħtek? What about their funding and presence in schools? At the risk of sounding cheeky, I personally believe that sessions with them in schools are more useful than say, Lenten talks (particularly if one is not Catholic), and these should be done every single year. But education and awareness alone is not enough;
We should strengthen psychosocial services in schools. We need more child therapists and educational psychologists in schools to deal with all the cases we have. Therapeutic interventions should not fall in the hands of guidance teachers who are NOT trained psychotherapists. But we simply do not have enough psychologists for all our students. We should also provide teachers with professional development and training sessions in the area for increased sensitivity to such issues.
We need to once and for all, clean up our act when it comes to school canteens and tuck shops. The healthy eating policy is a sham because no matter what, we still find pastries, oily foods, pizzas, salty snacks, processed meats and burgers. Then once in a while the school organises a "healthy smoothie day" as a fund raiser, after however, numerous "Jeans and Hot Dogs" days. Junk food is cheaper than healthy food and will sell more and that is why it seems, we will never get rid of these fattening wheat-based goods in schools. Let's also not forget the bread and processed meats the children bring from home on a daily basis, which after they consume, they will still buy the pizzas and pastries from the tuck shop.
People with BED see food as drugs, and we are psychologically addicted to it. At least while at school, we could eat a bowl of couscous or buckwheat (I bet many kids have no idea what this is) or Bulgur wheat rather than bread, pizzas and pastries.
We need to disarm and dismantle toxic masculinity in Malta. I believe that the machistic culture we have is the reason behind many social ailments, including undiagnosed mental health issues in men. Not just mental health, but health issues in general. We have worrying statistics of young people refusing to use condoms even in a country with high rates of sexually transmitted diseases, and I assure you it's not the PSCD teachers not doing their job, but the machistic culture, the conservative culture and the toxic masculinity we have in our culture are the culprits. Just like "Real men don't cry" we have "Real men don't use condoms".
We need doctors to refer obese people to eating disorder clinics even if the patient is not visiting them for that reason, and we need to allow healthcare professionals and educators to call a spade a spade. If a person is underweight, it raises concern but looking like a coat hanger makes one model material, right? So everyone stays quiet. If a person is fat, we are not allowed to say so because it's fat-shaming. So they're silenced too. We have created a culture in which obesity, or rather extremes, are celebrated.
Lizzo termed herself the "beauty standard" and that is fine and all, except for the fact that the problem is having "standards" at all. There are people who find it highly unrealistic that they could ever be like Lizzo as well. Why the undue pressure? All people have beauty in one way or another, but society needs to be allowed to say what is unhealthy and what is not without being gagged so that people can find the help they need. Balance is what is healthy, not extremes, but balance is not necessarily beautiful. Beauty and weight do not go hand in hand. But saying that being overweight or underweight is unhealthy, is what education and healthcare should do, without being accused of "fat-shaming".
For help with your mental health or your eating disorder, contact Dar Kenn Għal-saħħtek, Helpline 179, Kellimni.com, Aġenzija Appoġġ.