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NEDA TOOLKIT for Educators Are the issues different for males with an eating disorder? What do I say? Can’t people who have anorexia see that they are too thin? Some aspects may be different in males. Important issues to consider when talking to or supporting a male who may have an eating disorder include the following: Most cannot. Body image disturbance can take the form of viewing the body as unrealistically large (body image distortion) or of evaluating one’s physical appearance negatively (body image dissatisfaction). People with anorexia often focus on body areas where being slim is more difficult (e.g., waist, hips, thighs). They then believe they have “proof” of their perceived need to strive for further weight loss. Short-term weight loss and shape-change goals are often moving targets that can lead to a slippery slope of unhealthy weight loss. Body image dissatisfaction is often related to an underlying faulty assumption that weight, shape, and thinness are the primary sources of self-worth and value. Adolescents with negative body image concerns may be more likely than others to be depressed, anxious, and suicidal. • Stigma. Eating disorders are promoted predominantly as a female concern. Males may feel a greater sense of shame or embarrassment. • It may be even more important not to mention the term “eating disorder” in the discussion, but rather focus on the specific behaviors you have noticed that are concerning. • Keep the conversation brief and tell him what you’ve directly observed and why it worries you. • Eating disorder behavior presents differently in males. Although the emotional and physical consequences of eating disorders are similar for both sexes, males are more likely to focus on muscle gain, while females are more likely to focus on weight loss. What’s the difference between overeating and binge eating? Binge eating is distinguished by eating an amount of food within a specified time that is larger than the amount that most people would consume during a similar time and circumstance, and a sense of loss of control, or inevitability of a binge, such that the individual feels that he or she could not have stopped it from happening, and afterwards experiences shame and guilt. Sometimes, detailing daily eating patterns can be helpful in decreasing food consumption. However, it may be insufficient in addressing the underlying emotional or psychological components of an eating disorder and consequences of binges. Anyone who suspects that they may be suffering from binge eating disorder should speak with a trained professional in order to identify and address any underlying components. I know someone who won’t eat meals with family or friends, both in and out of school. How can he/she not be hungry? Does he/she just not like food? Most likely, the person is overwhelmingly preoccupied with food. A person with an eating disorder does not like to eat with others, does not like anyone questioning his/her food choices, and is totally consumed with refraining from eating. Is the person hungry? Yes! But the eating disorder controls the person. Page  | 7