The first time Aaron told me he was fat, I couldn't believe what I was hearing. A 5'11," 160-pound swimmer, he was lean and lanky, and as I thought privately, too thin. Yet there I was, sitting with him in the parking lot of his high school, listening to him as he complained about his body.
"I' going on a diet," he told me.
That should have struck a warning bell for me. But, after all, who was I to say--or know--anything? Barely 14 years old, I was constantly going on diets myself, trying to lose those extra pounds so that I could keep modeling after school and on weekends. I hardly paid attention to what he was saying, brushing it off as a joke. If anything, I was too concerned with my own body at the time to worry about his.
Yet it would be Aaron who would lose 25 pounds in the next two months. Swimming three to four hours every day, barely eating any food, he managed to bring himself to the brink of near-starvation. His eyes were dull in his bony face and his skin clung to his frame like gray sandpaper.
When it first started happening, I assumed it was because he had just broken up with his girlfriend, Since we went to different high schools, I rarely saw him during the school year. So when I heard, from mutual friends, what Aaron was doing to himself and how his body was degenerating, I couldn't believe it. None of us understood what was happening to him.
The truth was almost beyond our comprehension. Aaron was suffering from anorexia nervosa.
It's a disease that has gradually been acknowledged in American society. After almost two decades of books and magazine articles and TV talk shows, people are aware now that eating disorders exist. They vary from cyclical pattern of binging and purging (bulimia), to the rapid loss of body weight (anorexia), to eating when depressed or to relieve stress (compulsive eating).
Women comprise the majority of these cases; an overwhelming 95 percent of all victims of eating disorders are female. According to a recent study conducted by Associate Professor of Psychology Todd F. Heatherton, five percent of women undergraduates and one percent of men at Harvard have eating disorders. In a 1992 survey, Heatherton found that 55 percent of women said they were often or always dieting, compared with 40 percent of all men. While one out of five undergraduate women here indulge in bingeeating behavior, only one out of 20 men do the same.
The reason is obvious: there is much more pressure on women in western society to be thin, while underweight men are regarded as effeminate. Women's health and beauty magazines consist chiefly of articles aimed at weight reduction, but magazines geared to men focus on physical fitness rather than slenderness. Indeed, this produces its own complications: studies have shown that one to three percent of all college seniors and approximately 85 percent of all football players have taken anabolic steroids to build muscle mass at one time or another.
Yet eating disorders in women were only picked up on in the mainstream media in the last 20 year. Historically, the first well-documented case of anorexia nervosawas a 16-year-old male in 1694, Reports were published in the 17th, 18th and 19th centuries describing self-starvation in adolescent males.
Ironically, today, may physicians, when face with a painfully thin male, would be at a loss. "I don't' want to say that there's a bias against spotting eating disorders in men, but it's certainly much less likely to be diagnosed as quickly as in a women," says Heatherton.
Indeed, Aaron's dogged determination to lose weight was cloaked by his intense training regime. No one though it was strange when he began adding another hour or two to his already rigorous two-and-a-half hour swim practices. He managed to persuade his coach that, after his most important meets were over, he would regain the weight he had lost.
"Eating disorders in men aren't always clinical," says a male member of Eating Concerns Hotline and Outreach (ECHO), the eating disorder support group at Harvard. "They can get to clinical proportions, but most men, especially male athletes, aren't losing weight because they think they're fat. It's not about a loss of control." Male jockeys, wrestlers, swimmers and even dancers are all vulnerable to eating disorders because their professions necessitate weight restrictions. Yet while they may engage in aberrant eating practices, they resume regular eating patterns during the off-season.
Perhaps the one sport that has attracted the most attention in this wrestling themselves of food and fluids to "make weight" for matches. A survey at a major college wrestling tournament in the late 1980s revealed that 41 percent of wrestlers reported weight fluctuations of between five and nine kilograms every week of the season. While there are obvious short-term advantages to such a practice, weight "cutting" can throw off a wrestler's metabolic rate and can increase his risk of developing cardiovascular disease.
According to Dr. Arnold E. Anderson, associate professor of psychiatry at the Johns Hopkins University and director of the Eating Disorders Clinic with eating disorders both make tremendous psychological and physical investments in their bodies In an article entitled "Eating Disorders in Males: A Special Case?" Anderson claims that both male athletes and anorexics abuse substances in attempts to achieve near-impossible goals of body weight or muscular definition. Whether it be steroids or laxatives, in Machiavellian terms the end is though to justify the means.
Yet males with eating disorders, although a rarity, are different from male athletes who attempt to lower their body weight during the off-season. Anderson's studies document that males have a higher probability than women of having been obese prior to the onset of their eating disorders. Both males and females with eating disorders often come from families with affective disorders and have personal histories of mood an personality disorders. Various theories have been tossed around about what type of male is more susceptible to an eating disorder--some suggest that the incidence is higher among homosexual men while others imply that men who grow up with overbearing mothers are at greater risk--but these theories have been challenged and modified so many times that it seems impossible to determine what is fact and what isn't.
It wasn't until I reached college that it sunk in for me that Aaron was suffering from an eating disorder. It was only then that I found out the "true" story, through a friend--that Aaron's' bewildered parents had quietly slipped him into therapy, that he'd been kicked off the swim team until he gained the lost weight back, an that he spend a month with the threat of hospitalization over his head. He never the years that followed. but then, why should he have? I had female friends in high school with eating disorders that were tactfully even brought up, even in moments of intimate conversation.
Aaron is symbol of the tragic consequences of a society obsessed both with food and standards of physical fitness and thinness. Some may wonder why I focus on him, when the great majority of victims of eating disorders are female. Yet male eating disorders deserve to be talked about because they so rarely are presented in the mainstream media or brought into the public consciousness.
Our culture is one that seems unable to reconcile notions of physical fitness with notions of healthy eating and exercise patterns. Until we do, eating disorders and related behavior aberrations will be a prevalent part of our society--for both males and females.