When Ryan Sheldon told his family he had an eating disorder, they chuckled in confusion. When he brought it up to his doctor, he was told they missed it because the doctor never would have thought he was at risk.
And when he started speaking about his experience publicly, one audience member — also a doctor — stood to say Sheldon had been misdiagnosed because he was neither extremely large nor thin, he said.
Sheldon, 34, who is chair of the ambassador program at the National Eating Disorders Association, has wrestled with problems related to body image since he was eight years-old.
When those problems developed into a concrete eating disorder, he had trouble identifying it and getting help in part because of the stereotype that eating disorders only happen in teenage girls.
In the United States alone, 10 million males will be affected by eating disorders at some point in life, according to the National Eating Disorders Association.
As the organization starts its awareness campaign Monday for National Eating Disorder Week, experts share how eating disorders impact men and boys and why they are often left out of the picture.
WHAT AN EATING DISORDER LOOKS LIKE
When thinking about someone with an eating disorder, many people think of a girl or woman who restricts food, exercises obsessively, or secretively binges and purges.
Men can experience eating disorders in that way, said Dr. Blake Woodside, medical director emeritus for the program for eating disorders at Toronto General Hospital and a professor in the department of psychiatry at the University of Toronto.
But men also feel pressure to conform to a few masculine body types that society deems acceptable, such as the muscular superhero and the lanky computer geek, Woodside said.
Some of those ideals encourage men to limit their calorie count, but others do the opposite and encourage excessive workouts, overloading protein and heavily restricting nutrients like fats and carbs, Murray said.
When does an interest in maintaining a certain physique become an eating disorder? It happens when your behavior and interactions start to be ruled by the restrictions you are putting into place for your ideal body, Murray said.
“What should be the yardstick is: Does it impact people’s ability to have a normal and a functioning life?” he said.
WHY THEY ARE HARD TO TREAT
If men are so impacted by eating disorders, why aren’t we hearing about it? Stigma and exclusion.
Although anorexia nervosa was first identified in both boys and girls in the 19th century, Murray said boys were excluded from the research and the diagnostic criteria.
Until recently, changes in breasts and loss of menstruation were key to diagnosing eating disorders, Murray said. Although the criteria have changed since then, men and boys are still excluded from most research into eating disorders, he added.
That exclusion can often lead to stigma, with men and boys — as well as those around them — not recognizing their behavior or hesitating to get help because they believe it threatens their masculinity to say they may have a disorder disease pigeonholed to women.
To make matters worse, disordered eating behavior in men is often championed in the world of social media, Murray said.
Celebrities and influencers post their excessive workouts, along with shots of their bodies and cheat day meals, which are meant to trick their bodies out of going into starvation mode so they don’t burn muscle, he added.
Without looking at the context of gender, almost every doctor would classify that kind of behavior as bulimia. In men, “we see it as a sort of prosocial way of becoming more muscular,” Murray said.
WHAT WE CAN DO
Many families and family doctors still aren’t familiar with the signs of eating disorders in boys and men, Murray said, so the first place to start is knowing what to look for.
Teen boys are human locusts, who often demolish every bite of food in their path, Woodside said. If you notice someone you care about abruptly changing how much or how publicly they eat, they deserve attention, he said.
If the men or boys in your life are making big changes to the activities and relationships in their lives, it might be time to take a closer look, Woodside added.
From there, there is good news and bad news.
The bad news?
“The eating disorder field has to treat boys and men based on treatment studies that included only females. We have to make this big inference that we are on the mark,” Murray said.
But the good news is that men and boys often do well when they go through treatment for their eating disorders, Woodside said.
At one point, Sheldon had lost his job, his money and his relationships to his eating disorder. It took years of specialized treatment and the help of support groups to get his body and his life back on track.
Now, he says the best way to help men and boys like him get into treatment is to share the often hidden truth: They are not alone.
VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.
Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.
In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.
The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.
Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”
Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”
This report by The Canadian Press was first published Sept. 16, 2024
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
