(CNN) — 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 8 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.
It’s a belief that is harmful and untrue, as around 1 in 3 eating disorders will affect men or boys, said Stuart Murray, an associate professor of psychiatry and behavioral sciences at the University of Southern California and director of the Translational Research in Eating Disorders Laboratory. 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.
This story was first published on CNN.com “The muscly guy at the gym may be at risk for an eating disorder, experts say“.
Monkeypox: Cases found and suspected in Portugal, Spain – CTV News
Portuguese authorities said on Wednesday they had identified five cases of rare monkeypox infection and Spain’s health services are testing eight potential cases after Britain put Europe on alert for the virus.
The five Portuguese patients, out of 20 suspected cases, are all stable. They are all men and they all live in the region of Lisbon and the Tagus Valley, the Portuguese health authorities said.
European Health authorities are monitoring any outbreak of the disease since Britain has reported its first case of monkeypox on May 7 and found six more in the country since then.
None of the eight suspected cases in Spain has been confirmed yet, the Spanish Health Ministry said in a statement on Wednesday.
Monkeypox is a rare viral infection similar to human smallpox, though milder, first recorded in the Democratic Republic of Congo in the 1970s. The number of cases in West Africa has increased in the last decade.
Symptoms include fever, headaches and skin rashes starting on the face and spreading to the rest of the body.
It is not particularly infectious between people, Spanish health authorities said, and most people infected recover within a few weeks, though severe cases have been reported.
Four of the cases detected in Britain self-identified as gay, bi-sexual or other men who have sex with men, the U.K. Health Security Agency said, adding evidence suggested there may be a transmission in the community.
The agency in Britain urged men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.
The Spanish Health Ministry and Portugal’s DGS health authority Spanish did not release any information on the sexual orientation of the monkeypox patients or suspected patients.
The two countries sent out alerts to health professionals in order to identify more possible cases.
(Reporting by Patricia Rua in Lisbon and Christina Thykjaer in Madrid; Editing by Inti Landauro and Alison Williams)
Long Covid Patients' Symptoms Helped After Vaccination in Study – BNN
(Bloomberg) — Fewer Covid-19 patients reported lingering symptoms from the infection after getting vaccinated, according to a study that suggests the shots could help alleviate the burden of long Covid.
A first vaccine dose after infection with the virus was associated with a 13% decline in the odds of having long Covid and a second shot with a 9% drop in the study published Thursday in the BMJ. Over the course of seven months in 2021, researchers regularly visited the households of more than 28,000 people to ask whether they were experiencing symptoms long after infection.
The findings, together with evidence that long Covid is reduced in those infected after vaccination, suggest that jabs may help decrease the prevalence of persisting symptoms.
“The large scale of this study means that we can be fairly confident about what has been observed, but it does not mean we can be sure what it means,” said Peter English, a former chair of the BMA Public Health Medicine Committee.
“The most obvious — and perhaps the most likely inference — is that vaccination does prevent at least some cases of long Covid, and may reduce the severity of symptoms,” he said in emailed comments. But “we cannot yet say this with any confidence.” English wasn’t involved in the research.
An estimated 1.8 million people in the UK had reported experiencing long Covid as of April 2022, with two in three people saying the symptoms had affected their day-to-day activities, according to the latest Office for National Statistics data.
The scientists who ran the study called for more research to “understand the biological mechanisms underpinning any improvements in symptoms after vaccination, which may contribute to the development of therapeutics for long Covid.”
©2022 Bloomberg L.P.
Europe, US on alert after new monkeypox cases emerge – Al Jazeera English
US, Spain and Portugal announce cases of rare viral infection, two weeks after UK identified its first case.
Health authorities are on alert for the spread of monkeypox, a rare viral disease first reported in the Democratic Republic of Congo in the 1970s, after new cases emerged in Europe, and the United States confirmed its first infection.
Portugal said on Wednesday it had identified five cases of monkeypox, Spain said it was testing 23 potential cases, and the US state of Massachusetts announced it had found a case in a man who recently travelled to Canada.
The United Kingdom was the first to confirm a case of monkeypox earlier this month. It has now detected seven cases and is working with the World Health Organization (WHO) to investigate the virus’s spread after being unable to make a link between the initial case, in a man who had travelled from Nigeria, and the more recent ones.
Health authorities suspect some of the infections may have occurred through sexual contact – in this instance among gay or bisexual men – with four of the UK cases identified among people who visited sexual health clinics after developing the rash associated with monkeypox.
“No source of infection has yet been confirmed for either the family or GBMSM clusters,” the WHO said in a statement in Wednesday. “Based on currently available information, infection seems to have been locally acquired in the United Kingdom. The extent of local transmission is unclear at this stage and there is the possibility of identification of further cases.”
Monkeypox, which is similar to human smallpox, typically begins with a flu-like illness and swelling of the lymph nodes, followed by a rash on the face and body. Most people recover from the illness, which is endemic in parts of central and western Africa and usually the result of close contact with infected animals, within a few weeks, but it can be fatal.
The five Portuguese patients, out of 20 suspected cases, are all in a stable condition, according to the country’s health authorities. They are all men who live in the region of Lisbon and the Tagus Valley, they added.
Health authorities in Madrid said the cases discovered in Spain appeared to be linked to sexual contact.
“In general, its transmission is via respiratory drops but the characteristics of the 23 suspected infections point to it being passed on through bodily fluids during sex relations,” they said in a statement, without giving further details.
“All of them are young adult males and most of them are men who have sexual relations with other men, but not all of them,” Elena Andradas, head of public health in the Madrid region, told Cadena Ser radio.
US health officials said the Massachusetts man who developed monkeypox went to Canada to see friends at the end of April and returned home in early May. He is currently being treated in hospital.
Jennifer McQuiston from the US Centers for Disease Control and Prevention (CDC) said while it was the only case the CDC was aware of, “I do think we are preparing for the possibility of more cases”.
The agency is in contact with its counterparts in the UK and Canada as part of the investigation, but McQuiston said no link had been established so far.
There are two types of monkeypox virus: the West African clade and Congo Basin (Central African) clade. The case-fatality ratio for the West African clade has been documented to be about 1 percent, and up to 10 percent for patients with the Congo Basin clade.
The WHO said that while smallpox vaccination has been effective against monkeypox, the end of mass vaccination programmes for smallpox meant people under the age of 40 or 50 no longer had that protection.
The UK has previously reported cases of monkeypox – all linked to travel to Nigeria – as has the US. An outbreak there in 2003 was traced to pet prairie dogs that had been housed with small animals imported from Ghana that were found to have the virus.
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