Ah, que pena

We know that young women with eating disorders often feel intensely ashamed, and may hide their problem. With anorexian, they often cover up with baggy clothes and pretend at mealtimes that they've already eaten. With bulimia, embalagens vazias de alimentos podem ser contrabandeadas para o lixo e banheiros públicos usados para purgação.

Mas os homens não 'devem' se preocupar com o peso deles, e certamente não são esperados a mostrar que são vulneráveis. Como 'todo mundo sabe que transtornos alimentares são um problema de meninas', admitir não apenas angústia emocional, mas também uma resposta aparentemente pouco masculina, carrega um estigma duplo.

Muitos dos fatores que levam aos transtornos alimentares diferem entre homens e mulheres. Homens que desenvolvem transtornos alimentares frequentemente been overweight at some point. Women, on the other hand, are more likely to have felt they were overweight when they weren't. Men are also more likely to worry about their weight because of how it might affect their athletic ability: for women, a 'beautiful' body is an issue all by itself.

While most men with eating disorders aren't gay, men who are gay are up to 10 times more likely than heterosexual men to develop an eating disorder. Interestingly, lesbian women are menos propensos a se preocupar about their appearance than gay men.

Muscle dysmorphia - an obsession with developing the right muscles, which has much overlap with eating disorders - is much more common in men than in women. Closely linked to this is the use of anabolic steroids, as quanto em homens as anorexia and bulimia combined in women.

Se um instrutor de fitness pedisse a uma empresa de vídeos que produzisse um vídeo de exercícios no qual eles deliberadamente escondessem seu corpo tonificado, provavelmente seriam dispensados rapidamente ou considerados loucos. Da mesma forma, nenhuma revista vai deixar uma foto na primeira página em que a modelo tenha uma barriga flácida saindo debaixo da camisa: todo mundo sabe que a beleza vende. E Photoshop^® means they don't have to.

Few icons have either the power or the inclination to fight back - when Kate Winslet announced that she was refusing to allow her photos in a recent cosmetic advert to be photoshopped, it made international headlines. Yet young women who watch exercise videos led by an instructor in a body-contour outfit are more likely to feel unhappy afterwards, compared to doing the same workout while watching the same instructor de forma mais discreta.

Men, too, are more likely to be dissatisfied with their bodies when they're exposed to images of muscular, idealised men. These same images are more likely to causemento drive themselves at the gym to aumentar sua própria musculatura - and, as we've seen above, a desire for the perfect muscular body is often a precursor to an eating disorder in men.

Then there's social media - do endless carefully vetted images of everyone you know having a marvellous time, or pictured only in the most flattering poses, play a role? Dr Sandeep Ranote is a consultant child and adolescent psychiatrist, who has specialised in eating disorders for 15 years. She warns that we ignore this element at our peril. "We would be naive to say that there is no link between social media and eating disorders as well as other mental health problems like low self-esteem, depression and self-harm. We don't have absolute proof yet, and we don't know how to deal with it - but we definitely need to keep looking at it."

Como em tantas áreas da vida, prevenir é melhor do que remediar. Os médicos têm o dever de reconhecer que os homens podem apresentar sinais iniciais diferentes de um transtorno alimentar em comparação às mulheres, e de manter isso em mente como uma possível hipótese diagnóstica.

A indústria da moda finge se comportar de forma responsável em relação à imagem corporal: já vi inúmeras histórias ao longo dos anos sobre as casas de moda '< a > unindo forças para banir modelos de tamanho zero < /a >', mas eles constantemente retornam. Para os homens, pode ser ainda mais difícil. Em um mundo onde os níveis de obesidade estão aumentando rapidamente, a forma física tem grande prestígio social e o físico bem-tonificado do atleta provavelmente não ficará impopular tão cedo.

Dr Ranote is convinced that who gives the message is crucial. "Using role models is, if anything, more important for boys and men than for girls and women. Men will engage with their stories - the Campanha Estado de Espírito, set up six years ago by the Liga de Rugby e Rugby Union, has done amazing work in raising awareness of mental health problems. They've largely focused on depressive disorders, but they're starting to look at eating disorders as well, getting people to start conversations at local club level. The Associação de Futebol (FA) is also working at local levels to raise awareness - I would love to see the FA working with the Royal College of Psychiatrists so we can maximise our impact. I would love the English Cricket Board doing more - they have the power to get through to men in a way that doctors never could."

There are other shining examples of how we can beat the stigma. The brave decision of the international rugby referee Nigel Owens vai compartilhar sua batalha de 27 anos contra a bulimia is a case in point. You don't get much more manly than a rugby referee. And if it could happen to him, it could happen to anyone.