After years of hard training, Thomas got kicked out of his football training center. The sixteen-year-old teenager who dreamed of being a professional player takes refuge in the sport he practices excessively. He is running and pushing for three to five hours a day and is starting to cut fat from his diet. The boy loses weight and withdraws into himself. Neither his entourage nor his doctors detect symptoms of anorexia. Yet he ticks all the boxes. Thomas is not a special case: this eating disorder is more difficult to detect in men. This late diagnosis can have dramatic consequences.
Unlike other eating disorders (ACD), boys are less affected by anorexia than girls. They represent 10% of people suffering from this pathology. “Eating disorders arise from psychogenetic vulnerabilities (psychic, biological, hormonal) and these concern women more”, explains Corinne Blanchet, doctor at the Maison de Solenn. “The environmental factor, with the slimming injunctions that weigh more heavily on girls, must also be taken into account. “But the figure of 10% would be underestimated according to the doctor because the diagnosis is more difficult to pose in the male race.
A characteristic excess of sport
“Nearly one in two boys who suffer from anorexia were overweight or obese before the anorexic episode,” says Corinne Blanchet, before recalling that this eating disorder is multifactorial. For them, it all starts with a diet, which may appear legitimate in the eyes of those around them or the doctors. “Except that this diet gets carried away and it is the entry into anorexia. “This is the journey that Luca, 22 years old, a former little” round “boy lived. To “improve physically”, he increases his sporting pace and begins to eat healthier. “Gradually I found comfort in losing weight”. At 14, he lost twenty kilos in four months.
“The speed of weight loss is also characteristic of male anorexia”, adds Isabelle Siac, psychologist specializing in TCA. “Sports hyperactivity also exists in girls, but is even more marked in boys, often with the idea of having a muscular body”. According to Corinne Blanchet, most anorexic men keep relatively correct food intake, which creates a deceptive effect and does not particularly worry those around them. But these amounts are not suitable for hyper investment in sport and, gradually, undernutrition and weight loss set in.
A taboo that does not encourage consultation
The difficulty in spotting anorexia in boys is also explained by less consultation. “Strength, whether physical or mental, is socially valued in men,” said Mickaël Ehrminger, researcher in public health. “To admit that you have a mental disorder is to admit a weakness. This weakness, Morgan, 26, hid it for a long time. “We have the image of the man who must be strong, who must protect his family. We cannot afford to show that we are doing badly. “
“In addition to the shame of having a mental disorder, there is also the shame of having a disorder considered to be female,” explains the researcher. Consequence: men consult less. “As a liberal, I have never received a single call from a boy to tell me that he thought he was anorexic”, testifies Isabelle Siac.
A lack of identification decreasing awareness
Men with this aTD are sometimes not even aware of it. Lack of identification plays a significant role. “I felt weird because I thought it could only affect girls,” Luca admits. He never met any other boys who suffered from anorexia, not even during his stay in a mental hospital.
If neither the sick person nor those around them sometimes detect the disease, health professionals can also miss it. “In women, one of the main revealing criteria is amenorrhea, the absence of periods,” explains the public health researcher. “In men, there is a decrease in libido and erectile dysfunction but they are often associated with depressive anxiety disorder. Isabelle Siac says that one of her anorexic patients was given testosterone for these erectile disorders without realizing that it was a symptom of the eating disorder.
A later diagnosis
When he was ill, Thomas saw his general practitioner regularly. He had, like the other students, several meetings with the psychologist of his sports-studies course. None detected his anorexia. “My doctor weighed me regularly but I have the impression that he closed his eyes. No one helped me understand my illness. It is by typing his symptoms into a search engine that the young man understands what pathology he has.
“Unfortunately, primary care physicians very often refer these boys to specialized services for abnormalities identified without making the link with anorexia nervosa,” laments Corinne Blanchet. Young men may spend several weeks in the hospital looking for hematologic, digestive, or cancer disease. A huge waste of time knowing that 7% of people with anorexia die of malnutrition or commit suicide. “Not to mention the risk of being iatrogenic, because these explorations, like a general anesthesia in a very undernourished boy, can cause complications. “
Quasi-resuscitation situations
Corinne Blanchet explains this late diagnosis by the lack of training of primary care professionals. “An attending physician who sees a boy who has lost a lot of weight is not necessarily going to think about anorexia, except unfortunately very late. The patients then arrive at the hospital in quasi-intensive care situations, with heart failure, massive undernutrition and a risk to life. This is the case of Luca whose heart almost stopped beating but also that of Morgan who had to stay for many months in the hospital. To make matters worse, “for the same build, men are less tolerant of weight loss than women,” adds the doctor.
And during this long period of medical wandering, anorexia sets in. “Boys can sometimes say to themselves that if they have been able to live so long with the disease, they can go on like this,” laments Isabelle Siac.
Lack of representation
To avoid this situation, Luca, Morgan and Thomas decided to speak openly about their old illness. “We must talk about it to participate in the destigmatization of the phenomenon and so that the men who suffer from it feel less alone,” said Luca. Morgan regularly discusses his anorexic episode on his Instagram account. “The sick say to themselves that if I could do it, they can do it too. “
One day while walking in a bookstore, Luca saw several books of testimonies of women who suffered from anorexia. But not a single man. So he decided to write his own.