Males need help with body killers

Happily it is much more socially acceptable for men, young men and boys to seek professional psychological help by having psychotherapy or counselling these days.

So there are more opportunities for boys and men to change, and in some cases to save their lives.

Given that eating disorders and steroid use can prove fatal - it is so important for men to accept they need to seek help in the knowledge that they will be treated with respect and empathy, not criticism.

Now there is news that men and boys affected by eating disorders are often not spotted and think that only “fragile women are affected by eating disorders”, and so they are not given the help they need and all too often don’t seek it. At the other end of the spectrum it seems more men wanting to bulk up their bodies are using steroids, with one study revealing a staggering 645% increase in men injecting the drug, which is also taken by mouth.

Male eating disorders are "underdiagnosed, undertreated and under-researched".

As well as increasing the risk of strokes and heart attacks, steroids can have considerable impact through mood swings, triggering domestic violence and damage to relationships and users’ jobs. Use can cause heart, kidney and liver disease, make hair fall out and impair fertility. Ironically for a drug aimed at bulking up the body it can reduce the size of a man’s testicles and cause stunted growth in adolescents.

If you or someone you know has a problem with eating or drug use, of any kind, then the good news is that therapists who have undertaken special training can use wonderful research-based techniques especially for tackling eating disorders and also for addressing body image, drug use and issues such as self-respect.  

Clients need to receive empathy, respect and genuineness from their therapist, but added special techniques have been found in research to be particularly effective.

So if you are going to see a therapist, I suggest that you ask if they have had special training in the latest research-based techniques to help clients with eating disorders or drug use.

Eating disorders

Eating disorders are complicated conditions. There can be a large range of different factors, including genetics and the person’s childhood, experiences, friendships and environment affecting the risk plus commercial body image, social and cultural influences which turn into pressures and stresses.

Just because there might be a genetic link however, it does not mean that an eating disorder has to emerge.

Low self-esteem, distorted perceptions of their bodies, anxiety, trauma and loss are amongst many factors which can be involved with people living with an eating disorder, frequently wearing the mask every day pretending to other people that they are “fine”.

Eating disorders are thought to be the most dangerous mental health issue because such disorders are the most likely to kill the person affected.

Sometimes it is linked to trauma such as rape, parental break ups or abuse. Sometimes it is linked to loss, such as the loss of a partner, close friend or relative, or the loss of a job or university place.

Secret club

In some cases a person has met a very influential “friend” who has an eating disorder and they are “sold” the idea that adopting the eating disorder lifestyle is a “cool” thing to do, like being part of a secret club.

The habit of repeated negative behaviours, which can include eating piles of food and then secretly vomiting, can become deeply ingrained. It also often has considerable impact on people close to the person affected.

Where appropriate (and with the permission of the person living with an eating disorder) it can be useful to work with their family and explore how the person has been affected by things happening in the family, helping to boost support from their family or friend network.

A massive industry promoting men looking good has expanded in recent years, with many boys and men feeling under pressure to have the perfect body shape.

The BBC reports that: “Researchers from the University of Oxford and University of Glasgow interviewed 39 young people aged 16 to 25, including 10 men, about their experiences of diagnosis, treatment and support for eating disorders."

They say young men with eating disorders were "underdiagnosed, undertreated and under-researched".

This is partly because the men themselves were unaware of the symptoms, despite purging, not eating for days or obsessive calorie counting, they said.

"Our findings suggest that men may experience particular problems in recognising that they may have an eating disorder as a result of the continuing cultural construction of eating disorders as uniquely or predominantly a female problem," said Dr Ulla Raisanen and Dr Kate Hunt.


Steroids are taken orally (by mouth) or injected into the muscles. Many users are unaware of the dangers.

Using injectable drugs also puts users at risk from serious blood-borne diseases such as hepatitis B and C and HIV. Plus there is the risk all drug user face of connection with a sometimes dangerous drugs culture and financial trouble.

The BBC reported yesterday (9th April 2014) that the National Institute for Health and Care Excellence (NICE) says there has been “a dramatic increase in those using performance or image enhancing drugs in the last few years.”

A needle exchange scheme has found a staggering 645% increase in people injecting steroids.

Steroids are a class C drug. Side effects range from acne and hair loss to heart and liver problems and scary mood swings which can turn nasty.

NICE says, “long-term steroid use can affect some of the same brain pathways and chemicals—including dopamine, serotonin, and opioid systems—that are affected by other drugs, and thereby may have a significant impact on mood and behaviour.”

“Abuse of anabolic steroids may lead to aggression and other psychiatric problems, for example. Although many users report feeling good about themselves while on steroids, extreme mood swings can also occur, including manic-like symptoms and anger" (e.g., “road rage”) "that may lead to violence. Researchers have also observed that users may suffer from paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming from feelings of invincibility.”

NICE adds that: “ kidney impairment or failure; damage to the liver; and cardiovascular problems including enlargement of the heart, high blood pressure, and changes in blood cholesterol leading to an increased risk of stroke and heart attack (even in young people)."

Steroid use commonly causes severe acne and fluid retention, as well as several effects that are gender and age-specific:

  • For men—shrinkage of the testicles (testicular atrophy), reduced sperm count or infertility, baldness, development of breasts (gynecomastia), increased risk for prostate cancer
  • For women—growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice

  • For adolescents—stunted growth due to premature skeletal maturation and accelerated puberty changes, and risk of not reaching expected height if steroid use precedes the typical adolescent growth spurt


Returning to eating disorders, shockingly anorexia nervosa can lead to a slow heart-beat.

People living with anorexia do not think about food in the same way as other people. So it starts to affect their behaviour in various ways which can also harm relationships with other people. For example, NICE reports that they may:

  • tell lies about eating or what they have eaten
  • give excuses about why they are not eating
  • pretend they have eaten earlier
  • lie about how much weight they have lost
  • find it difficult to think about anything other than food
  • spend lots of time reading cookery books and recipes.

They can also refuse to weigh themselves except in private.

NICE adds: “Someone with anorexia nervosa strictly controls what they eat. For example, by:

  • strict dieting
  • counting the calories in food excessively
  • avoiding food they think is fattening
  • eating only low-calorie food
  • missing meals (fasting)
  • avoiding eating with other people
  • hiding food
  • cutting food into tiny pieces – to make it less obvious they have eaten little, and to make food easier to swallow
  • taking appetite suppressants, such as slimming or diet pills."

NICE continues that signs of anorexia apart from weight loss can include:

  • fine downy hair (lanugo) growing on their body
  • more hair on their face
  • their pubic hair becoming sparse and thin.

“Their heartbeat may be slow or irregular, which can lead to poor circulation. They may also:

  • have pain in their abdomen (tummy)
  • feel bloated or constipated
  • have swelling in their feet, hands or face (known as oedema)
  • feel very tired (fatigue), as their sleep patterns may have changed
  • have low blood pressure
  • feel cold or have a low body temperature (hypothermia)
  • feel light-headed or dizzy.”

Bulimia nervosa 

Bulimia involves binge eating and getting rid of as much food as the person can, sometimes called purging. They often consume substantial quantities of food in a short time followed by trying to purge themselves, usually by vomiting, taking laxatives, stimulants or diuretics.

Some people excessively exercise.

Contrary to popular belief, people living with bulimia are not necessarily thin and are often of average weight and in some cases may even be overweight.

It often involves a considerable feeling of guilt and sometimes eating other people’s food if they are visiting or flat sharing. I have known people who then feel ashamed and go out to buy the food to replace what they have eaten and whilst they are out eat even more food and then return to purge again.

Vomiting can lead to blood loss and the rupture of the pipe leading to the stomach, the oesophagus. It can also cause an electrolyte imbalance in the body, which can trigger fatal heart problems.

The vomiting can cause serious dental damage.

Do you or does someone you know often disappear to the bathroom?

Like anorexia it can spiral out of control and lead to hospitalisation for weeks and even months. So the sooner it is addressed the better.

Eating disorders can be so disabling that it is impossible for a person to study or work without treatment.

Eating disorders often go hand in hand with other psychological problems which need to be constructively tackled. In particular I have found people affected by anxiety, depression and avoidance behaviours.

A reported Columbia State University study in 1985 found 88% of people with bulimia had a mood disorder and 70% depression.

So if you think you or someone else needs help around body image, or with any other challenges or goals, you can take that step now or today or this week by calling a qualified experienced psychotherapist.

It could save a life and transform a life…

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Leamington Spa CV31 & Warwick CV34
Written by Penelope Bould, MBACP +Addiction Professionals Regd. Psychosexual. Cpls. CYP
Leamington Spa CV31 & Warwick CV34

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