July 29, 2008

Publication: Irish Independent

Date: Tuesday, July 29, 2008 Page: 15

Author: Gemma O' Doherty

Headline: Eating disorders – boys suffer too

Diseases like anorexia are normally associated with young girls, but their male counterparts are increasingly at risk. By Gemma O'Doherty Jack* had fish and chips for tea last week after a family day out at the beach. For him, it was the meal from hell. He winced as an overweight Italian doused the grease-lined bag with salt and vinegar. It is a look his mother Margaret* has come to dread. On the journey home along the Wicklow coast, she watched her 12-year-old son from the rear view mirror performing his meal-time tricks holding a chip up to his mouth, grimac- ing, pretending to chew, then stuffing it back into the bag or the pockets of his shorts in disgust. From time to time, he caught his mother's eye, attempting a smile for fear his charade would be exposed. But the contact, as usual, didn't last long. He'd look away and stare into a distant field, venturing into the other world that Margaret tries so desperately to reach.

It is a scenario faced by all families of children struck down by anorexia nervosa. In their relentless pursuit of thinness, the desperate measures to avoid food become part of normal family life. Some smear their dinner into their hair to try and conceal it. Others hide it in their under- wear or vomit into their school bag after their packed lunch. Like heroin addicts in need of a fix, no act is too vile or extreme in their mission to stay thin. What makes Jack different is that he is one of a growing number of young Irish boys falling victim to anorexia nervosa, a disease long thought to be exclusive to teenage girls in search of the perfect body. Only now, doctors are beginning to realise this chilling condition has many faces, and can have just as devastating an impact on boys as it does on girls.

Specialists who treat the illness say more and more boys are walking through their doors, demented by food, fixated with calories, emaciated from self-imposed starvation. They see the same tell-tale signs as they do in the girls they treat: the wrinkled skin, the crumbling bones, the defiant refusals to reveal a dreadful secret. Dr John Lehane, a Cork- based GP and co-author of a new book, In Search of Thinness: Treating Anorexia and Bulimia, believes at least 200 boys will be treated in his region this year alone, but that is just the tip of the iceberg. "For every one that is seen, there is at least another one who we never hear about," he says.' "The boys I see with eating disorders are very gifted, highly artistic, from all sorts of social backgrounds, but unlike girls, they can be harder to treat as they often find it very hard to talk and open up. "Typically, they are silent, they grunt at you, they are very hurt, they are very deep. The relationship with their siblings and parents is usually far from perfect." A new study has revealed that while llpc of Irish girls are at risk of developing an eating disorder, at least 3pc of boys are in danger, but their needs are often overshadowed because of the perception that only teenage girls mess with their weight. Experts believe the real figure is much higher and that many young males go unrecognised and untreated.

According to Bodywhys, an Irish organisation which offers support to people with eating disorders, men now account for lOpc of anorexia and bulimia sufferers, as they come under increasing pressure to fit "an unrealistic ideal of male physique." "Wrinkle creams, waxing, there's even a male girdle nowa days, so it's no wonder men are becoming obsessed with their appearance and their weight," says Suzanne Horgan, psychotherapist and founder of the Eating Disorder Resource Centre of Ireland. "Now that obsession is trickling down to young boys. In the last week, I have been contacted by the families of a 10-year old and a 12-year old boy with the condition.. They are getting younger all the time." In Britain, a new book called Boys Get Anorexia Too was written by Jenny Langley, the mother of an anorexic boy Joe, who came close to death at the age of 12. A gifted child, talented at sport and very popular at school, one day Joe started to physically disappear. Within four months, he had lost 25pc of his body weight and had become dangerously ill. He spent another four months hospitalised under a strict regime where his every move  was monitored. Without that help, it is unlikely he would be alive today.

Involvement in high endurance sports such as running and gymnastics is a risk factor for anorexia in boys. In the case of Joe Langley, his obsession was fitness rather than reaching size zero, which his mother suggests can be beneficial in treatment. "My son wanted to lose weight to be better at sport, so he completely defeated his objective by getting so weak that he couldn't even walk upstairs. That meant that he had a real carrot to get better so he could play sports again." But when anorexia strikes, doctors say there is virtually no difference between boys and girls in the way it takes control of their lives. It can, however, be harder to spot in young males. One of the first diagnostic signs in anorexic girls is the cessation of periods. When girls cut out sweets and fatty foods, it can also spark alarm bells in the family. However, when boys take similar action, it is often put down to a newfound interest in fitness and a desire to do better at sport rather than a craving to be thin.

Medical Director of the Eating Disorder Programme at St Patrick's Hospital in Dublin, Dr John Griffin is one of the country's most experienced medical experts in anorexia. When he began working in the area in the 1970s, 5pc of his patients were young males; today they represent more than 15pc. "There were hardly any gyms 25 years ago," he says. "Men were not nearly as image conscious as they are today. And that is what is goes back to in the end: body image. Despite the perception, anorexia is a genderless disorder. "You are just as likely to hear the question 'Does my bum look big in this' from a boy with an eating disorder as you would a girl. We have a 16-bed unit in the hospital with two males in it. They blend in really well with the girls and the girls get on really well with them. "They are an exact mirror image of girls with the disease. They are perfectionists, high achievers, good at sport, good at school, and very, very good at anorexia. *Not their real names

Information about eating disorders is available from Bodywhys (1890 200 444; www.bodywhys.ie or The Eating Disorder Resource Centre of Ireland (053 913 0506; www. ea tingdisorders. ie)