Testosterone deficiency and depression: signs of an eating disorder in men

According to a survey conducted on more than 1,000 young Russians by the online school of psychological professions Psychodemia (part of Ultimate Education) and the educational community for teenagers and youth from UNESCO “Dvor”, 57.7% of respondents are dissatisfied with their bodies. Among men, those aged 16-21 and 22-27 are the most likely to be dissatisfied, at 39% and 21% respectively. Meanwhile, 81% of male respondents at risk for developing eating disorders (ED) have experienced figure judgment. Of these, 51% were aged 16-21 and 22% were aged 22-27.

Experts spoke about the main risk factors for the development of RPD in men and the adverse health consequences of eating problems.

Social factor

It is quite difficult to objectively assess the frequency of RPP in men due to the low rate of diagnosis, as they are less likely to seek help. Stigmatization in society and lack of awareness also play a role.

The main factors of RPP occurrence in men, as in women, are social. Thus, according to a study, 39% of young people surveyed, after watching glossy or social media celebrities, began to feel dissatisfied with their bodies and try to lose weight or gain muscle mass. The age range of 16-21 years old is the age group most affected (25%).

Unrealistic beauty standards from the media as well as social expectations are also influential. For example, those who faced condemnation for their figure were:

• 63.5% of all respondents – by family members;
• 60% – by peers;
• 23% – by strangers;
• 20% were judged by friends;
• 16.8% were judged for their figure in sports sections;
• 15.5% were judged by partners;
• 9% were judged by coworkers.

The development of eating behavior problems is also influenced by eating habits formed in the family. For example, when in childhood parents forced a boy to finish his food against his will, manipulated food, commented on the size of portions and the quality of the child’s body.

All this has a devastating effect on the relationship with food and in the future can provoke compulsive overeating in adults and their subsequent “working out” – in the gym or on diets.

Emotional factor

Sofia Sokolova

Clinical psychologist, specialist in working with RPP, Psychedemia expert

The onset of the disease in men is noted later than in women (15-18 years and 19-26 years respectively). Dysmorphia as one of the components of RPP in men is more often manifested in dissatisfaction with their muscle mass – it seems smaller than it really is. This is called bigorexia – a pathological desire to increase muscle mass.

According to some studies, about 33% of male athletes are at increased risk for RPP or already suffer from eating disorders. Among those at risk of developing RPP, 60% of young people prone to RPP consider themselves perfectionists. Of these, 41% are between the ages of 16-21.

Perfectionism is associated with many mental illnesses, including increasing the risk of RPP and making recovery more difficult. These people tend to be very controlling of their diet, striving for the perfect figure. This striving can give a sense of pride and success. However, it is actually a big obstacle to recovery.

To overcome the influence of perfectionism on RPP, it is very important to work on both behavior change and mindset change. It is very important to expand the importance of other areas in a person’s life. It will also be helpful to develop, accept and recognize some flexible and realistic approaches to nutrition, that is, rather taking the focus of ideal nutrition to normal nutrition.

At the same time, among people at risk of developing RPP, very sensitive people (more strongly and longer worried than others) consider themselves to be:

• 43% of RPP-prone men aged 16-21;
• 15% of RPP-prone men aged 22-27;
• 5% of RPP-prone men aged 28-33.

Psychologist, RPP specialist, Psychodemia expert

People with high emotional sensitivity are more susceptible to criticism, due to which they form unrealistic demands on themselves. This contributes to the development of eating disorders.

In the absence of a balanced diet, food as a way of regulating emotions can lead to very frequent overeating and compensations – grueling workouts, diets, use of various drugs – just to avoid feeling shame and guilt.

To learn to live with high sensitivity, you need to master the skills of emotional regulation. For this purpose, it is necessary to turn to specialists.

Physical and psychological health factor

Various chronic diseases – such as diabetes, allergies, autoimmune diseases – also influence the development of RPP. Among the risk group, 20.8% of men have diagnosed physical illnesses and 12.4% of men have mental illnesses. 27% of men at risk suspect the presence of diseases in themselves.

Irina Ushkova

Clinical psychologist, scientific director of RPP psychotherapy at Psychodemia.

The development of RPP on the background of chronic diseases is associated with a subjective and illusory feeling of control, the lack of which is experienced by a person with a disease – and as a result of such control food begins to control the person, not vice versa. Also, in many chronic diseases, doctors recommend dietary restrictions, and food restrictions, in turn, provoke the development of RPP.

In addition, ailments can be associated with weight changes. Losing weight as a result of the disease can provoke a desire to maintain the new weight, and gaining weight – attempts to reduce it. All of this develops a person’s fixation on body weight, a major marker of RPP. Therefore, when treating a chronic disease, it is recommended to take care of not only physical but also mental health.

Sleep problems can also provoke the development of RPP. 43% of men at risk are dissatisfied with its quality. The largest number (40%) falls on the age group of 16-27 years old. At the same time, 27% of the risk group report very low levels of mood and energy, 48% rate them as average, and 14% have frequently fluctuating energy and mood levels.

Only 11% of at-risk men and 10% of at-risk women rate mood and energy as consistently good.

Sleep is indeed linked to eating disorders, and the connection comes in different ways for each individual situation. However, there are a few things to be aware of to reduce its influence on the development of an EBD:

• First, lack of sleep increases overeating because a person doesn’t get enough sleep, they lack energy, and in order to replenish it and get through the day, they need to find a source of energy. The most accessible is food;
• Secondly, food restriction during the day affects the quality of night rest. When a person skips breakfast, snacks at lunch, and has a heavy dinner, then he cannot sleep. In the morning he wakes up broken, does not want to eat, and the day repeats.

With dietary restrictions there is a temporary increase in energy – it becomes very much, it does not want to sleep, a person may be enough four or five hours of sleep, and at the same time he feels cheerful. However, this is an alarm bell, because in this way the body signals that there is not enough food. It is saying, “I am now giving you the strength to go and find us food.”

If food doesn’t show up or it continues to be insufficient, the body goes into energy-saving mode. Severe drowsiness and weakness appear, because staying awake and conquering the highs is not as important as keeping yourself alive.

Consequences of RPP in men

The very structure of RPP does not have any gender differences as such: there is a core of the disorder – a super-valuing of body weight and figure or excessive concern about weight, as well as other related symptoms. In general, there are more differences between any two people suffering from RPP, for example between two girls with an eating disorder, than exactly between a man and a woman with RPP.

PPD leads to devastating effects on the body: heart and blood vessels, gastrointestinal (GI), esophagus, teeth, brittle bones and hormonal disruptions, depression, anxiety disorder and sociophobia.

Malnutrition can trigger a decrease in testosterone levels and affect erections. RPP in adolescents also inhibits their normal development and can cause a child to not grow up the way they could have if there were no dietary restrictions.

Experts recommend starting recovery by seeing a specialist. If we talk about independent work, it is necessary to first establish a sleep and eating habits, for example, in accordance with the nutrition plan of Marsha Herrin – the creator of the program for the prevention and treatment of eating disorders. The essence is to have three full meals, one to three snacks, and “food for joy” in a person’s daily diet.