Eating disorders can affect anyone. While they may be associated with girls and women, about 1 in 3 people struggling with an eating disorder such as anorexia nervosa, bulimia nervosa and binge-eating disorder are male. About 10 million men, teens and boys in the United States will struggle with these potentially fatal illnesses at some point in their lives. And for reasons that researchers are still working to understand, that number is increasing.
“It could be that detection of eating disorders in males is improving,” says Cynthia Bulik, PhD, founding director of the Center of Excellence for Eating Disorders at the UNC School of Medicine. “We hope that means the stereotypes around eating disorders are being broken down somewhat so that detection, referral and treatment are improving for men.”
For males of all ages, stereotypes and stigma around eating disorders can prevent them from talking about it or seeking help. In other cases, they don’t recognize that they have an unhealthy relationship with food and exercise, or a distorted view of their body.
That was the experience of Jacob Day, who had anorexia. The now-29-year-old from Ashe County, North Carolina, is sharing his survival story to cut through stereotypes and help support anyone who may need help.
Seeking Control as a Teenager
Day was overweight as a preteen and bullied by his peers for it.
“When I was around 14 years old, I decided I wanted to lose weight and be healthier,” Day says. “I started changing what I was eating, restricting calories and working out.”
Day started losing weight and receiving compliments from people around him for doing so. He started feeling good about himself and gaining confidence. He didn’t want that feeling to stop. His weight decreased to a healthy weight—but it didn’t last.
“It got to the point that the only thing that made sense to me was seeing the number on the scale go down,” Day says.
“We are seeing more and more that the fitness, cosmetic and diet industries are targeting men,” Dr. Bulik says. “Just as they have been doing with women for decades, they are trying to undermine men and boys’ body esteem by encouraging physical comparisons with models and actors who have six-pack abs and undetectable body fat.”
Dr. Bulik says that living in a society that praises specific physical ideals can make people feel bad about their own bodies and can damage self-esteem and body image on a daily basis. For Day, it meant wanting to be lean. And so he pushed himself, drastically limiting his caloric intake and working out for hours every day. By the time he was a junior in high school, he was dangerously underweight.
Dad Insists on Finding Help
Day didn’t think he had a disorder. He’d been told by society that exercise and weight loss were considered to be good things.
He was also going through a lot of changes in his life during this time. In addition to the normal emotional ups and downs of teenage life, there was a lot of change; his mother was going back to school and his father was starting his own business. Day felt like his eating, his exercise and his weight were the only things he could control. But when his weight plummeted, his father took action.
“I thought I was going to the doctor because I had shortness of breath,” Day says. “It actually turned out that my dad had done his own research into eating disorders and made an appointment with a physician for an evaluation.”
At the appointment with a doctor in Boone, they learned Day’s heart rate was around 20 beats per minute (bpm). The average heart rate for someone his age should have been between 60 and 100 bpm, or between 40 and 60 bpm for physically fit people. His low heart rate was a concern because it could be an indication that his heart’s electrical system wasn’t working properly. He was transferred by ambulance to Brenner Children’s Hospital at Wake Forest Baptist Health in Winston-Salem.
At Brenner, Day was evaluated and his father continued doing research on eating disorders. He decided to take his son to the UNC Center of Excellence for Eating Disorders in Chapel Hill, where experts could provide personalized medical, psychological and nutritional care.
Not Ready for Change
Day went into the program at UNC in denial—he didn’t think he needed to be there. After around three months of going back and forth between inpatient and outpatient treatment, he hit the goal weight set for him in the program. With an eating plan, recovery guidance and a therapist at his disposal, Day tried life without the program. He maintained his weight for about a month before he began restricting calories and excessively exercising again. And he tried his best to hide it from everyone around him.
“Stereotypes and stigmas around eating disorders still exist for everyone,” Dr. Bulik says. “Unfortunately, those stigmas have been and still are worse for males, and many men are hesitant to come forward to seek help.”
Day soon started college at the University of North Carolina-Chapel Hill. During his sophomore year, his health started to decline. He wasn’t eating enough to fuel his body and was exercising too much. He started losing weight again.
“I don’t consider myself to have been a good friend during this time,” he says. “I had such a strict schedule in high school and college when I was struggling with anorexia. I said ‘no’ to a lot of things with friends because I didn’t want to miss a workout, or I wasn’t sure if I could eat the food that would be there. I feel like I missed a lot of opportunities and experiences.”
Then, the last semester of his senior year, he’d had enough.
A Revelation
“I told myself, I either get better, or I won’t survive this.”
Day was starting to think beyond college. He realized how much of his life was in front of him, and how he would need to adapt to life outside of school. His set routine and particular eating habits wouldn’t work in the real world, he thought, and he didn’t want to make them work. So, he started opening up to his friends and family about his struggle.
“A major step in my recovery was just being open and talking to people about my anorexia,” he says. “For so long I hid my illness because I was ashamed. It was a big hindrance. Getting over that and starting my recovery was one of the hardest fights I’ve ever had, and I know that if I lost that fight, I wouldn’t be here.”
By leaning on friends and family, Day started making strides in his recovery. And he started feeling better physically, which helped his mental health. He began reworking his relationship with food and shifting his mindset around gaining weight and what his body should look like. Instead of spending one to two hours exercising every single day, he started taking rest days and worked to change the thought patterns that used to leave him feeling guilty.
Living a Healthy Life and Sharing Wisdom
Day graduated from college in 2014 and started working for the UNC School of Medicine as a genomics research technician. His recovery was ongoing; he considers 2016 to be the year he fully recovered from anorexia nervosa. Now, he wants to help others.
“I feel like there are men out there with eating disorders who don’t know they have one, and think what they’re doing is considered healthy,” he says.
If you recognize the signs of an eating disorder in a friend or family member, let them know you care, Dr. Bulik says.
“Have materials available to help them find treatment. Encourage them to take that first step and get an evaluation. Advocate for them if necessary and support them through recovery,” Dr. Bulik says.
Day says if you aren’t quite ready to schedule an appointment with a doctor, at the very least, talk to a loved one about what you are going through.
“This is something you shouldn’t have to face by yourself. Know that the process of recovery will be difficult, but it’s worth getting to the other side. Being recovered feels like saying ‘yes’ to life.”
If you or a loved one is struggling with an eating disorder, learn more about treatment options. Telehealth services for eating disorders have increased significantly and are available for people who would like confidential treatment from the comfort of their own home.
If you’re a person of any gender who has experienced an eating disorder, you can read more about an international research study led by UNC, the Eating Disorders Genetics Initiative (EDGI). EDGI is designed to understand how genes and environment influence risk for developing an eating disorder to inform development of new treatments, improve outcomes and eliminate deaths from eating disorders.