Although self-starvation in men is rare, it does occur. In fact, a paper published in 1694 by the physician Richard Morton-generally recognized as the first unequivocal description of anorexia- describes two cases, one of whom was a sixteen-year-old boy. As the author stated:

[The boy] fell gradually into a total want of appetite, occasioned by his studying too hard, and the passions of his mind, and upon that into a universal atrophy, pining away more and more for the space of two years … I advised him to abandon his studies, to go into the country air, and to use riding, and milk diet (and especially to drink Asses milk) for a long time. By the use of which he recovered his health in a great measure, though he is not yet perfectly freed from a consumptive state . . .

The criteria for diagnosing anorexia are virtually the same in both sexes. Like female anorexics, male anorexics starve themselves and may or may not use self-induced vomiting or some other extreme means of weight control. Males experience fear of fatness related to loss of control over eating. Paralleling the female’s loss of menstruation, there is a disorder in the activity of the reproductive hormones. This leads to a decline of interest in sex and a decrease in ability to perform.

The pattern that anorexia follows in men and women is also similar. Although the illness occurs in people from all social levels, there is a disproportionately high incidence among the upper classes. Depression is more common in families with a male anorexic member; his siblings are also more likely than average to have anorexia nervosa. Some anorexic males are involved in activities in which low weight or weight control is valued. Those at particular risk include jockeys, ballet dancers, wrestlers, flight attendants, and models.

The illness usually begins during the boy’s adolescent years. The trigger is often an attempt at dieting, although it may also be a stressful life event, a disappointment caused by failure at school, “or” a social loss such as rejection by a girlfriend. Sometimes a prolonged illness leads to weight loss. If the boy sees the loss as desirable for some reason, he may decide to continue starving himself.

Homosexuality is not a criterion. Part of the tragedy of eating disorders is that they strike vulnerable individuals at a time of life-adolescence-that is already fraught with enough emotional and physical turmoil to last a lifetime. During the teen years, young people have their hands full trying to recognize just who they are and to incorporate that awareness into their personalities. Confusion reigns-confusion about gender identity, social roles, self-worth. Youngsters who start out with low self-esteem and poor ego defenses may feel successful in achieving thinness. That feeling then escalates into a vicious cycle of anorexia.

These young men, like anorexic young women, are literally starving for attention.


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