Men, we need to talk

Sam Ikin:

This is the Butterfly: Let’s Talk Podcast from the Butterfly Foundation, your national voice for people living with body image issues and eating disorders. Research tells us that when people think of someone with an eating disorder, they tend to think of a young, wealthy white woman. And while many people who do fit that description certainly are affected, it really doesn’t tell the whole story.

Sam:

In this episode, we’re going to challenge that stereotype and look at how eating disorders and body image issues affect men and boys; and why they in particular find it so hard to talk about this destructive mental illness.

Brock McLean:

It just became a really unhealthy, sort of, obsession. Just spiraled into, I guess, worse behaviors and really unhelpful behaviors.

Braiden Fitzsimmons:

It’s honestly, it’s still a daily battle. The main differences is that I’ve got three or four years of therapy under my belt now.

Mitch Doyle:

I was diagnosed with anorexia when I was 11 so it was a very crucial point in my life.

Sam:

I’m Sam Ikin, and like more than a million other Australians, I have an eating disorder. Eating disorders and body image issues come in heaps of different forms. Most common ones are bulimia, anorexia and binge eating disorders. That last one, the binge eating one, that’s me.

Sam:

Even saying it now, in the safety of my studio, reading it from a script that I wrote myself, I still feel a twinge of shame just saying the words. It’s been so deeply conditioned from a really young age that my weight is a massive personal failing, and that talking about eating disorders is not something people want to do. And it’s that stigma that makes this such a difficult category of mental illness to assess. But people affected by eating disorders are as diverse as the spectrum of disorders themselves. This illness doesn’t discriminate and while the stereotype is a young woman, boys and men are just as susceptible; we just don’t want to talk about it. There’s something built into our DNA that makes us just want to suffer in silence and hope that it all goes away; but of course, it won’t. Without getting the right help, it’ll probably get worse.

Scott Griffiths:

Men are really reluctant to go and see a doctor in the first place.

Sam:

That’s Dr. Scott Griffiths from the University of Melbourne. When it comes to eating disorder research in Australia, he is like one of the best minds that there is.

Scott Griffiths:

I run the Physical Appearance Research Team, which runs research on all things to do with physical appearance, including the psychological disorders that people can develop when appearance becomes a big problem for them, including eating disorders.

Sam:

He tells me that study after study shows that men are reluctant to engage, not just with a doctor; but with their friends; or with a psychologist; or anyone at all.

Scott Griffiths:

One of the easiest things to point blame at is masculinity and adherence to traditional ideas of that which discourage help-seeking, because self-reliance and being emotionally equipped and in control is a part of that traditional masculine archetype. And sure enough, the dudes who have muscularity-oriented eating disorders; they are particularly adherent to those ideals of masculinity. And I think that is a large contributor of why the eating disorder field just does not see those men.

Sam:

According to figures from Butterfly about 36% of people known to be experiencing eating disorders, identify as male. But Dr. Griffiths says it’s really difficult to get an accurate assessment.

Scott Griffiths:

If we assume that the eating disorders that we see and know about now are all that are out there, then men are a minority of eating disorder diagnoses; except perhaps for binge-eating disorder, when men account for approximately half.

Sam:

But he say’s we’re slowly starting to see the emergence of a larger pattern.

Scott Griffiths:

What research teams around the world are finding, is that if you accept that how eating disorder’s manifest differs depending on the population you’re looking at, it would not surprise me if there are many more men with eating disorders out there; we just don’t see them because we’re not ready to look for them; they don’t come and see us.

Hamish McLachlan:

It’s Brock McLean. He’ll kick from 30. He’s got the ball. McLean takes it. He runs in. He’s kicked! And it’s a goal!

Brock McLean:

My name is Brock McLean and once upon a time I played AFL. I played at Melbourne for six years, and I think 94 games. And then at Carlton for five years, and I think I played 63 games there, so finished up at the end of 2014. And since then I’ve been on, sort of, a roller coaster ride, I guess you could say, in terms of my mental health.

Sam:

Brock McLean is one of three men who have taken the brave step of speaking openly and publicly to us, about their struggle with eating disorders. Next, we have Mitch from Sydney. He’s been struggling with an eating disorder since his early teens.

Mitch Doyle:

I was diagnosed with anorexia when I was 11 so it was a very crucial point in my life for experiencing something completely horrendous; but also experiencing something horrendous that is perceived as female.

Sam:

And from Geelong, Braiden says he’s been experiencing his eating disorder since he was eight years old.

Braiden Fitzsimmons:

I could just physically see around me that I was bigger than a lot of my mates. Yeah, and I guess that then introduced the thoughts around, “Well, why am I bigger than my mates?”. And it was made quite clear early on that this was a bad thing. So, it was always constantly, growing up, something that I thought I had to change. I always thought I had to change my body in the way of losing weight.

Sam:

Body dissatisfaction is a huge risk factor for eating disorders, especially among younger men and boys. And remember, high-performing athletes in male competitions tend to be young men. Brock McLean describes himself as an all-or-nothing kind of guy; whether it was study, footy training, or nutrition. If Brock perceived at the time it was worth doing, he was all in.

Brock McLean:

There was a period in my career where I was injured a lot and my leg speed, which wasn’t great to start with, became even more troublesome. So, part of my solution was to strip a bit weight. I was naturally a big solid guy; I wasn’t overweight or anything, I was just very…a stocky build. Myself, and the clubs that I were at, just felt that if I shed a few kilos, that would really help me I guess, with my running capacity. Maybe also help out with a bit of my speed as well. So, my diet became integral to, I guess, that aspect of my life.

Brock McLean:

I was a very all-or-nothing person so, when it came to dieting and eating the right food, I took that very, very seriously. And I became quite obsessive. A lot of weighing food and depriving myself of some of your junk food, or your bad foods, just so I could say to myself that I was doing everything in my power to do the right thing in terms of my diet and it just became a really unhealthy obsession. It just spiraled into, I guess, worse behaviors and really unhelpful behaviors.

Brock McLean:

I mean because I’d told myself in my head that if I ate anything sort of bad, or that wasn’t nutritious or healthy, that I was going to put on weight. In effect that was going to affect my football career and things were going to get worse, and eventually I wouldn’t get picked for the team. And that would be my downfall. So, it just became this really, really unhealthy obsession. Just very out of touch with reality and playing a really unhealthy story out in my head that if I ate anything bad, that that was going to negatively affect my football career.

Sam:

So Brock’s experience is from when he was a young adult, but there’s increasing data telling us that body image issues are affecting people much younger. A recent study found 55% of boys aged between 12 and 18 wanted to alter their body in some way. While another found half of 14 to16-year-old boys were taking muscle-building supplements.

Sam:

Earlier, Mitch told us he was diagnosed with anorexia at the age of 11. And for him, it compounded from there.

Mitch Doyle:

11 is incredibly young and we do know that eating disorders are manifesting in young people which is heartbreaking. Childhood is such a vulnerable period of development and, in my mind, it’s a period where kids should just be allowed to run free in the world and be innocent. And to spend what was the better part of my childhood and adolescence and early adulthood, in a place of negative introspection where, everything I articulated about myself was negative and how I looked and how I appeared to the world – and coming out as gay in that instance. I remember I came out first when I was 16, which was at the peak point of quite a significant relapse for me. Those years were like a rogue firework in a tin shed. It was everywhere and it was loud and it was noisy and it was bright and it was weird. Things did get bad there for a period of time, particularly in my early twenties.

Sam:

For reasons that we’ll get to shortly, men are far less likely to ask for help with eating disorders than women. For Braiden, that reluctance to reach out almost had tragic consequences.

Braiden Fitzsimmons:

I did everything wrong in the sense of, I bottled it all up and it got to the point where it was very unbearable, and I felt like taking my own life was the only way out of this. And obviously I was unsuccessful in doing that, but from there I was taken the hospital, and then that’s where it was all brought to my family and my close friends’ attention that I was really unwell and really struggling. And then that’s how I got the support that I needed.

Sam:

Back in the research lab at the University of Melbourne, Dr. Griffiths tells us there are lots of ways that men and women differ in the way their eating disorders present. So, if we’re looking for the stereotypical behaviors usually associated with women, it’s easy to see how eating disorders in men could go unnoticed.

Scott Griffiths:

Men on average tend to be quite different. It stems from the types of bodies that men and women want for themselves. If you take a hundred boys and a hundred girls, and you say, “Hey, what do you want to look like? What stresses you out? How do you think you should look?”, they’ll give very different answers. Girls will describe wanting to be thin or skinny or toned. They probably won’t mention things like their height, for example, or to be conspicuously muscular. But boys will. They’ll use terms like, “I want to be stacked”; “I want to be built”; “I want to be tall”. And the basic thesis is that eating disorders reflect the differences in how people go about trying to get those bodies for themselves.

Sam:

Brock said he had a lot of trouble accepting that he had a problem in the first place, and he was reluctant to make that first step and just reach out and tell someone that he had a problem. As far as he was concerned, it was a sign of weakness and football players need to be strong.

Brock McLean:

I was never someone who was comfortable with talking about feelings or what was going on inside my own head or my own body, let alone something as serious as an eating disorder. That was always a real struggle for me, and on top of that, I grew up in a very old school family. No complaining. No whingeing. It was just…anything that happened to you, you just had to suck it up and get on with it and just deal with it. Having that added unseen pressure that I put on myself: that I’m old school, the family’s got to see that I’m tough, I can’t complain – that just compounded everything as well.

Brock McLean:

It all just started just by going to a psychologist, that was over three years ago and even then I was very reluctant and very hesitant to speak openly and honestly. Just because of the stigma; if you speak up and ask for help, that it’s a sign of weakness. In fact, it was the complete opposite. To go to someone you don’t know and put yourself in a really vulnerable position, say “Hey, I’m struggling here”, “I’ve got this going on” or “that going on”, is a huge sign of strength. So, changing the storyline in my head was something that took a lot of therapy to get to a point where I could see it as a sign of strength and not as a sign of weakness.

Sam:

Mitch from Sydney also struggled with the stigma that comes with being a man. But as a gay man, there was another level of complexity.

Mitch Doyle:

There were these compounding elements of eating disorder, masculinity and the conflict between that; of experiencing a disorder that is predominantly seen as female, which threatens that masculine aspect, but also at the same time, not identifying with the masculine aspect because of my emerging sexuality. So, there was all of these things that acted as a melting pot to an experience which was just confusing and complex and overwhelming.

Mitch Doyle:

What drives eating disorders and what drives negative body image are distorted thinking patterns around body image, around how we think we look, and how we feel about our bodies; how we compare ourselves to others; the societal impacts of pumping out unrealistic appearance ideals into the culture and saying, “As a male, this is how you should look”, “As a gay male this is how you should look”, “As a straight male this is how you should look”, “As an athlete this is how you should look”, “As this, this is how you should look”. And we know that’s not the case. We know that there are so many unrealistic expectations placed on young people and people of all ages that cause, or at least contribute, to negative thinking about their appearance. Because we do compare. We’re wired to do that to some degree, especially when we compare and say, ” I’m less than that”. But that image that I’m comparing myself to is actually fake. We’re fighting a losing battle.

Sam:

Back in Geelong, Braiden can relate to both stories. He says the stigma was a major factor in his reluctance to seek help until it was almost too late.

Braiden Fitzsimmons:

‘Taking the Mickey’ out of your mates about the way they look, and how you greet them: “Hey, how are you going big fella?” All that kind of stuff emphasizes the anxiety around talking about it because a lot of people, a lot of blokes… If it is seen as more of a woman’s problem to talk about the way you look, it just gets all bottled up and then gets to that point where you just don’t know how to bring it up, or how to talk about it, so you just suppress it for as long as you can. I think as I got older and the longer that I dealt with the eating disorder alone, that the harder it got to reach out for help.

Braiden Fitzsimmons:

And I guess the stigma side of it was: For me coming from a particular sporting background, where there’s so much focus on your physical health, and how you’re performing on the field or on the court, and what you look like while you’re doing that, that there’s never any room for a conversation about how you’re actually going mentally. It was definitely a real struggle to even just comprehend that I could get help. Because I think for a long time, I didn’t even know that there were services available, things like Headspace and that, that are free for kids and for youth and that. So, it was also just that knowledge of just not even knowing that those things even existed.

Sam:

Overcoming these issues and encouraging men who are at risk to come forward and ask for help requires a bit of out-of-the-box thinking, according to Dr. Griffiths. In order to reach men, you have to go where they already are. He says one of the most successful surveys taken recently was called Gay Bodies Worldwide, and to reach their target audience, they used a platform they already knew was being used by gay men. They ran advertisements in the hookup app Grindr. And the results were record breaking.

Scott Griffiths:

Ultimately recruited 8,000 people into that study, which is the largest longitudinal study of gay men in history. We did that on a $30,000 budget.

Sam:

So they found the platform that they would use to reach the target audience, and then they designed the campaign. But how could you apply that logic to other demographics? Or to reach a broader category of men? As an example, Dr. Griffiths points towards a group on the social media platform, Reddit.

Scott Griffiths:

This is just where men congregate to talk about steroids and their reasons for using them, and how to do it safely. And advertisers won’t touch this subreddit because it’s involved an illegal activity. The only advertisers doing anything there are advertising supplements and, largely fake, steroids. If someone wanted to reach a community of 80,000 individuals, of whom a very substantial proportion are going to have the type of thinking and worries that characterize eating disorders, that could be done.

Sam:

For people who are concerned that they might have a problem, the best place to start is the Butterfly Foundation. I’ll throw out their contact details at the end of this episode. For example, they could put you in touch with a psychologist near you who specializes in eating disorders. Wherever you do go for help though, that first step needs to be: reaching out and telling someone what’s happening. Each of our guests for this episode struggled to take that first step, and the stigma played a huge part in that. But when they did, it opened up lots of possibilities for recovery. For Brock, it was the body whose job it is to look after the wellbeing of football players, the AFL Players Association.

Brock McLean:

I got in touch with the AFLPA who have been absolutely fantastic for me in my recovery journey, and they’ve provided all the psychological services and mental health, wellbeing services; they provide all those to their ex-players free of charge. So that was the first step; and then seeing my current psychologist; and then eventually seeing a psychiatrist; and my two stints in the Melbourne clinic, which is a psychiatric clinic here based in Richmond. So the AFLPA pays for all my stays there, so they’ve been absolutely amazing and instrumental. But reaching out to them, first and foremost, got the ball rolling. And got me started on my mental health recovery.

Brock McLean:

The biggest thing: I’ve always been a very impatient person, so my mindset when I started seeing my therapist was; I just want to be fixed; I just want to get this done and dusted. And really, it’s not just going to happen in one or two or six sessions. I’ve been seeing a psychologist every week for over three years. So, you can get better; you can unlearn bad habits; you can rewire your brain; you can remold your brain; but it just takes a lot of time and hard work and effort; and patience; and taking a long-term view approach to getting better. I think the one thing that people really need to realize is, as I spoke about before is a holistic approach. You’re going to have to make changes in your life. But first and foremost, find a psychologist or whoever your therapist is that you really resonate with and you really connect with. Because from what I’ve read and what I understand, from my own personal journey, is that’s the most important thing in your recovery efforts: The connection you have with a psychologist.

Sam:

For Mitch, it took a long time to find that path to recovery. But now he works for the Butterfly Foundation using his experience to help others take that first step to tell someone about it.

Mitch Doyle:

My lived experiences is something that I’ve learned to harness, and use, for the better sense of the word, use for a purpose of good; and to educate; and to advocate; and to use as a point of empathy too. Because I understand when I’m hearing people’s stories, that I can say, “Oh, that would be tough”, but to actually really understand how tough that is, offers a sense of “I’m here with you in that”. And because I know how vulnerable it can be for people to share their stories and I know how nerve wracking it can be because, as we know, an eating disorder and body image difficulties are incredibly insidious and shrouded in a deep sense of shame and guilt, and it’s exactly those feelings of shame and guilt that, to some degree, prevent people from wanting to share their experience. And sharing their experience could be with anyone. It could be with…the first time that they share with a health professional, a friend, a family member, a partner. So being able to actually draw upon my own lived experience to say, “I know how tough that is”; it offers accurate and empathy and a chance to actually get on the same page as someone and know what they’re experiencing, to help them push through that nervousness and anxiety around sharing their experience.

Sam:

Braiden found his road to recovery when he finally reached out to a psychologist who helped him identify the problem, and then helped him find specialised care. But he says, it’d be much easier for young people if more celebrities and people who already have a platform, people like Brock McLean, spoke publicly about their struggles.

Braiden Fitzsimmons:

If you’ve got people with a following, whether they’re athletes or actors or whoever they may be, I think when we look at those people, we put them on that pedestal that they’re almost not human, and that they don’t struggle with mental things that you can’t see; And that’s because they’re so good at what they do, or they have all this money. And I think if more of them were to come out and talk about their experiences in a real educational way, I think it definitely normalises these thoughts that we have, and bring people together, and understand that: One, there is help out there. Two, you’re not alone; and, three, something can be done about it. You don’t have to live like this the rest of your life.

Sam:

Having those conversations, providing a platform and allowing people to speak publicly about their experiences is what we do here at the Butterfly: Let’s Talk Podcast. But looking to the future, Dr. Griffiths says we need a large-scale change in attitude, or what he calls, “a reckoning”.

Scott Griffiths:

We’re approaching the point where technology is allowing us to shape our appearance in increasingly radical and permanent ways: whether that’s advances in plastic surgery or the advent of gene editing for embryos; things that allow us to shape our appearance to be more in line with an appearance that we value, but which is largely, I would say, co-opted by what society values or deems attractive. So, if we’re going to reconcile with these technologies, we have to reconcile with how important we want appearance to be in our lives, because it is just unfair to have people valuing their appearance and to manipulate their body weight, and then to turn around and call them vain or tell them to outright stop, when all of society clearly values it so much. I think it useful for a reckoning where we decide, hopefully, that it ought to be a lot less important, because unless we do that, people will still get caught in this bind.

Sam:

If anything from this episode sounds familiar, or you think you want to find out more about eating disorders, I really encourage you to reach out. The Butterfly National helpline is free, safe, and confidential. It’s open to everyone. Call 1-800-ED-HOPE. That’s 1-800-33-46-73. You can also chat online or check out all the resources available at the website, butterfly.org.au, or you can email support@butterfly.org.au.

Sam:

Now we know that recovery is possible, but effective services are essential. So that number again, 1-800-ED-HOPE. That’s 1-800-33-46-73. The butterfly podcast is an ICAN media production for the Butterfly Foundation. It’s hosted, edited and produced by Sam Ikin. That’s me. With the assistance of Belinda Kerslake, Camilla Becket and Mitch Doyle. The music is from Cody Martin and Breakmaster Cylinder. With special thanks to Brock McLean, Braiden and Mitch, for taking the huge step of sharing their stories. If you know someone who you think could benefit from hearing this podcast, we’d really appreciate it if you could share it with them. Or subscribe to Butterfly: Let’s Talk wherever you get your podcasts.