Wasting away: what's driving young gay men to starve, binge, and purge?

"I realized I had an eating disorders after I chipped my tooth while binge-eating," says Jamie Mattson, a 24-year-old gay Seattle man. "It was erosion of the enamel from throwing up two or three times a week for the past three years. I had to undergo hours of oral surgery because the tooth abscessed and required a root canal. I never realized being bulimic could be so harmful.

"I tried dieting, but it never seemed to work, because after skipping a few meals I would feel so hungry that I would wolf everything down in sight. I'd feel so bad afterwards that I would drink a huge amount of water and then induce vomiting," says Mattson.

According to Abigail Natenshon, a psychotherapist and one of the nation's leading eating disorder experts, an estimated 80,000-320,000 gay men in the United States suffer from eating disorders, with over 50% of them under the age of 25. Various sources report the incidence of eating disorders among gays to be between 10% and 42%. These numbers should be interpreted cautiously, as research on the subject is very limited. But further research is at last taking place in this field. New studies will look at contributing factors, behavioral patterns, and the prevalence of eating disorders among gay men.

"Many people believe, probably correctly, that the grossly idealized images so pervasive in [gay] culture are partly responsible for the skewed, compromised self-esteem that many gay men have," says Matthew Brooks, a Seattle therapist. But Brooks emphasizes that the issue is far more complicated: "While there is truth to this idea, it's more likely the ease that eating disorders develop when there are many factors at work over time, including family pressures, shame, and mixed messages about food, appearance, and weight. This all leads to bewilderment about one's sexuality as well as those impossible standards from mass culture."

At 5 foot 8 and 120 pounds, 21-year-old A.J. Kuchnicki Wheeler agrees that media images influence the way he views his body. The mixed messages he was bombarded with led to a three-year battle with anorexia. One of the first images to really leave an impression was Brad Pitt in Fight Club. "I wanted to leek like him so bad," Wheeler recalls. "I wanted a lot of body characteristics simply not possible for most men to have, beth feminine and masculine."

Brooks says eating disorders involve not just binging or starving but, as in Wheeler's case, obsession: "Besides anorexia and bulimia, eating disorders or body image problems can take the form of intense preoccupation with weight and appearance, purging or obsessive dieting, and changes in social functioning. More people are somewhere on this bread spectrum of eating disorders than [the subset] who have been diagnosed with anorexia or bulimia."

Unfortunately, many programs for people with eating disorders are geared toward women and teenage girls. Gay men are less likely to seek help because a preoccupation with physical appearance is considered a social norm by many. There are serious consequences if these issues are not addressed.

"Getting help and getting it quickly is important," says Brooks. "Eating disorders for gay men often are accompanied by depression, isolation, or substance abuse. The diseases do not go away on their own, and they tend to get worse the longer they last."

For help regarding eating disorders, contact the National Eating Disorders Association at [phone] or www.nationaleatingdisorders.org.