After a 20-year-long battle with depression, anxiety, low self-esteem and shame about being overweight, a fateful encounter with a large plate of chicken wings finally convinced fourth-generation Baltimorean Andrew Walen that he was suffering from an eating disorder. It happened one night that February 2004, when Walen, who was especially stressed, tired and irritable, joined some friends for their regular poker game.
“I had lost $80 in about 45 minutes and was feeling really anxious,” he recalled. “So I went into the kitchen and started eating wings. I was in a dissociative haze and lost all sense of time. There were about 100 wings on the plate, and I ate all but six of them. I looked down and saw those six wings sitting in this congealed fat and I felt all the food that was filling me up to my sternum.
“This voice kept saying, ‘Eat another one … eat another one.’ I was crying because I could not stop the motion of picking up the wings and bringing them to my mouth,” continued Walen. “After that, I went home and confessed all to [my wife] Jenn. That night I went online and researched eating-disorder treatments and got some help.”
Now a psychotherapist and founder and executive director of the Body Image Therapy Center in Columbia, Walen, 41, a licensed clinical social worker, treats others, especially boys and men, with eating disorders. His new book, “Man Up to Eating Disorders,” is both a memoir and self-help book for men struggling with such issues as body image, self-esteem and shame.
Walen, who lives with his wife and 12-year-old son George in Stevenson, wrote the book because during his own recovery from binge eating disorder (BED), he found only two books written for men with the condition and related illnesses. Walen believes the lack of literature on male eating disorders is due to the fact that most people, even mental health professionals and doctors, aren’t aware of the extent of the problem. Walen said that despite seeing several therapists over the years, his eating disorder went unrecognized until he diagnosed himself after that poker game 10 years ago.
“There is no language for eating disorders in men. The self tests [used to identify eating disorders] ask questions like, ‘Do you feel your thighs are too big?’ and, ‘Are you obsessed by the number on the scale?’ Guys are worried about having six-pack abs, being cut, being muscular,” he explained. “Those questions don’t resonate for them.”
Like most people, Walen had previously understood that eating disorders such as anorexia and bulimia were diseases that only affected girls and young women. To make matters worse, BED was not even recognized as an eating disorder by the psychiatric community until 2013, when it was finally included in the “Diagnostic and Statistical Manual of Mental Health.”
According to the National Eating Disorders Association, males make up about 10 percent of eating- disorder cases. But another study in 2007 by the National Association for Males with Eating Disorders concluded that the actual figure is more like 25 percent.
“Throw in binge eating, and that number is closer to 40 percent,” said Walen.
One reason why he thinks that male eating disorders are so infrequently diagnosed is because of the shame associated with having what’s considered a “female disease” or a disease that only affects men who are gay.
“We have to be able to discard the shame and guilt of being a boy or man with an eating disorder and bring those who suffer out of the darkness,” he writes in his new book. “We have to be able to say this does not make you weird, you are not intrinsically flawed and you’re not alone.”
As is usually the case among men who suffer from eating disorders, Walen was biologically and environmentally predisposed to the disease, he explained. His mother had an eating disorder and also suffered from depression. She and the rest of his family members all placed a premium on being thin and attractive. They made it clear that his body was unacceptable and pressured him constantly about his need to lose weight.
Only when starvation diets and excessive amounts of exercising resulted in short-lived periods of weight losses did his parents show him love and encouragement, he said. So desperate was Walen to gain the acceptance of his family and to live up to society’s standards of attractiveness that he starved himself and exercised to the point where he caused permanent damage to his hip and tore both rotator cuffs, requiring complete reconstructive surgery in both shoulders. He suffers with chronic pain to this day.
Walen wants people to know that there is hope for men like him.
“If you have an eating disorder, you have to take both the psychological and the nutritional issues very seriously,” he said. “If there is an underlying psychiatric condition [such as depression or anxiety], you must see a psychiatrist. There is a lot of misinformation about nutrition that also needs to be addressed.” Walen discourages fad diets as “not legitimate ways of eating.” In addition to advocating individual, couples, family and group therapies, Walen said that working with a nutritionist is a vital part of recovery.
His Body Image Therapy Center offers different levels of treatment, from once weekly individual and group therapy sessions to an intensive outpatient program that includes nine hours of group therapy, one hour of individual therapy and 30 minutes of nutritional counseling each week. Depending upon their needs, patients attend the program anywhere from four to 16 weeks.
For those who don’t seek treatment for eating disorders, the costs are great, said Walen. “About 1,000 people die every year from [conditions related to] eating disorders, making it the deadliest mental illness there is.
“My hope,” he added, “is that men will begin ‘manning up’ by expressing their emotions and living honestly.”