Qu'est-ce qui déclenche les troubles alimentaires chez les hommes ?

Oh, quel dommage

We know that young women with eating disorders often feel intensely ashamed, and may hide their problem. With anorexien, they often cover up with baggy clothes and pretend at mealtimes that they've already eaten. With boulimie, des emballages alimentaires vides peuvent être dissimulés dans la poubelle et les toilettes publiques utilisées pour se faire vomir.

Mais les hommes ne sont pas censés se soucier de leur poids, et on ne s’attend certainement pas à ce qu’ils montrent leur vulnérabilité. Puisque « tout le monde sait que les troubles alimentaires sont un problème de filles », reconnaître non seulement sa détresse émotionnelle, mais aussi une réaction apparemment peu masculine à celle-ci, entraîne une double stigmatisation.

Les hommes viennent de Mars, les femmes viennent de Vénus

De nombreux facteurs déclencheurs des troubles alimentaires diffèrent entre les hommes et les femmes. Les hommes qui développent des troubles alimentaires ont souvent been overweight at some point. Women, on the other hand, are more likely to have felt they were overweight when they weren't. Men are also more likely to worry about their weight because of how it might affect their athletic ability: for women, a 'beautiful' body is an issue all by itself.

While most men with eating disorders aren't gay, men who are gay are up to 10 times more likely than heterosexual men to develop an eating disorder. Interestingly, lesbian women are moins susceptible d’être préoccupé about their appearance than gay men.

Muscle dysmorphia - an obsession with developing the right muscles, which has much overlap with eating disorders - is much more common in men than in women. Closely linked to this is the use of anabolic steroids, as courant chez les hommes as anorexia and bulimia combined in women.

La folie des médias

Si un professeur de fitness demandait à une société de production vidéo de réaliser une vidéo d’exercices dans laquelle il dissimulerait volontairement sa silhouette musclée, il y a fort à parier qu’on le renverrait très vite ou qu’on le prendrait pour un fou. De même, aucun magazine ne laisserait paraître en couverture une photo où le ventre flasque du mannequin dépasse de son haut : tout le monde sait que la beauté fait vendre. Et Photoshop^® means they don't have to.

Few icons have either the power or the inclination to fight back - when Kate Winslet announced that she was refusing to allow her photos in a recent cosmetic advert to be photoshopped, it made international headlines. Yet young women who watch exercise videos led by an instructor in a body-contour outfit are more likely to feel unhappy afterwards, compared to doing the same workout while watching the same instructor habillée de façon plus couvrante.

Les hommes et les médias

Men, too, are more likely to be dissatisfied with their bodies when they're exposed to images of muscular, idealised men. These same images are more likely to causemento drive themselves at the gym to augmenter leur propre musculature - and, as we've seen above, a desire for the perfect muscular body is often a precursor to an eating disorder in men.

Then there's social media - do endless carefully vetted images of everyone you know having a marvellous time, or pictured only in the most flattering poses, play a role? Dr Sandeep Ranote is a consultant child and adolescent psychiatrist, who has specialised in eating disorders for 15 years. She warns that we ignore this element at our peril. "We would be naive to say that there is no link between social media and eating disorders as well as other mental health problems like low self-esteem, depression and self-harm. We don't have absolute proof yet, and we don't know how to deal with it - but we definitely need to keep looking at it."

Quelle est la solution ?

Comme dans bien des domaines, mieux vaut prévenir que guérir. Les médecins ont le devoir de reconnaître que les premiers signes d’un trouble alimentaire peuvent être différents chez les hommes et chez les femmes, et de garder cette possibilité à l’esprit lors du diagnostic.

L’industrie de la mode se contente de belles paroles lorsqu’il s’agit de prendre ses responsabilités en matière d’image corporelle : au fil des ans, j’ai vu d’innombrables articles sur les maisons de mode 's’unir pour interdire les mannequins taille zéro', pourtant, elles reviennent sans cesse. Pour les hommes, cela peut être encore plus difficile. Dans un monde où l’obésité connaît une progression fulgurante, la forme physique jouit d’un immense prestige social, et le physique athlétique parfaitement sculpté ne risque pas de perdre sa popularité de sitôt.

Dr Ranote is convinced that who gives the message is crucial. "Using role models is, if anything, more important for boys and men than for girls and women. Men will engage with their stories - the Campagne État d'Esprit, set up six years ago by the Ligue de Rugby et Rugby à XV, has done amazing work in raising awareness of mental health problems. They've largely focused on depressive disorders, but they're starting to look at eating disorders as well, getting people to start conversations at local club level. The Fédération anglaise de football (FA) is also working at local levels to raise awareness - I would love to see the FA working with the Collège Royal des Psychiatres so we can maximise our impact. I would love the English Cricket Board doing more - they have the power to get through to men in a way that doctors never could."

There are other shining examples of how we can beat the stigma. The brave decision of the international rugby referee Nigel Owens va raconter son combat de 27 ans contre la boulimie is a case in point. You don't get much more manly than a rugby referee. And if it could happen to him, it could happen to anyone.