April 9, 2014 -- Eric, a man in his 20s from Texas is 5-feet 8-inches tall and weighs only 105 pounds –- five pounds lighter than he weighed in the sixth grade.
“He basically hasn’t gained any weight in 13 years,” his mother, Mary, told ABCNews.com
“At the age of 3, he didn’t want to eat dead animals and he would only eat white rice and white bread and milk, but more and more as he got older he became more restrictive and selective in the way he would eat,” she said. “He ended up with only two or three things he would eat and he suppressed his hunger pains so much, he didn’t want to even come to dinner. Thanksgiving was horrible for him.”
Mary, who for privacy reasons, did not want to use their real names, said the family had sought help from numerous doctors who did not recognize her son had an eating disorder –- one, who even suggested he had a heart ailment.
“They basically shamed and scared him,” said Mary.
Another therapist recommended Eric to treatment centers, but one was exclusively for teens and another for only girls. So her son has not yet received a clear diagnosis, Mary said.
Even Eric, himself, has had difficulty recognizing his struggles with food.
“Part of the problem is labeling and stigma,” said his mother, who has sought help from the online forum F.E.A.S.T. (Families Empowered and Supporting Treatment of Eating Disorders). He "has never really said, 'I have a disorder.'"
Now, a small study in the journal BMJ Open confirms that the perception that anorexia, bulimia, binge-eating and non-specific eating disorders like Eric’s are problems for women alone delays men getting help.
Men suffering from eating disorders can go days without eating -- purging, calorie counting, exercising and obsessively weighing in, and, like Eric, they can isolate themselves from others, the study found. Often the situation reaches a crisis point before these men get help.
“Men with eating disorders are under-diagnosed, under-treated and under-researched,” write the authors, Ulla Raianen of the University of Oxford, and Kate Hunt of the University of Glasgow.
“Our findings suggest that men may experience particular problems in recognizing that they may have an eating disorder as a result of the continuing cultural construction of eating disorders as uniquely or predominantly a female problem,” they add.
This perception has “also been embedded in clinical practice,” they note, adding that in order to improve the outlook for men with eating disorders, “early detection is imperative.”
A 2011 study in the International Journal of Eating Disorders reveals that eating disorders affect 4 million Americans and can be just as damaging to men, who seek treatment less often.
Other studies have suggested that men account for one in four cases, but the true prevalence is not known because symptoms are not always recognized, according to the British study.
Researchers reported many delays in diagnosis, issues of comfort with doctors who were not empathetic and even one case of a gastroenterologist who urged a patient to “man up,” after he had prolonged vomiting and weight loss. Even when given information, or referred to support groups, several men felt it had an approach tailored to women and no specific guidance for males.
“It’s a stigma for girls -– but it is horrendous for boys, but it’s not something that is necessarily the same etiology,” said Keith Ayoob, director of the nutrition clinic at the Rose R. Kennedy Center at Albert Einstein College of Medicine in New York City. “It can be the guy who is purging to make weight on the wrestling team or the guy who wants the perfect body, but not necessarily the kind girls want -– they want to look shrink-wrapped for training.”
Dr. Evelyn Attia, director of the Eating Disorders Research Program at Columbia University Medical Center, said men often feel isolated from treatment and support groups.
“Men often feel their early signs and symptoms are not related to an eating disorder but are related to a specific behavior such as being a perfectionist or pursuing athletic activities in an appropriate way,” she said. “They often do not recognize that they’re putting their bodies at risk and getting into trouble.”
“Families and health care providers need to realize this is a gender-neutral illness that affects all walks of life equally,” Attia said. “As such, early detection and treatment is key. There is no clear data of specific causes for eating disorders in men, thus the focus should be on early symptoms and behavior.”
Upwards of 70 percent of cases of eating disorders are associated with a history of abuse, substance abuse or coexisting psychiatric illness, according to the latest British study.
Such was the case with Ron Saxen, a former model who lives in California. He said he used food to numb himself against an abusive father and developed a binging disorder.
He'd go to McDonald's and order a couple of Big Macs, large fries, a cheeseburger and a chocolate shake, then go on to Taco Bell for more and follow that with several king-sized candy bars.
Afterwards, horrified by his out-of-control eating, Saxen would run 30 miles. But as he got fatter, he couldn't run and burn off the weight, and he permanently damaged his knees.
When 6-foot, 1-inch tall Saxen ballooned from 180 to nearly 300 pounds, he dodged his modeling agent out of embarrassment and sabotaged his career.
"I learned at an early age that food erases anxiety," said Saxon. "If I ate a bunch of food, it would calm me down. It became the way I dealt with things."
Saxen began to realize he had a problem, but it took years to get help, mostly because of the shame.
In 2007, he wrote a book, “The Good Eater,” hoping it would help others. But the book failed.
“Men think it’s a woman’s problem. I know I did,” he told ABCNews.com. “Men, no matter what the malady, are slow to get help. We think a real man deals with it, gets over it by sheer will.”
Saxen said “late in the game,” he got help form a therapist and his healthy today at 51.
“A man has to be a bit more aggressive than a woman to get help,” he said. “He has to push through all the stuff: the words and the images that scream ‘female world,’ not male. And, since the numbers that do exist point to males being more rare, it makes us feel even more weird.”
As for Eric, he is “in transition” and is in Los Angeles with his mother seeking intensive treatment. One day, he hopes to go to culinary school, which his parents are supporting as a way for him to develop a better “relationship with food,” said his mother. “It’s a matter of education, labeling and stigma.”
“The root of this is abandonment and identity,” Mary said of her son’s eating disorder. “You have to believe that you are valued enough to deserve food, to maintain and grow and bring life to your body –- that you are worthy.
“Some people just want to disappear,” she said. “This can turn literal and they deprive themselves so much, they become smaller.”
Dr. Alok Patel from ABC News' medical unit contributed to this report.