Stepping on to the scales: one fifth of Britons with eating disorders are male. Photo: Mason Masteka on Flickr via Creative Commons
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Breaking the silence: why we should be talking about male eating disorders

An eating disorder doesn’t consider your gender. It is indiscriminate.

James Mitchell suffered from bulimia nervosa. He would eat around 15 packets of crisps in the space of 20 minutes and in an effort to control his fluctuating weight, he would then vomit. “It’s insane. It’s more food than anyone could possibly need or want. Binge eating is like any addiction: when the mood strikes you just want to consume everything in sight,” explained James over the phone. He’s currently revising for finals, so apologises throughout for “mumbling”. During his struggle with the eating disorder – which he has still not fully recovered from – his girlfriend ended their relationship after becoming increasingly concerned about his health.

One evening when James was in a nightclub in Cambridge with his friends he sneaked off to the toilet in order to purge, somewhat of a routine for him. By this point he had been bulimic for almost a year and a half. When pulled from the toilets by the bouncer he explained the situation, and for the first time openly confessed his bulimia. A week or so later, James was forcibly ejected from the toilets of the same club and called a “bulimic twat” by security. They presumed he was purging, when in fact he had just gone to relieve his bladder.

“I was shocked. I hadn’t shared this information with anyone else,” James says. “Then the insults turned nastier, they started to get homophobic.

“Back in the early days when I admitted to having an eating disorder, even girls were shocked. It’s not very attractive. I think women in particular give each a lot more support with the issue,” he says.

The NHS estimates that a fifth of the 1.6 million Britons suffering from some form of eating disorder are male. Yet new research by academics published in the BMJ Open journal claims that young men who suffer from disorders including anorexia are “underdiagnosed, undertreated and underresearched”. The researchers from the University of Oxford and University of Glasgow interviewed 39 young people aged between 16 and 25, including 10 men, about their experiences of diagnosis, treatment and support for eating disorders. According to the study it is partly due to men being unaware of the symptoms, despite purging, not eating for days and obsessive calorie counting. One of the participants, who described himself as “one of the lads”, said he thought eating disorders only affected “fragile teenage girls”.

“Our findings suggest that men experience particular problems in recognising they may have an eating disorder as a result of the continuing cultural construction of eating disorders as uniquely or predominantly a female problem,” said Dr Ulla Raisanen and Dr Kate Hunt in the BMJ Open.

An eating disorder doesn’t consider your gender. It is indiscriminate. It is society, along with its tedious gender norms, that has exclusively associated eating disorders with the fragile teenage girl or the starving model eating tissue to preserve a size zero figure. What doesn’t come to mind is the young male bingeing in the dark, on his own, with four or five large pizzas and then purging into the toilets of a nightclub. We need at all costs to break the stigma attached to male eating disorders if we are to avoid a silent epidemic.

In 2008, the former deputy prime minister, John Prescott, was praised for his courage to confess his two decade-long battle with bulimia. He binged on burgers, crisps, fish and chips until he had the pleasure of feeling full. And then he would vomit. Prescott’s confession did much to address the shame associated with male eating disorder, yet his efforts were constantly undermined by comedians constructing cheap one-liners that dismissed his eating disorder as gluttony and suggested he failed at being bulimic because of his weight. It is a myth that all bulimia sufferers are a size zero: somebody who is overweight when they develop an eating disorder will hold on to that weight.

Hugh Smith suffered from anorexia nervosa in his early twenties. Photo: Ashley Cowburn

Hugh Smith suffered from anorexia nervosa in his early twenties.

Hugh Smith, who is now 23, suffered from anorexia nervosa. “I would run obsessively for an hour everyday to the point where I would be exhausted. I had no energy at all,” explained Hugh over coffee in Camden Town. He believes his anorexia started during his first year at the University of Birmingham and spiralled out of control during his third year, which he spent in Redon, a small town in the north-west of France. His alienation from his friends worsened his eating disorder. “It was the sort of provincial town where once you get to 18 you head off to a city. So there were very few people around to notice any change.”

It wasn’t until Hugh returned from France after losing a substantial amount of weight that his mother (luckily a mental health nurse) spotted the problem. “Men who have eating disorders are not likely to boast about it,” says Hugh. “It’s very easy to read the message in the media that everyone is overweight so everyone must lose weight. For someone who doesn’t have the weight to lose that’s a very dangerous message.”

“When I was diagnosed, it felt like a relief. To actually have a label for it and make it something I could envisage or conceptualise, that made a big difference. It became something I could latch on to and begin to deal with it. Before the diagnosis, I had no idea. It was like a bolt from the blue.

“Since I’ve gone through most of the process of recovery, I have more energy and I’m more able to live my life,” he explains.

Hugh is now a trustee of the charity, Men Get Eating Disorders Too, which primarily aims to raise awareness that eating disorders are indiscriminate.  In both James and Hugh’s struggle with two different types of eating disorders, their situations were compounded by the fact that they didn’t actually recognise it was an eating disorder.“You’re only told it’s an eating disorder afterwards. The eating disorder isn’t the problem  it’s the fact that people don’t speak up about it. I was going years without telling anybody and that was the reason I didn’t recognise it as an eating disorder. . . if you want to feed your anorexia or bulimia then don’t tell anyone about it, because that’s the most important part of an eating disorder,” says James.

The charity BEAT claims that anorexia in the UK has the highest mortality rate of any psychiatric disorder, from medical complications associated with the disorder as well as suicide. BEAT also estimates that 20 per cent of those who suffer will die prematurely from their illness. In 2011, the NHS reported that the past decade had witnessed a 66 per cent jump in hospital admissions in England due to poor eating habits among men.

The fact that male eating disorders are so little discussed compounds the problem: the issue has been stigmatised to the point that eating disorders are seen as a female affliction – never mind the strangeness of the idea that there can even be such thing as a feminine mental health condition. Society views the young male devouring four or five large pizzas before purging as a behavioural choice rather than a mental health issue. Overeating and bingeing is seen as amusing and funny. It is a necessity for men to speak out and break the taboo of male eating disorders in order to save lives; we need more young men like James and Hugh to come forward with their stories and provide a lifeline for those in need. 

Ashley Cowburn writes about politics and is the winner of the Anthony Howard Award 2014. He tweets @ashcowburn

 

 

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Inside Big Ben: why the world’s most famous clock will soon lose its bong

Every now and then, even the most famous of clocks need a bit of care.

London is soon going to lose one of its most familiar sounds when the world-famous Big Ben falls silent for repairs. The “bonging” chimes that have marked the passing of time for Londoners since 1859 will fall silent for months beginning in 2017 as part of a three-year £29m conservation project.

Of course, “Big Ben” is the nickname of the Great Bell and the bell itself is not in bad shape – even though it does have a huge crack in it.

The bell weighs nearly 14 tonnes and it cracked in 1859 when it was first bonged with a hammer that was way too heavy.

The crack was never repaired. Instead the bell was rotated one eighth of a turn and a lighter (200kg) hammer was installed. The cracked bell has a characteristic sound which we have all grown to love.

Big Ben strikes. UK Parliament.

Instead, it is the Elizabeth Tower (1859) and the clock mechanism (1854), designed by Denison and Airy, that need attention.

Any building or machine needs regular maintenance – we paint our doors and windows when they need it and we repair or replace our cars quite routinely. It is convenient to choose a day when we’re out of the house to paint the doors, or when we don’t need the car to repair the brakes. But a clock just doesn’t stop – especially not a clock as iconic as the Great Clock at the Palace of Westminster.

Repairs to the tower are long overdue. There is corrosion damage to the cast iron roof and to the belfry structure which keeps the bells in place. There is water damage to the masonry and condensation problems will be addressed, too. There are plumbing and electrical works to be done for a lift to be installed in one of the ventilation shafts, toilet facilities and the fitting of low-energy lighting.

Marvel of engineering

The clock mechanism itself is remarkable. In its 162-year history it has only had one major breakdown. In 1976 the speed regulator for the chimes broke and the mechanism sped up to destruction. The resulting damage took months to repair.

The weights that drive the clock are, like the bells and hammers, unimaginably huge. The “drive train” that keeps the pendulum swinging and that turns the hands is driven by a weight of about 100kg. Two other weights that ring the bells are each over a tonne. If any of these weights falls out of control (as in the 1976 incident), they could do a lot of damage.

The pendulum suspension spring is especially critical because it holds up the huge pendulum bob which weighs 321kg. The swinging pendulum releases the “escapement” every two seconds which then turns the hands on the clock’s four faces. If you look very closely, you will see that the minute hand doesn’t move smoothly but it sits still most of the time, only moving on each tick by 1.5cm.

The pendulum swings back and forth 21,600 times a day. That’s nearly 8m times a year, bending the pendulum spring. Like any metal, it has the potential to suffer from fatigue. The pendulum needs to be lifted out of the clock so that the spring can be closely inspected.

The clock derives its remarkable accuracy in part from the temperature compensation which is built into the construction of the pendulum. This was yet another of John Harrison’s genius ideas (you probably know him from longitude fame). He came up with the solution of using metals of differing temperature expansion coefficient so that the pendulum doesn’t change in length as the temperature changes with the seasons.

In the Westminster clock, the pendulum shaft is made of concentric tubes of steel and zinc. A similar construction is described for the clock in Trinity College Cambridge and near perfect temperature compensation can be achieved. But zinc is a ductile metal and the tube deforms with time under the heavy load of the 321kg pendulum bob. This “creeping” will cause the temperature compensation to jam up and become less effective.

So stopping the clock will also be a good opportunity to dismantle the pendulum completely and to check that the zinc tube is sliding freely. This in itself is a few days' work.

What makes it tick

But the truly clever bit of this clock is the escapement. All clocks have one - it’s what makes the clock tick, quite literally. Denison developed his new gravity escapement especially for the Westminster clock. It decouples the driving force of the falling weight from the periodic force that maintains the motion of the pendulum. To this day, the best tower clocks in England use the gravity escapement leading to remarkable accuracy – better even than that of your quartz crystal wrist watch.

In Denison’s gravity escapement, the “tick” is the impact of the “legs” of the escapement colliding with hardened steel seats. Each collision causes microscopic damage which, accumulated over millions of collisions per year, causes wear and tear affecting the accuracy of the clock. It is impossible to inspect the escapement without stopping the clock. Part of the maintenance proposed during this stoppage is a thorough overhaul of the escapement and the other workings of the clock.

The Westminster clock is a remarkable icon for London and for England. For more than 150 years it has reminded us of each hour, tirelessly. That’s what I love about clocks – they seem to carry on without a fuss. But every now and then even the most famous of clocks need a bit of care. After this period of pampering, “Big Ben” ought to be set for another 100 or so years of trouble-free running.

The Conversation

Hugh Hunt is a Reader in Engineering Dynamics and Vibration at the University of Cambridge.

This article was originally published on The Conversation. Read the original article.