Starved for approval

On a typical day, Chris, 19, wakes up with hunger pangs. He goes to his classes at Ryerson University, smoking in between lectures to pass the time until 4pm, when he indulges in his only meal of the day: two pieces of whole-wheat bread with two tablespoons of peanut butter.

About every 10 days, Chris lets loose and binges on things he craves. He stuffs himself with cookies, ice cream and chips, and then throws up afterward. Sometimes the binging and purging lasts two hours, sometimes an entire weekend.

Chris, who asked that we not use his last name, doesn’t think he would have an eating disorder if he were straight. He says the pressure on gay men to conform to one of two ideal body types – thin and waif-like or buff and toned – is intense. He believes if a guy doesn’t fit in, he won’t be loved.

“Either you’re working out six days a week and running on the seventh, or you’re just completely thin and skeletal,” he says. “I know I can’t be the big musclebound type guy, so I’m going to be the other one.”

At six-feet tall, Chris is noticeably thin. Three years ago he was 200 pounds, but the morning I write this, he weighed in at just 137.2 pounds. He has clung to anorexia and bulimia for three years and is slowly starving himself to the bone.

Chris isn’t alone among gay men going to extremes to fit into a culture that is not, perhaps, as accepting as it should be. While acceptance of queers and queer culture has increased in the mainstream in recent years, acceptance within the community is still too often determined by a person’s appearance. The bear movement notwithstanding, standards of gay male beauty remain surprisingly narrow.

“I think it’s getting worse because there’ve been no changes in the images that are being portrayed,” says Miles Cohen, a Toronto psychiatrist who treats gay men with eating disorders. “If anything, it’s getting stronger. I think it’s going to keep getting worse over time. It’s just such a narrow depiction of what people should look like.”

Most estimates, including those provided by the Toronto-based National Eating Disorder Information Clinic (NEDIC), the Mental Health Resource Centre Of Manitoba and Ottawa’s Hopewell eating disorder clinic, suggest that about 10 percent of people with eating disorders are men.

While the UK’s Eating Disorders Association says about 20 percent of men with eating disorders are gay, Cohen says the actual numbers are probably higher since men are often reluctant to identify themselves as gay for a study.

“About half of the men with eating disorders are gay,” he says. “That’s significant because if you look at the population, only about five percent of men are gay, so you’d only expect five percent of men with disorders to be gay.”

Cohen says gay men are more susceptible to eating disorders for a number of reasons. A large factor comes from growing up gay in a culture that is, despite many recent advances, less than accepting. “Gay men generally start out feeling badly about themselves. You grow up with a sense that you’re bad or this is wrong,” he says. “There might be other issues as well. They could be overweight when they’re young and have a lot of teasing.”

The combination of personal background, self-esteem issues and the need for acceptance in an image-focussed culture can quickly lead to body dissatisfaction. “When you try to come out in the gay community, you quickly learn there’s a lot of cultural pressure within the community to look a certain way. I think it’s much stronger in the gay community than in the heterosexual community,” says Cohen.

“Because we’ve been so beat up by straight society, we can now do this to ourselves,” says Robin, a 40-year-old gay man who has suffered from eating disorders for 14 years. He is not only critical of the way he looks, but of the men he dates as well. “I had a 250-pound boyfriend,” he says. “I found it revolting.”

At 5’9″, Robin’s weight fluctuates between 112 and 122 pounds. “It’s a constant battle I have within myself,” he says. “I hate myself. I’m full of shame. I don’t deserve to eat.”

Robin says growing up in a society that was not as accepting of homos as it is now was difficult. His self-esteem was low, he often felt guilty. When he was 26, he dated someone who told him, “I don’t want to be with a big fat slob.” Anorexia, bulimia and obsessive exercise have plagued him ever since.

It is a vicious, if not ironic, cycle. Robin works out to become muscular but because he feels he can never become as muscular and buff as he wants to be, he punishes himself with anorexia and bulimia. Thin and sickly, he is the epitome of what he strives to avoid.

Another factor that has contributed to gay men’s susceptibility to eating disorders was the growth of the “AIDS look” in the late 1980s. Cohen – as well as Arnold Andersen, Leigh Cohn and Thomas Holbrook, authors of Making Weight – says when gay men with AIDS began to look sick, there was a knee-jerk reaction among many gay men to automatically want to look healthy, which usually meant bulking up and toning muscle to “distance themselves from appearing ill, and hence further stigmatization and rejection,” according to Cohen. But for many gay men, the new ideal body type was, and still is, unattainable.

“Eating disorders are the gay man’s response to AIDS,” says Robin, though he admits there are other factors, too. He agrees the AIDS look took hold in the late 1980s and people were afraid of anyone who looked like they had the disease. Even men without HIV were rejected for looking like they had it. Robin recalls one incident when a man on the subway yelled out at him, “You have HIV! You have HIV!”

Because he is so thin, Robin says he attracts a very particular type of guy. “The only people interested in me are men that are HIV-positive. I’m negative, but they think I’m HIV-positive,” he says. “There’s this thing where it’s like, ‘I can have unprotected sex with you because we both have the virus and it doesn’t really matter.'”

The day before we met, Robin says he told his psychiatrist he wanted to commit suicide. “I’m very desperate,” he says. In the quiet following his comment, I compliment him on a silver pinkie ring on his right hand with three hearts. “I wear it for hope that something positive will come into my life.”

Despite the apparent prevalence of eating disorders among gay men, there’s a stunning lack of awareness of the issue. “It’s very hard to diagnose an illness that people don’t talk about,” says Ann Kerr, director of Sheena’s Place in Toronto, a centre dedicated to supporting people with eating disorders. “I think media definitely plays a large role, but at the end of the day, it all occurs in a society that values image so much.

“The ultimate question is: why does our society promote this so much? How did we become so invested in this? I just don’t know,” says Kerr. Although Sheena’s Place offers a support group specifically for gay and bisexual men with eating disorders, there’s no session currently running, because they need a minimum of three men to make a group. Out of the thousands of gay men who deal with eating disorders in Toronto, just two have signed up to find support.

The problem is not being talked about enough within the community itself, but also that organizations that might make a difference aren’t paying enough attention. According to employee Beth Sapiro, NEDIC’s primary focus is on women’s eating disorders.

“We do recognize it’s a population that needs attention,” she says when I ask about educating gay men in particular, “but it’s not something that we spend a lot of time talking about.”

* For more information about Sheena’s Place check out Sheenasplace.org or call (416) 927-8900.