They are more common than you might think.
It's rare that you hear men talk about their own issues with food. But Zayn Malik is breaking that taboo.
The singer/songwriter (and former member of One Direction) first opened up about his struggle with restrictive eating in his autobiography, which came out last fall. “It wasn’t as though I had any concerns about my weight or anything like that,” Malik wrote in the book. “I’d just go for days—sometimes two or three days straight—without eating anything at all.”
Last weekend, in an interview with The Sunday Times, Malik explained that he didn't have an eating disorder, but his behavior was tied to an emotional need during a very stressful time: “Every area of my life was so regimented and controlled, it was the one area where I could say, ‘No, I’m not eating that.' Once I got over the control, the eating just came back into place super naturally.”
Malik certainly isn't alone when it comes food issues. Some 10 million American men suffer from diagnosable conditions—such as anorexia, bulimia, and binge eating—according to the National Eating Disorder Association (NEDA). And it's likely many more suffer from other types of disordered eating.
"Disordered eating is on a contiuum," says psychologist Elizabeth Lombardo, PhD, author of Better Than Perfect. It includes abnormal behaviors like not eating for days at a time (as Malik described) or simply skipping meals, she explained in an email to Health. "This can be caused by putting health on the back burner and focusing instead on work or taking care of others."
Keep reading to learn five important facts about disordered eating in men.
RELATED: Subtle Signs of Eating Disorders
Certain eating disorder behaviors are affecting males at a faster rate than women
There are twice as many women with eating disorders than men. But research suggests certain eating issues are becoming more common among males. In a study that compared data from surveys taken in 1998 and 2008, researchers found that purging and extreme dieting increased at a faster rate in men compared to women.
Disordered eating often accompanies other conditions
Men may be at higher risk in their early 20s than in their teens
In a study that followed more than 13,000 young people from age 14 to age 20, researchers found that the prevalence of eating disorders in the male study participants rose from 1.2% at age 14 to 2.9% at age 20.
Some signs of disordered eating in men in women are the same
Aside from weight loss, there are other universal symptoms, says Lombardo. "When the body is malnourished, it can be more easily fatigued and less coordinated, resulting in an increased potential for falls or accidents," she explains. "The immune system can be compromised, making it more likely for you to get sick or stay ill longer because you cannot fight off infections." Disordered eating can also take a toll on mental and emotional health, Lombardo adds. The person may have trouble concentrating or learning, for example, or feel more irritable and stressed.
And certain signs are more common in men
Men who struggle with food issues tend to be preoccupied with looking "cut or ripped," says Stephanie Zerwas, PhD, clinical director of the UNC Center of Excellence for Eating Disorders. "They may get into dangerous cycles of bulking and shredding that might resemble a binge/purge cycle in women," she told Health via email. "Those types of behaviors are often really encouraged in gyms and by trainers, and it can be dangerous for men to hear how 'great' they look from their friends or loved ones." Zerwas adds that many men who come to her clinic talk about how they wanted a six-pack.
But it's important to remember that disordered eating isn't about vanity, she points out. "Often it's a way that people choose to handle their anxiety." It can quickly get out of control, and it's okay to ask for help, she says: "Asking for help isn't a sign of weakness but of incredible strength and courage."