According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), men make up about 1 million of the 8 million Americans with eating disorders.

"It's a myth that these are illnesses of rich, white, perfectionist women," says Chris Athas, ANAD vice president. "Just as a man or woman may become an alcoholic, either may fall victim to an eating disorder."

Medical professionals say the disorders most often surface during the teen years, but in rare cases, men as old as 60 and boys as young as 8 can be afflicted. In both sexes, the illnesses can lead to lifelong medical and psychological complications. An estimated 6 percent of cases result in death. Most people find it difficult to halt the behavior without professional assistance. Though some men ultimately seek help, many continue untreated with the disorders, often for years, and sometimes for a decade or more.

Another problem, says ANAD, is that a great number of doctors and health-care professionals are not trained to identify or treat male eating disorders, especially anorexia. Families, too, often fail to see the diseases' symptoms. The illnesses then can progress to a more advanced stage where they are harder to treat.

During recovery, men sometimes are unwilling to participate in support-group sessions because the groups are mostly female. "Men as a whole are not comfortable in eating disorder support groups," says Athas. "But we encourage them to go anyway."

Unlike many women, who acquire eating disorders because they "feel" fat, men often are medically obese at some point in the illness and feel pressure to be thin. Sometimes athletic activities induce this struggle to be lean, prompting not only the eating disorder but also compulsive exercising. Men also may adopt disease behaviors when teased or criticized about being fat at critical development stages, such as puberty.

Treatment can be very effective, according to Arnold Andersen, M.D., an expert on eating disorders in men who has written a book on the subject. He describes a regimen of inpatient or outpatient hospital treatment, depending on the illness severity. Conditions such as anemia or depression are treated, and patients gradually relearn proper eating habits. Treatment also usually includes psychotherapy, which helps patients understand why they have the illness.

One antidepressant drug, Prozac (fluoxetine hydrochloride), is under review by FDA as a treatment for bulimia. Other antidepressants also are being studied. One, Wellbutrin (bupropion), was shown to induce seizures in both anorexia and bulimia patients. Doctors sometimes prescribe tricyclic drugs--a class that includes Elavil (amitriptyline), Tofranil (imipramine), and Norpramin (desipramine). FDA has approved tricyclics for other uses but not specifically for eating disorders. However, doctors may prescribe approved drugs for "off-label" uses if, in their judgment, the patient will benefit.

Patients also undergo what Andersen calls "nutritional rehabilitation," which allows them to regain a desirable body weight. Treatment is followed by weeks, months, even years of follow-up to ensure complete recovery.

Men in support groups for eating disorders, as well as those for breast cancer and osteoporosis, say the public gradually is becoming more aware that these disorders can occur in men. They also say there's a long way to go. Some think doctors need to be enlightened. Others bemoan the lack of research. But most seem to agree that men should be educated about the disorders and how to detect them.

As breast cancer patient Seymour Kramer says: "Men need to get the word that, yes, this is a woman's disease. But you're not immune. It can happen to you."

For More Information

• National Association of Anorexia Nervosa and Associated Disorders, Box 7, Highland Park, IL 60035--Offers free programs to help victims and families, including counseling, support groups, health-care referrals, and a newsletter; telephone (708) 831-3438.