Eating disorders have long been stereotypically viewed as only affecting women. However, a growing body of research indicates that men are also affected, albeit mostly silently.
Of 10 people who suffer from anorexia nervosa, one is a man; and in the case of bulimia, one man in 20.
But these statistics may be the tip of the iceberg, as not many men admit to battling the disorders and subsequently do not come forward for treatment. In fact, a South African study indicated that only about 15 percent of men actually seek treatment for eating disorders.
*Bandla Fakazi is one of them -- but it took him almost a decade to seek help.
"Not even my mother knows," he admitted to HuffPost SA. "Only an ex-girlfriend and that's because you know, I thought she was the one and oh I got caught," he jokingly added.
The 31-year-old from Lanseria, in Johannesburg, said he battled bulimia for most of his twenties. "I was always the chubby guy, you know and people made sure I knew it. Like it was the acceptable joke and at first I didn't mind and then it kinda stung."
At varsity, Fakazi says he "just exploded" [referring to weight gain]. "I tried the gym and running... maybe I was not patient but I did not see change."
He admits that it depressed him a lot.
It's around this time that he started purging after eating. "I knew there was something wrong but I also didn't think I was sick. I just wanted to lose weight fast and this way worked."
No one knew until a girlfriend found out when he was in his late twenties. "I mean it's harder to squeeze time after dinner to go throw up when your girlfriend is always there or you have visitors. She only found out very late actually," Fakaza said.
And it is after this is that he sought help. "I am in treatment, but I have relapsed I won't lie... but the treatment I can say has really helped."
Breast cancer survivor Ian Fife believes masculine attitudes around diseases and disorders "perceived to be women's diseases" are problematic.
"We are told to be men and men don't cry, only women cry. Men also don't get diseases like breast cancer and they certainly do not suffer from eating disorders," said Fife.
"When I was diagnosed with breast cancer, people said 'but you don't have breasts' and I realised that the problem with gendered misperceptions around diseases is big," he said.
Psychiatrist Dr Sarvani Pather points out that disorders and diseases do not discriminate. "They affect people across the board, irrespective of age, sex or race," she said.
And they are triggered by different circumstances or factors, such as genetic, psychological, social, sport and family, explained Pather to HuffPost SA.
For rugby union referee, Nigel Lawson -- who has openly shared his almost three-decade long battle with bulimia, it was the realisation as a teenager that he was different.
"I was finding myself attracted to men and couldn't figure out on earth what was going on," he told the BBC. He revealed that he was very depressed by this, and later started making himself sick.
"Mental health issues, depression over my sexuality, bulimia and steroids -- my life was an unrelenting nightmare."
No one knew about Lawson's struggles until he attempted to take his life when he was 26, but survived.
Although some people battling eating disorders can hide it very well, Pather said there are some tell-tale signs.
Pather pointed out that both anorexia and bulimia can result in a swollen or puffy face. Sufferers may complain of headaches, dizziness, constipation, fatigue and stomach pain. Rapid fluctuation of weight, redness of eyes and dry, blotchy skin may also present as eating disorder signs.
Anorexic individuals, in particular, may also experience insomnia and become anaemic, while tooth decay, enamel erosion, scars on the index finger may present in bulimic individuals.
Eating disorder behaviour, in general, may include:
- Anorexia: concealing food in clothing, bedding or throwing it away; obsessing over fat, food fads -- such as sucking ice, chewing gum, excessive tea and coffee
- Bulimia: these individuals may either gobble up food or eat normally and then binge. the smell of, or residual vomit in the bathroom, hoarding food and even stealing food from other people.
The good news is, eating disorders can be treated, but men and women alike need to seek the help.
Although treatment differs, people with eating disorders may need to be admitted into a treatment centre. Out-patient treatment is also an option. Pather further stressed that a combination of medication, medical management, where necessary, and psychotherapy can greatly improve the outcome.
A strong family support system also goes a long way for people recovering from eating disorders, she added.
Here are a few local places you can get help:
1. The South African Depression And Anxiety Group (SADAG) on 0800 567 657, a toll-free number. The organisation offers counselling for a range of disorders and or mental illnesses.
2. Anorexic and Bulimics Anonymous -- the group offers support and guidance for people recovering from eating disorders. They hold meetings in some major cities in the country.
3. Overeaters Anonymous -- the support group for compulsive eaters has an extensive recovery programme.
*Name protected for privacy at the request of the interviewee.