Sarah Alexander on male eating disorders

The Art of Not Breathing: male eating disorders

Sarah Alexander grew up in London with dreams of exploring the world and writing stories. After spending several years wandering the globe and getting into all sorts of scrapes, she returned to London to complete a Master’s degree in Creative Writing at Birkbeck College in 2013. Previous jobs include: tomato picker, travel consultant, mental-health support worker and suitcase administrator. Now she works in publishing. Sarah lives in London with her husband and two chickens. THE ART OF NOT BREATHING is her first novel.

Each member of the Main family deals with their grief in a different way. Elsie physically hides, initially in an abandoned boathouse and later underwater. Her mum hides inside a bottle of gin and her dad immerses himself in his job. And then there’s Dillon. On the surface, he looks as though he’s the one member of the family who’s holding it together – he has friends, a girlfriend and is doing brilliantly at school, but underneath he’s drowning in his own emotional turmoil. Dillon deals with his grief by controlling what he eats.

Throughout the novel, he visibly fades away until he’s at a dangerously low weight, but the worst thing of all is that nobody notices what’s happening. Like many people with eating disorders, Dillon goes to great lengths to hide his illness.

The truth is that eating disorders can be easily missed if you don’t know what the signs are. But there’s also a lack of awareness that boys get eating disorders too, which leads to a further delay in diagnosis and treatment.

I didn’t initially make a conscious decision to include a male eating disorder in The Art of Not Breathing, but as Dillon’s character developed I realised that, with his personality traits and the trauma in his past, he was at risk of developing one, and I wanted to explore it further.

I did a lot of research but most of my knowledge comes from my job as a therapeutic support worker in an adolescent eating disorders hospital a few years ago. Before I started the role, I had a preconceived idea that eating disorders were mainly related to weight and body image, but this changed when I saw first-hand how complex and devastating eating disorders are – for the sufferer and the sufferer’s family.

Here are ten things I learned about eating disorders while I worked at the hospital:

  1. There are many types of eating disorder, and behaviors and severity will vary from person to person.
  2. Eating disorders can cause irreversible physical damage but those with the illness often suffer from other mental illnesses too, including anxiety disorders, depression and self-harm.
  3. Eating disorders carry the highest mortality rate of all mental illnesses.
  4. Just because someone is at a healthy weight does not mean they don’t have an eating disorder or that they’ve recovered.
  5. The risk factors for developing eating disorders are thought to be largely the same for males and females.
  6. Eating disorders can develop at any age in both males and females but are most likely to occur between the ages of 14–25.
  7. There are many underlying factors that contribute to the development of an eating disorder. Often, eating disorders are a coping mechanism for dealing with difficult situations and an attempt to gain control. They can also be a manifestation of a sub-conscious desire to disappear because of a lack of self-worth or self-esteem.
  8. People with eating disorders have to battle their illness all day, every day, not just at meal- times or around food.
  9. Treatment involves taking the control away which leads to further trauma and setback — even for those who have accepted that they need help and want it.
  10. Treatment focuses on dealing with thoughts and behaviors, and might contain a combination of psychotherapy and cognitive behavioral therapy as well as input from a specialist dietician. It can take a long time but it is possible to recover.

My hope is that Dillon’s character will start a conversation about eating disorders in men so that we can work on erasing the stigma attached.

Sarah Alexander’s book is The Art of Not Breathing and Sarah can be found at her website, Facebook and on Twitter.

The art of not breathing by Sarah Alexander — a girl jumps from a great height over the sea