The Uneducated PT Podcast - Ep.82 Unspoken Struggles: Exploring Men's Binge Eating, Body Image, and Cultural Pressures with Brian Ó hÁonghusa

Episode Date: May 14, 2025

In this compelling episode, we sit down with Brian Ó hÁonghusa to delve into his research on men's experiences with binge eating and body dissatisfaction. Brian sheds light on how societal norms and cultural expectations often silence men's struggles with eating disorders, leading to feelings of shame and dismissal. We discuss the lack of data surrounding men's mental health in this area, the unique challenges faced by male athletes concerning body image, and the broader implications of cultural narratives on men's health. This conversation aims to break the stigma and encourage a more inclusive dialogue around men's mental and physical well-being.Brians Instagram Men's Survey

Hello and welcome to the uneducated PT podcast with me, your host, Carlo Rourke. The goal of this podcast is to bring on interest and knowledgeable people from all walks of life, learn a little something from each conversation and for you, the listener, just learn something from each episode. So don't forget to subscribe to the channel, press the box below, show some support and I'll see you on the next episode. Brian, welcome to the podcast. Can you give the listeners a little bit of insight into your background

and what you do currently and what we're essentially going to talk about today? Yeah, 100% Carl. Thanks for having me. So my background is in, it's 10 years ago now. I finished a degree in human nutrition, which seems like a long time ago. And I've been working in the industry as a nutritionist and a nutrition coach since 2017. And, you know, through that period, I was working with a lot of different types of clients. What's sad to see more and more of the sort of disordered eating type presentations.

And because I kind of had a liking to say cognitive behavior therapy, which is sort of informed by Stoic philosophy in terms of there's a lot of underpinnings of stoicism into CBT and in terms of how we have it in the modern day. So there's the kind of a flow there. And I suppose I was helping people with that kind of thing and then just doing my own sort of like learning on the topics. but the more people I started to work with in terms of having disordered eating with a lot of success, you know, I'd like to say. I did just want to advance my expertise in terms of being able to work with people with actually clinically relevant eating disorders. You know, because there is this spectrum from like normal eating to eating disorder and then kind of disordered eating is because more over that little side of the clinically. diagnosed eating disorders. So I want to be able to help people with that. So that has brought me to come into the end now of a two-year master's in cognitive behavior therapy. So I'll be qualified

fully, very shortly as a CPT psychotherapist. That's not the only type of therapy I use in practice. I use some other third wave approaches, as they're called, things like acceptance and commitment therapy, dialectical behavior therapy, a bit of compassion-focused therapies. It's kind of integrated, but they're all in kind of the broader CBT heading without logging anyone down the details. But that's where I'm at now. And then, as you know, I'm doing this research project, like the last step of this master's is to finish my dissertation. And I've been doing clinical practice then as part of the master's for the last 13 months. So I've done quite a lot of actual client sessions at this stage more formally.

mostly for people who have eating disorders disorder eating body image issues sometimes there's like a junk thing like depression or anxiety to to treat within that that's causing the eating problems but yeah this brings me to the

research that I'm doing which is in binge eating in men in Ireland specifically and specifically in the gym going population so that's kind of a quick what what what inspired you to explore that topic specifically in terms of you know gym going men yeah jim going men well first of all there's a practical element to be honest where i think i could get like get my so i'm using a survey questionnaire that i've distributed and i thought i'd

have a better chance of getting enough respondents leveraging connections in the fitness industry Ireland, basically. But I'm also interested because some of the research questions I had were, you know, even someone with, say, quote unquote normal BMI or healthy BMI, are they experiencing similar rates of binge eating to, say, overweight or obese, which, you know, it does seem to have higher rates in that type of population. But I'm just interested because of the kind of body image side of things, the body dissatisfaction, how that can interplay within, you know, people who are obviously training and maybe for men, you know, in particular pursuing

muscularity potentially, you know, in terms of the body image idealization. Like for men, it's not quite just like the tin ideal, it's more into the muscularity side of things. So that's a little bit different and, you know, something I think worth exploring in in that specific gym going population. So there's a few reasons there that I wanted to explore it in that population specifically. And then for men, it's just because like, you know, if we go down the levels, mental health research and men is not that prolific eating disorders, even less so.

And then, yeah, that's kind of what I wanted to contribute to. because if we have something like binge eating disorder, as it's clinically defined, is the most common of all eating disorders. You know, so the global point prevalence, it's called.

So that would be like, if you just took a snapshot of like the entire world right now, how many people have binge eating disorder? It's estimated about 1%. Which is a lot of people like when you consider the entire global population, right? And there doesn't seem to be a difference between

high income, low income countries. So it's not isolated in that sense. It doesn't seem to be. And then in terms of the lifetime prevalence, it's about 1 to 3% of men. So that means that at any point in time, they will have met the criteria for binge eating disorder.

And then it's a little bit higher women at 3% to 5%. But there's still a lot of men that obviously experience it. And then when I look, so throughout the master's that I was doing, like any time we were told to like do an assignment would usually be given a bit of autonomy on what that would look like but i always just picked eating disorders because that's my main area of interest in the work that i do right because i do nutrition coaching and now i combine it with therapy and and tried to have it that way so i was always just by default doing a lot of reading on different eating disorders um a lot of binge eating a lot of anorexia um i just saw that like you know when you see the research studies don't on binge eating sort of treatment, you know, it was 10 to 20% of participants were men, even though there's a lot more than that in the population that are experiencing binge eating. So there's a mismatch there because, like, you know, for some of the other eating disorders,

like it is more biased towards women, it seems that that have those. So it sort of makes sense that more of the research, sorry, do you want to come in there? No, sorry, no, keep talking. I was just going to ask why do you think it is? underrepresented in men just to have your thoughts on that yeah there's a few potential reasons I think like being able to recognize it is problematic like there's a there's a difference there I can I can see men not even being aware of it or even if they do seek support it's not getting picked up because there's more of this like I you're a fella like you've a good

appetite kind of stuff, which is not quite the same for, for women. So that's kind of tropes coming into it. And if you look at, say, some of the criteria for diagnosing binge eating disorder, which would be you have to binge eat at least once a week over a period of three months, where a binge is defined as eating a, in most cases, eating objectively a large amount of food in a short space of time with some other criteria such as going to the points where you feel overly full or you feel sick. You might do it alone or an isolation for ashamed things.

You want people to see the amount that you're eating. You might eat a lot faster than usual and then feel quite like guilty, disgusted, etc. After doing that. And then there has to be some amount of distress associated with the binging itself. So some of those things could be missed, I think, and or maybe not consider that like, oh, this is actually a problem that I could have. And then, you know, just kind of, it is kind of obvious in the literature that eating disorders are seeing as kind of a feminine topic. You know, some men I think are less likely probably to even be aware, first of all.

But then even if they do seek treatment, like the, the stats, some of the stats on that are like, obviously depending where you look, but some of the, the ones that I've seen are, you know, 50% of people with binge eating disorder will seek treatment. It might take an average of six years for them to get that treatment. Wow. And then I've looked at some more specific, if I recall correctly, to like psychotherapy treatment, which should be the main best treatment for eating disorders in general. That being generous, like 30 to 50% use evidence-based practice for eating disorder. orders. So again, if we have more levels there, it's like, all right, if 50% seek treatment,

or 50% get treatment, they should say, only half of those again, maybe getting, or less, even, maybe getting evidence-based treatment. That's a little bit of a tangent, but I think there's probably, I think there's probably issues with men seeking treatment and then also getting picked up. Because like if you, you know, maybe if you go down to your GP and you say, hey, I've been struggling with this, it may be a bit hit or miss as to whether the GP will take that seriously, you know, in this kind of stigmatization of eating disorders and things like that. You know, so like it could be kind of fubbed off as like, ah, you just have a good appetite, you like to eat a lot of food. And in the same breath, I'll probably tell you like, oh, you need to

lose weight actually as well, you know. Yeah, they're damned if they do, damn this, they don't kind of thing. That's maybe a bit cynical of me, but yeah, sorry, to answer your question. Well, that's, that's insane percentages of like, you know, it might take them six years and then, you know, if they do actually get treated or they're not dismissed, then even less than that, some of it's not even going to be evidence-based treatments. Could you distinguish the difference between, you know, treating someone evidence-based versus maybe someone falling into the category of, you know, being helped with non-evidence-based treatments?

Yeah, I mean, I suppose, like I had to do some assignments there recently, like one, you know, a reflective assignment of all the like a few hundred hours of practice I've gone over the last year. So that was definitely getting me thinking of like, well, you need to be able to justify why you take a certain treatment approach. Like this is what I didn't write this, but like you can't just go on vibes and be like, well, I'm doing therapy. I'm being present with the person and I'm satisfying the core conditions. But like in terms of what is, what it does seem to evidence based, it would be cognitive

behavior therapy. and there is a type of CBT that's designed for eating disorders. So it's called CBT Enhanced or CBTE as it's referred to. That has by far the largest evidence base for treatment of eating disorders and that extends to binge eating as well. The treatment of anorexia is a little bit, it's not as convincing. There's a few different options that seem equally good for the treatment of anorexia, but for say, bulimia and binge eating disorder,

cognitive behaviour therapy seems to be the best, but within that camp, it should be, based on what I've seen, that specific type of CBT, which, you know, it doesn't look hugely different from some, say, good nutrition practices, because some of that treatment is genuinely getting regular meals in throughout the day, for example, keeping a food diary, monitoring, kind of emotions, monitoring where the binges are, so there's a kind of self-monitoring that comes into it. But then the more therapeutic side of the treatment is looking at what would be some of the main, I suppose, driving factors for someone to have binge eating. So it would be things like perfectionism comes up a lot. There's the, this, this is common amongst most eating disorders,

but the overvaluation of weight and shape as a important thing, which then leads to greater body dissatisfaction and poor body image. which can lead to things like dieting and excess dietary restriction and restraint, which is a major potential driving factor as well. And, you know, that's how you get people into like, you know, trying to fast all day or eat as little as possible and then binging at night. But low self-esteem comes into it. And then a lot of what I would work with is kind of the emotional side as well. So like people are using it as a coping mechanism either to blunt.

difficult emotions. It doesn't have to be like negative emotions necessarily, but I don't want to go into too much detail on this because like it's sort of various from person to person, but like someone would have just difficulty in general with feeling, say, big emotions, whether they're positive or negative. So a lot of it depends on their, their background and their upbringing and stuff. But the general mood tolerance, emotional tolerance comes into it. And that would be why I bring in some other sort of therapeutic treatments aside from from CBTE specifically because say like dialectical behavior therapy or DBT that was that was designed for um borderline personality disorder and which is characterized by a lot of kind of difficulties with with mood tolerance so you can translate that to

something like helping people emotionally regulate to avoid things like emotionally driven binge eating and bulimia and, you know, purging tendencies. So there's that and then there's, you know, so there's not as much research on that, let's say, compared to CBT, but the little bit that's there, I think, is quite promising. Interpersonal therapy, as it's called as well, which, again, this is another kind of feature of why people might have issues of binge eating is like just interpersonal difficulties, like, so relationships, lack of relationships, these kind of things. are one of the big contributing factors as well.

And so there is a type of therapy for that, if that seems to be the main reason that someone is having difficulty with these things. So there's those and yeah, and then I think like sort of some mindfulness combined CBT approaches seem to work well, acceptance and commitment therapy, which is a CVT kind of format,

but different, the way it's delivered is a bit different, and the kind of spirit of is a little bit different. But when I think about these things, I do think that they're more similar than they are different in terms of the treatment approaches. So I think that's why you probably see success somewhat across the board with some of these things.

Yeah, there's a lot of crossover. I think so. I think like, again, from, I'm obviously still a novice at the therapeutic aspect, but from thinking about it and looking at sort of the research on it, yeah, it does seem like there's a lot of crossover.

So a lot of the principles, I think, are quite similar. And then it's just the methods are somewhat different, you know. Yeah. It's kind of like with diets and nutrition, it's like satisfying similar principles of like, you know, how people relate to their thoughts and emotions, influencing behavior. Like there's many different ways to approach that in a therapeutic sense. It doesn't have to be just like the pure like CBT way, like the act way works pretty well too. So those are the evidence-based treatments.

and I think that's where someone should start in that sense. And obviously a lot of good nutritionists and stuff can support. Where are the statistics coming from people practicing non-evidence base? Is that like, you know, powboys online pretending that they can solve your binge eating disorder? Well, I mean, there is that. And I think, like, if I recall correctly, what I'm talking about there in the lack of evidence-based treatment is actually within psychotherapy. okay. It's actually therapists not using evidence-based methods in the treatments, which is pretty wild. And that's why I was saying, like, you know, when I was reflecting on the way I was treating people, it's like, you have to be able to justify why you do certain things. So, like, if that's wild in itself. That's within evidence-based. Yeah, yeah, yeah, yeah. That's within evidence-based treatment in that psychotherapy is, you know, the better treatment method. method. But then if we go outside of that and like what you said, people who just, you know, claim that they can resolve your binge eating.

And, you know, and like, it depends on what they're practicing. Because like I said, there's, there's some aspects of, say, CBT that I think overlap a lot with, say, coaching, right? Because I do. And that's something that I've really reflected on a lot over the last year. Like, geez, there is a lot of overlap. And between the two. They're not the same. And they never will be the same. if someone's sort of aware of the differences, but there is a huge degree of overlap, especially like, you know, I'm sort of assuming person-centered coaching as opposed to like,

yeah. Yeah, yeah, like coaching and not instructing and not being like telling some of what to do but trying to guide them into a path that is beneficial for them. Exactly, yeah, yeah. So, and you know, like, I don't want to, I don't want to say that everybody should be a therapist

to help people with something like binge eating. Now, if it's act like a clinical manifestation, then maybe, yeah, you probably should. But like... For the listeners, can you kind of distinguish the difference between like clinical bingey and like subclinical bingey and her... Yeah, I will.

I just sort of like to throw in that like I don't... I don't care too much about the specifics of that stuff because like that's yeah i mean like you need the categorization but like i would i would often just boil it down to like look as you're eating behavior causing you distress and you know in that case then is it binge eating if so then it's worth getting support because um when you look at say subclinical binge eating the rates are much higher right so if we get into the the subclinical levels it's more like eight percent um like of men and women and then if you look within certain age brackets it can be higher again so the most prevalent in say subclinical and disorder eating sorry that's that's to encompass

all the sort of eating not just binging specifically but it's between like the the group is like a 15 to 24 I think and and that's between like 15 and 30% almost so like that's a lot more people than who are meeting the clinical criteria which which was the at least once a week for at least three months those criteria around what a binge is in terms of like eating a lot of food in a short space of time feeling overly full it's it's like three of the five um of like feeling really full feeling distressed and doing it in isolation um uh what are the ones the uh yeah feeling like disgusted depressed do you have do you have any thoughts on why dad age category would would be more prevalent?

Well, it does seem like the most eating disorders develop in adolescence, right? That's capturing that group if it's 15 to 24, right? Yeah, and then you could ask me, like, well, why is that? Like, why do adolescents seem to develop it more so? Like, some of the factors that, and that's for all disorderly eating, right? So you can imagine that, say, like anorexia, for example, and you know obviously it's not being clinically class in that sense but like the tendencies but I would probably point some of it back to like you know how it is to be a teenager the social pressures

the lack of compassion at times because like one of the biggest well sorry I'm one of the big that's that's kind of extreme language but an important contributor to something like binge eating is being bullied about your weight as a child or adolescent, you know. So there's those components of it. You know, it can be a difficult time, I think, objectively, for people in terms of growing up. There may be the interpersonal difficulties

depending on what the, you know, familial environment is like. the kind of genetic contribution to eating disorders can be quite high in fact so for anorexia and bulimia it's between like 70% genetic contribution is quite significant

it's not so much for binge eating disorder it's about 40% but you know that points to you know that's a very significant component that genetics can play a role in this and that's that's a lot you know like objectively um so yeah those are some of the reasons i suppose why it's probably more prevalent in in that younger age group and i again

maybe like this maybe not objective science but like our body image body image body image concerns worse in that age group quite likely I think I don't have like stats on that but I would say so that's the case Do you have any advice for parents who might be listening to this

who might be thinking now this is something that you know is quite high happening in adolescence and is there anything that I can do in the family home to reduce the likelihood of this happening to my child? yeah so for binge eating specifically and this may be extensive other aspects of eating disorders as well but there are there are such thing as like familial protective factors so regular family meal times being one of them the talk about food the talk about bodies the criticism about bodies the basically like if your family is a family that does not appear to oh.

overvalue weight and shape that is very protective. So that's the kind of body in me. And but like I see so much of this in practice where like daughters, I'm treating daughters of mothers who had like they're grown up and everything. Mothers have the same issues basically and sort of past that some of that onto them. And and you know there is that issue with like, you know, talking about somebody about how they look like oh geez she's such and such has put on a lot of weight there. hasn't she? It's like that kind of talk is is very unhelpful. Yeah. Generational diet. And can I tell you a story about a client that I had actually. She's she told me a really powerful story when we were when we were discussing this. And

and she told me about how, you know, she, she, she suffered with her relationship with food, you know, up until her 40s. And she rematch she, she, she told me a story of when, um, she was younger and she used to watch her, her mom basically pick herself apart in the mirror and say like, I hate this about my arms and I hate this about my waist and I hate this about my hips and stuff like this. And, you know, she, uh, her as a child, I think she was like six or seven watching, observing this. And, you know, she said that I looked exactly like my mom. And, uh, you know, like what, what does, what was that, the story that basically she, the mom was basically telling the daughter by picking herself apart that, you know, I hate this about myself and you look exactly

like me and therefore I am going to grow up with this body, this, this faction as well. Mm-hmm. Yeah. It's like that, that kind of. self-attacking and you know say children seeing that excuse me being aware of it you can see it with you know how people talk about food or how they how they eat they're oh I'm being good today not eating the chocolate or whatever it is or I'm being bold today I'm having the cake um you know because that that all just sort of creates a narrative around round food and bodies and and the sense of self-worth attached to bodies versus it being broader than that, you know, that's where that overvaluation of, you know, just

physical shape, kind of objective, like, objectification of the self and objectification of others. And all that is super, like, unhelpful. You know, some of their, so they're kind of like more familial, environmental protective factors. You know, that would extend to like, you know, kids, peers, you know, what's that network like? How do they, how do they value those things? And it's like, where does that come from? You know, so that's like, there's some, there's components of like media literacy about this stuff that are going to be important. And fostering body appreciation. And again, things like, you know, body functionality appreciation and thinking about the whole self and not just like, oh, you look, you know, you lost your way. You look great. That.

on the stuff. Can you go into that on a body functionality as well and in terms of like, you know, tips or advice for people listening in terms of the actual talk around bodies? Yeah, sure. So there's an exercise that's that's evidence based and to foster more positive body image and I use it in most of my check-ins, right? So I have these questions in my check-ins with clients. So one of them is, you know, pick one thing that you're grateful for. your body in how you've been able to experience life. That's me paraphrasing it slightly, but that's basically what it is.

So what, in practical terms, you can think about this in terms of the five senses. You know, if you have access to all of your five senses, of course. But what does, like the body facilitates everything in that sense, right? So it's,

it's trying to extend it beyond just what it looks like. It's like your body facilitates you, being able to hug a loved one. Right? So there's a like that's, you know, feeling in terms of the five cents. It helps you, you know, experience, like, see a nice sunset or flowers or it carries you through a nice walk. And, you know, people, in my experience doing this, so people, clients often get very focused on just the physical capacity side, which is important. But then I also, like, so they're like, oh, it enabled me to, like, do a hard train and say,

you know those kind of things like all about like what the body does um but then i just talked to them about the kind of five senses component and it's like think about everything like taste smell and you know hearing words of affirmation from from someone that you care about like none of that happens without without the body right in terms of facilitating that so it's a lot more than just you know how defined are your abs you know or how white are your teeth kind of stuff so that's that's the idea you know speaking on back on to men and bingy and did you find or do you think in terms of like gym culture do you think that's kind of a net positive or a net negative in regards to the prevalence of binge eating and men question um yeah i mean it's tricky to answer maybe but like you're

going to consider to what degree is there in terms of internalization of cultural body ideals. So, you know, so if we think about the kind of flow of how these things can happen, not to say that they will happen this way, but how they can happen for people who are at least susceptible to these things. Yeah. You know, I want to be jacked and lean. Right. What do I need to do to make that happen, right? I need to train. Like, that could mean training a reasonable amount, could mean training excessively. And I need to get my diet in order. So what does that mean to me, do I try overly restrictive diets that are very restrained? And then if I break it, so to speak, does that contribute to my binge eating? Like, that's often how it can happen.

But, like, that's sort of driven by the body idealization and then trying to pursue that. So, it depends on what kind of message, I suppose, men are picking up from that. Because, like, I mean, it's a bit of a shit show on social media in terms of, those aspects of things, you know, and then like, I mean, this is kind of stuff that's been happening for, for a long time, you know,

but it's just maybe more becoming more prevalent for men in recent, in like modern times. Yeah. You know, yeah. You've probably seen that kind of, um,

evolution of the action figure. Yeah. Yeah. Yeah. Yeah. And like this, this distorted view of like what like a male physique is supposed to, uh,

look like. Or did you see that trend? There's a trend going on. Instagram and TikTok and it's like it's like this lad he was you know he might be just into the gym

or he's a PT or whatever and he's been like lifting weights for the last 15 years but like he's not on gear or anything like and he goes this is what this is what like a normal body looks like after like 15 years

of weight train and like he's in decent shape like he looks good but like it's just a it's a normal physique and then all the comments are like from like probably 15 year olds or 14 year olds saying like oh you need to do this

or you need to do this and all basically like criticizing his physique because they're probably so distorted looking at like the 0.001% of the population that's a genetic freak and also taking steroids. Yeah, no, I've seen that. Like I actually quite enjoying that, that, obviously not the criticism that they're getting, but the, um, I suppose bringing a reality check to it. But like, yeah, so many people in the comments, me're like, oh, bro, you need to get a refund for the last 50.

Yeah, yeah. Jesus Christ. Like, yeah. People are in good shape. And they're taking care of themselves. you know that's that is a big part of like you know fostering a good relation to the food a relation to your body is like doing things from a place of self-care not self-loathing that's not good enough as I am therefore I need to change the process becomes quite quite punitive whereas if we can

frame it as self-care making compassionate choices for my benefit on the whole um things tend to go a lot better. So yeah, I mean, I suppose part of the reason I'm looking at this kind of research, like I said, is that I want to see, you know, is there even maybe a, what's the kind of rate of binge eating behavior in men who are training that maybe are not overweight or obese? I know I said that, I think, at the start. But I am interested to see that. And to see like levels of body dissatisfaction is one of the, you know, things I'm looking at in the, in the questionnaire that I have. So levels of body dissatisfaction in, again, normal, say, BMI and people. Now I'm aware, and I'll write this into the limitations and stuff that, like, you know,

BMI in a, especially in a gym going population, is maybe even less useful. Because, like, you know, I'm overweight BMI based on BMI, it's white being, you know, at a healthy level of body fat and everything else. Yeah. So there is that kind of like contribution of muscle. But look, we'll see what comes back from it when I do the data analysis. And then, you know, because it's kind of already fairly well established that, you know, obese or overweight, people will have more prevalence of binge eating, let's say. It's a common thing that goes together, you know, which going to make sense if there's excessive mental.

of calories being consumed on a somewhat a regular basis. It's hard to not be overweight or obese in that context and you know that's where the differential is between that and bulimia. In binge eating there's no compensatory in binge eating disorder there's no compensatory

compensatory behavior so I mean I was thinking another I gave a lecture recently in Athlone talking about disorder eating in athletes so that that encompasses all disordered eating, but essentially rates of disorder eating

are much higher in athletic populations than they're not. So they're not. Than not. So they're higher in athletes basically, disorder eating. And higher within athletes than within like weight class sports

or what they call gravity defying sports, you know, where some element of lower body weight being more beneficial. So I mean, like, that's not exactly, that's not the same as people who go to the gym, but there's some degree of like similarity in terms of like athletes versus people training, you know? What, so in terms of, that's an interest in terms of, uh, of athletes and people who play sport and also, um, um, weight centered, um, sports as well. So what, what is the reason for

that, obviously, because hyper, um, focused on way constantly and stuff like that yeah yeah there's the fixations on it um the kind of again the culture around it like the culture in the sport and you know you hear a lot of stories in ireland about you know uh sort of like just club level g a team's getting like caliper tests and stuff like that and you know i've worked with people that have been told who if they didn't lose x amount of weight that they'd be dropped off the team you know, so the pressure and some of those people have binge eating

as a result, like, because it fed them into that pathway when they were susceptible to it. And yeah, there's this kind of, again, the cultural presentation of athletes and the what we call like the athlete's identity

as well. So there's like a certain way you're supposed to look potentially if you are an athlete you know and that's that's it's kind of like the body image stuff as well but just apply it to athletes and then i find like it's interesting you can have a difference between like the athletic identity and then just the the person separate from that so for example i've worked with some people who might have like let's say women higher levels of muscle mass and they feel great when they're in a training context like say they're doing like high rock star crossfit but then they're on a night out

and all of a sudden I don't like my arms because they're too big and I feel conscious of them, you know? That's interesting. Yeah. Yeah, so there's, and this was the kind of pressure of the sport, right? The pressure to perform, pressure, pressure to, yeah, like, just maybe poor education in some of those contexts as well in terms of properly fueling. But, I mean, to be fair, I made this point in that lecture that, like, you know, people can find. all into low energy availability and under eating just out of kind of ignorance and not because it's disordered.

But a lot of disorder eating will contribute to that because people are eating less and again, trying to control their body composition quite tightly and getting quite focused on that. And then, you know, of course, if they can't do it or they're eventually, you know, break and then they binge and that's, that's where that comes from. So that kind of pressure of meeting the athletic ideal maybe is definitely a big part of it. Yeah, that's very interesting. And in terms of the actual survey that you did as well, how difficult or easy was it to get, you know, meant to disclose this information? Because I presume doing this research can be quite difficult if, you know, there's a cultural attitude around, you know,

you know, men not talking about this or not being a very open discussion. Yeah, it's like I use that example in the lecture as well, like, because I have, or I just talk about this in general that like, I have plenty, I have and I have had plenty of clients who are, you know, men and athletes and stuff like that. You struggle with this stuff. They don't want anyone to know about it, you know. They don't want to talk about it. don't because you know I could tell you prominent athletes who deal with this stuff and then of course

I helped them and they get better but they never want me to share any kind of testimonials or anything because they don't want to be identifiable um in this which is a shame I understand why it is of course but it's a shame but I just like to talk about that more and more now because like again I don't you're not in the you're not in the business of easy marketing with your line of work no no at least not towards men like i think again women i think are a bit more forthcoming and seeking health in general you know definitely seems to be the case for women um you know because again there's this kind of like what would you say gender roles in terms of like masculinity femininity um so i do try and get that point across because i know there's a lot of people out there that

probably feel like that the only one that that's struggling with this on the team or whatever you know on the GA team that they're playing with. But in terms of recruiting people, it's been gone pretty well, to be fair. I have asked a lot of people like yourself to share and try and get the word out. Now, my initial plan was to, and I had sort of teed this up to share it amongst some gyms in Ireland. And one of those has just not been responding to me since. I obviously won't say who it is. But they were going to have several thousand members.

that I was hoping to distribute it amongst. And if half of those were men, just take it as guess, like say half of them are men. And I'd only need a very small percentage to actually respond. So I was optimistic about that, but that hasn't come through. Did they give any reason as to why?

No, I just haven't responded to my messages. Yeah, so I may try and do, like, reach out to some other ones just to, or even people that have like smaller training, operation or gym operations let's say um because like i do need to get a few more and i don't have too much longer that i can leave it out um because i need time to do the analysis and and write it all up so um yeah i don't i don't need that many more to kind of like the minimum viable now you could argue that like there is no minimum viable because it's like a master's level it's a top

masters you know it's not a research masters necessarily so like but i am trying to make it good and more valuable rather than just ticking a box. So I would like to get another few responses on it. Another kind of third here so would be good as of today.

But anyway, I've gotten that many more than that in one day. So like it's not. It's definitely not. So again, I don't know. I've been getting people to share it.

Obviously a certain amount of people have gone and clicked through and done it. And I've been trying to I suppose the point you don't have to be having issues with your eating to do the survey. I just wonder if that's clear because you're eligible to do the survey if you're a lad and you're over the age of 18 and you're going to the gym. That's all I need.

And then whatever comes through in terms of people who have trouble with their eating, you know, will it come through as being similar to those, you know, percentages that I said earlier. It's really going to establish and just see what the rates are, you know, in this kind of population, which is maybe not entirely representative of all of men in Ireland because, you know, there's only a certain amount that are obviously partaking in, say, gym training. So, yeah, so it's somewhat of a specific population in that sense. But, yeah, it hasn't been too hard to get people, I think, just some things didn't go according to plan. and, you know, if I need to go on just DM people one by one, I'll deal that like, because there's a lot, like, that has happened a lot as well. I was like, you know, I've asked somebody like that I would, you know, know, I've known fairly well.

I'll have you done that yet? I know, I meant to do it and I just forgot. That does happen. So, I don't know, I might put out like a call to action. Like next time you're on the toilet, just think of me and think of my survey. Yeah, yeah. When you're, when you've just said down your caffeine and you're about to do your gym, session, but you need to go out to the toilet

first. It's all, sorry, sorry, you could have guys. No, you go. It's all completely anonymous, like, so I can't, you know, so that I think, obviously, it can encourage his participation, because, like, no one will know that, you know, you

submitted it and what you said in it, you know, so there's nothing that can be traced back to anyone, so I think that helps in terms of, anyway, I set it up that way, obviously, for purpose. Yeah. Do you think that this topic in general

you know, being eating around men and even actually just eating disorders in general in Ireland, is it underfunded? I don't know, to be honest, I can't, I don't have any figures and I don't want to just

hazard, oh, I mean, I can hazard a guess and I would say probably because it's generally those things aren't too well funded, I don't think. Yeah. Although, in fairness, a lot of people have said to me that, like, if you wanted to do doctoral work on this topic that you would get funding because, you know, it's mental health and it's eating disorders and, at least in the context of anorexia, and eating disorders are very dangerous. So, you know, it's a worthwhile thing to explore. But I don't actually know about funding, to be honest.

So I don't want to speculate. Do you think that it's something that should be kind of taught a little bit more in skills? I mean, I suppose I don't know like what level it's taught at in schools. Like if I reflect on our like we reflect on our own time in school. I didn't have any. I can't exactly recall. You know, it could have been like one speaker maybe in the course of, you know, six years of secondary school. But I mean, it would make sense, right?

Because it's that adolescent group that seems to experience more disorderly eating. I know, I know there are some people, all right, who go to schools and maybe talk about this stuff, or at least talk about mental health in general. And, you know, this eating disorder falls into this mental health category. But, I mean, I think it would be good to have more awareness of these things because, yeah, I mean, you wouldn't know necessarily if someone's struggling with any of these things. Like, you much hard, like, hard enough to spot something like bulimia because, like, you don't have the, say, really low body weight that you might have an. in an inorexia. And then with binge eating, like you wouldn't know if someone is binging necessarily.

All you can go by is like, again, parents might have some idea. Like they find rappers of stuff like hidden in places or something like that. They might signpost it a little bit. But generally you wouldn't know. So it would,

I think it would be certainly valuable to have more, more at that in school. so people, yeah, so the kids know what to talk out for, you know, how to, again, you know, think about some of those protective factors that I talked about, why those are important. Yeah, because I think it can be quite hard at that age to, you know, detach from the idea of, like, physical appearance and how important that is. So if they could get some support with that, I'm sure that would be a benefit, yeah. For fitness professionals, listen, whether it's like online coaches or,

PTs because I know a lot of them do, listen to this podcast. Do you have any advice in terms of dealing with a client who maybe going through food related issues or like creating a safer space for maybe if they're working with men to open up about these issues

or anything like that? Yeah, like the way you communicate is always important in these situations and what I would classify as just kind of good coaching communication anyway. But you're like, you know, you're asking open. end questions.

You're being curious. You're just trying to, like you said, create that space that if they want to come into that space and have a dialogue about those things that they can. You know, you can't force anyone into talking about any of those things. But you can ask, you can ask good open-ended questions. And again, that's a therapeutic technique as well. So they teach us that in therapy that you need to ask open-ended questions and not close questions.

So there is that. I think screening is really important. That's probably one of the biggest issues that you see. Because like I was talking to somebody recently who, you know, applied to work with a coach who then referred them elsewhere. And then the referral didn't screen for eating disorders. And they had an eating disorder and they just got put on a fat loss diet. You know, so I suppose as like coaches being able to screen appropriately.

Would you, could you give an example of like a good screening process for a, for a personal trainer who might be trying to take on fat loss clients? Yeah, so like at least at some level you could ask on like if you're doing a face-to-face or you're doing like an intake form like, you know, ask again, maybe an open any question like, how is your relationship with food? Do you have any difficulties with it that you'd like, you know, just as you have any difficulties with it. Try to see what, that's what I always talk to people about like because I have a lot of people who come to work with me to improve their relationship with but I don't know what that means to that person until I ask.

So I have to ask like, all right, so what does it look like right now? And what would you like to be different? And that'll give you a very good idea of what someone's struggling with and then how you might be able to help or maybe you have to have to refer out. So you need to ask, I'd say that kind of question, like how's your relationship with food, relationship with your body potentially? And then definitely asking a question, like, you know, do you have any, history of an eating disorder, like past or present, like, do you currently have an eating disorder?

You know, that's silly not to ask that question if someone's maybe not going to disclose it. So you need to give people an opportunity to disclose that. And then, like, specifically, I would use a specific eating disorder questionnaire in my intake forms. So I get people to fill that out. So that's called the eating disorder questionnaire. What would that look like? In terms of the questions or?

It's a lot of questions about, it's actually the questionnaire I'm using for my research is a condensed version of it. So the one I'm using is the EEQ-EQ-13. So 13 questions. So it's condensed because I didn't want, I didn't want to make any longer than it needed to be to try and get these questions.

But it asked questions about like, you know, eating behaviors over the last month, you know, so in terms of like trying to highlight, say, binging behavior, it'll look at, it'll ask question about body dissatisfaction. It'll ask questions about dietary restraint. So it's actually, there's a few kind of subheadings for it, but that's what the questions are based on. So it's dietary restraint and purging behavior, binging,

and body dissatisfaction. They're the main things that it covers. So there's multiple questions under those different headings, if you like. that can help assess these things and then you can calculate, get a score calculation and see how that, you know, fits. That's maybe a bit more advanced than what some coaches might want to do. But even the short version, you know,

the short version that I'm using in my research, like the 13.1, because the one that I use is like 28 questions, it's a bit longer. but that that is a good way to screen it's not the only one and there's but I think it's probably the best overall to to use as a screen maybe even that short version would be would be good because that'll give you a good idea of like where someone and it's only a few more questions so it's like where someone's um sort of body image at and where somebody and there's this other questionnaires you can use for body image but uh what what's their kind of level of restraint or desire for

fat loss fasting behaviors things like that and are they experiencing any binging behaviors that sort of thing so that would be a good way but just screening and then you know you maybe won't always get everything

disclosed like in the initial onboarding because you have to build some rapport maybe with the client or they'll be happy to talk about some of these things so I understand if some of this stuff comes out a bit later on in the process but I think just ethically screening early is important and then understanding your scope of practice

you know getting additional training if that's something that you want to be able to support people on or being able to refer out if it's if it's not something like but like you know you have to you can't just assume that everyone who's looking for fat loss is in a good place mentally with their body image and with their eating behaviors so you need to plan accordingly

I would say. Well, is this the problem where, you know, a lot of people maybe who are coming to coming to a fat loss coach for a fat loss, but don't realize that the issue is a lot deeper than that, that they probably have, you know, some sort of eating disorder or disorder and eating tendencies and, you know, for that coach to be able to be able to spot them to refer out if the client itself doesn't even realize that that is the actual issue? Yeah, I think that happens a lot to me. honest that client will seek a coach when that might be might not be what they need and like I've

seen that in my own practice over the years like before I was trained as a therapist like you know a lot of clients that like they'd probably be better off seeing a therapist than than working with a coach but there's a less stigma about working with a coach you know I just get help with my fitness and my nutrition and like obviously a lot of coaches are very good at the broader kind of body image work and things like that as well definitely so i think i think coaches can do a lot for people and it's just being aware of like what's your certain current skill set right now because they always say that's like i'm a much better coach than i'm a much better coach now than i was obviously when i started right so you just keep keep learning and you keep getting better and when i often reflect on that

i was like geez yeah there's a lot of people there in the early days of coaching that i probably didn't help that well compared to how I could help them now, but I don't think you can avoid that. No, no, it's, it's, it's, it's, it's, it's, it's printed into the process kind of. Yeah. Yeah. Yeah. But having, having the kind of awareness of that and, and, you know, obviously, striving to, to do your best and, and understand what it is to, like, work ethically and not just put everybody on fat lost diets without knowing what their headspace is or how they might respond to that, you know, because again, and then also, because it's not like everybody is a bad candidate for fat loss either, right?

So I also don't want to do that. Like we're talking about a more specific group, but in general, the body image side of things is probably underappreciated and therefore it should be brought in more generally, let's say. What changes would you like to see in how, like, binge eating is discussed or diagnosed or treated in men? Yeah, I mean, like, I'd like to see, I'd like to see more men in the research treatment processes because, like, I just wonder how targeted are the treatments for men compared to women if the majority of research participants are women and therefore the treatments are, it's just by different. fault than targeting that kind of group.

So I just wonder, like, is there anything that we should do differently when it comes to treating men with these sorts of things? I don't necessarily, I'm not saying that's the case, but... It's an interesting time. Yeah, we don't really know is the problem because of that kind of lack of men in the research settings. So, yeah, I would like for people, obviously, to be generally more aware of, well, eating disorders in men in general, you know, because it's definitely underappreciated.

and I think the awareness is pretty good for for women in terms of eating disorders but again that's part made part of the problem because it's more it's considered than a feminine thing so just to appreciate that look men have eating disorders certainly binge eating disorder a lot of men have and then you know and that's that's just the again the clinically diagnosed um version as opposed to like people who have struggled with disorder eating in general it's not that's just the again the clinically diagnosed um version as opposed to like people who to struggle with disorder eating in general it's not that's not that's just the the it's going to be subclinical. So I don't actually even know if I asked that, answer that question earlier properly, but like basically subclinical would just be like, the frequency doesn't meet that clinical frequency. Essentially, that's what the main difference would be. So it would still be like engaging in binge eating,

but not necessarily at that kind of frequency or maybe not for as long. That'd be the main difference, I think, because... Is that an issue with people not getting treated then? if it's not, if they, they can't get diagnosed quickly enough as,

as clinical. Yeah, because like it's, it's maybe hard to diagnose as well, because, like, I wouldn't diagnose anybody with, with an end disorder, you know,

it wouldn't be, it would be, like, a psychologist or a GP or sort of a combination. And so, you know, I can use these questionnaires and stuff, but, like,

even those, like, a self-administered questionnaire is not technically, like a diagnostic tool. Does it does it take long to get diagnosed? Because like you said, that sometimes people can be waiting six years to be, to be treated almost.

Yeah, I mean, it shouldn't take that long to get diagnosed, you know, provided as well you talk to the right people. And like, you know, the body wise is the eating disorder charity in Ireland.

Like, they do really good work. And they have great resources, actually, like in terms of their podcasts and YouTube videos and their website is really good. So they do, they do a lot of good work. work and my my clinical supervisor because I have to work with a clinical supervisor to talk about

the therapy I do with my clients so oh yes I remember talking to a therapist I had her on the podcast and I remember she said that to me that every therapist needs to have their own therapist basically yes you have your own therapist but then you also have a supervisor so you get therapy and then you also talk to basically like a mentoring role really um because then I go in and I talk about the sessions that I was doing and how I was doing certain things and they'll say well like you know why did you do that or or if I get games game strategy yeah yeah exactly no I get if I get stuck as well with somebody and I'm not sure you know where to go next with them and that can be super helpful but she's she's very involved in body wise um which is why I sought her out as as

supervisor because I wanted that specific support because there's not that many people who specialize in eating disorders realistically in a therapeutic sense. So, you know, it's important to get the right supervision and then the right treatment as well. But yeah, I mean, I would like more awareness. I would like just to be more information about what it's like in Ireland because we don't have a lot of data on that. Like, you can kind of extrapolate from other countries. And like I said, it doesn't seem to vary too much country to country.

It seems to be kind of a global thing in terms of binge eating. but yeah I suppose just to be aware it's not like a feminine thing and you know men need to need support in terms of how they relate to their thoughts and feelings and just like women do and that's you know they can get help for it as well and they're definitely not the only people dealing with it because I think that's one of the biggest issues I know that's kind of a trope at this stage but like you know like I was saying all those especially those kind of gap layers and stuff that I work with that yeah I would very much think that they think that they only ones on the team, you know, dealing with it. And it could be, but they're not the only one in all the teams, you know, and dealing with it. How do you, how do you, it's very difficult to think of how you change that culture. So for more people to, to be okay with, we, we're speaking about it. So then you have more, more data to pull from. Like, I suppose you probably need, like, even if you look at it from the GAA,

context, I suppose you probably need like a big name to come out and talk about it. Yeah. Yeah. I mean, you know, practitioners like myself can do as much as we can to share. I'll like, look, people like this trouble with these things. But then I'm like, you know, it's like, why aren't people willing to talk about it? And that points back to probably the cultural perception of it. That it's like, like, what does it mean for me as a a man to struggle with with binge eating disorder. And he was like what does it mean for me as a man to have an eating disorder or just eating you know it's like what does what does that mean to the person and then what

what creates resistance to maybe talking about that like how do they think they'll be perceived these are all the things that would limit those conversations. So yeah it's it's not that me not easy um but at least we can bring more awareness to the matter and keep talking about it and, you know, see if people did come out and, you know, you will get people who are courageous and you do see that in, in athletes, for example, you know, I think like Freddie Flintoff talking about. Yeah, yeah, that's a good example. And things like that. So, you know, you have people who do have the courage to talk about it. But again, it's like, you know, what, what, what

you know say like what do we think about him now as a result of talking about it like we don't think anything bad of them at least i don't think so but it's like so that's like you know it's like what people what are people worried about that like boy said to one of the lads on the team that like oh i'm actually struggling with you know binge eating you know it depends obviously on the relationship but it's like what are what are they afraid of i guess yeah i don't know i'm saying you haven't answered that question either no no like i was just thinking to myself as you were speaking there like yeah I can understand like someone will look at like Freddie Flintoff or something like that and be like oh yeah well done fair play to him on coming out and and think nothing negative about him

but but for some reason when they when it's them they feel like oh but but my my situation will be different I'll be judged yeah you know which is how though like say again I don't want you to answer that but like yeah or someone going to be judged or someone going to be like like I'm like like I don't know. I can't even like verbalize like what, what might be the concern like that they. Yeah. Well,

I think your own, your own insecurities are always, always feel bigger than anyone else's insecurities, don't they? Yeah. Yeah, definitely. If someone was listening to this and they, you know,

especially in the context of men, because in the context of men, it's like, oh, yeah, well, my problem's not that bad. You know what I mean? I'll get on with it. So like, you know, if someone might be struggling with food

or feels like they're struggling with food, but don't think that it's serious enough to get help or to reach out, what would you say to them? You know, my assessment for that kind of thing is always like, is this, like, what's it costing you to keep carrying on with this, potentially?

You know, so, like, is it causing distress in your life? Like, how is it impacting your life? and would it be worth trying to change that based on how it is? And you know, like it's kind of interesting, this kind of a side tangent, but like say for saying like acceptance and commitment therapy, like one of the, as the name suggests, it's a lot of it is about acceptance of thoughts and feelings as they are without getting the terms they use or fused to them, without getting fused to them. So they influence behavior. so I often I often share this with with clients that like the guy who developed act as a therapy he has a tinnitus right so you know what that is so well it's like a chronic ringing in your ears that doesn't really abate so yeah it's a medical condition um to have tinnitus and

you know a big part of him applying the therapy they developed to that it was like because he came from a place of like being suicidal because like I have this fucking constant ringing in my ears and like I can't deal with that to learning basically to accept it and then the other part of like act therapy is acceptance and then the commitment part and the commitment is just to action that serves you well in your life and it's meaningful and it's like kind of you boil it down it's like whatever's going on for you is going on for you how do you continue acting in a way that's meaningful for you that will lead to a meaningful life or a meaningful living so I just say that as well because it's like you know can someone have some negative thought patterns

you know and the kind of the act treatment of that would be like again that separation from the thoughts so it's like they're just words so you may have them but you can still live your life anyway you know, without it being something that you fuse to and then it influences your behavior and it makes you, sorry, like, you know, act in ways that you don't want to act, whether that's like avoiding things or doing things that you don't want to do. So I just try that in there because, like, you know, I'm just, I suppose,

I'm arguing with myself now. Like, you know, is there an element of like, can you carry on? Like, where's the limit on carrying on? as you said like if you're kind of ah it's not that big a deal yeah like like you said that i i completely understand what you're saying there's like well like can you accept that and say all right i have these thoughts but i can still you know park them and still actually get on with with my life and have a good quality of life but i suppose it's if it's like you said if it's causing you to not have a good quality of life then like that's when it probably needs to it needs to

to be addressed. Yeah. And like even in that example, you know, like if someone is, you know, dealing with something like binge eating on a, on a lower level, it's still probably related to, like, thoughts and feelings that they're having. And then obviously that is not a committed action that they want to take in terms of binge eating necessarily. So you still will work to address it. But yeah, look, I just do think it's like, right, is this, how much of an impact is this having on me, would I like it to be different? Would it be worth exploring how I could change it and make it different? And so yeah, and just the fact that a lot of people do struggle with this stuff. So, and it can be quite complicated, you know, when you consider like the interpersonal

contributions and the mood contributions and the, you know, the body image side and the dietary restriction and where that comes from and all that sort of stuff, low self-esteem, those kind of things, you know. So like, you know, that the eating is the symptom. Yeah, I always, I always like that saying, like, it's, it's, it's rarely or it's never about the field. Yeah. Yeah. Yeah. Food is, like, it's very, you know, if someone, if someone wants to eat as a, as a coping mechanism, it's, you know, it's effective. It's easy to access. As soon as you learn that, then it can become kind of habitual. So you just, you know, if I'm feeling a certain way, then I end up eating to make either make myself feel better momentarily or at least just block out how I'm feeling because

you know that's the the kind of mindlessness of binge eating is like you're tuned out and which is why I use so much mindful eating in the in the treatment of it um because you can't can't eat mindfully and binge like those two things are opposed you know and coexist I don't think um so yeah I I you know what what harm in seeking help if it is something that is maybe bothering you know that's what i would say to to answer that question after my several tangents no i love that i really appreciate the work you do i think it's really interesting and i'm looking forward to seeing seeing where you take this if anyone wanted to keep up with the work you do or reach out or anything like that even have any questions about this where can they go to find you brand yeah the best place would be

just to go to my instagram which is at brian o'heng and it's O-H-A-O-H-A-O-N I mean if you put that into the Instagram probably get it at that stage but oh H-A-O-H-O-N G-H-U-S-A and you find me there yeah and then you know we have content and stuff on the on the triage method website and I've done actually a lot of podcasts on some of these topics obviously this one included and so I do have a playlist I think linked in my Instagram with all the podcasts I've been on on on let's talking about a lot of the same things in fairness but um there are those but yeah instagram basically is is the best place to to find me and to talk about any of these things and

i do try and make content not extremely consistently but uh you have you have your you have your hands full to be fair and uh we'll obviously put all the links uh on the description as well and what about the survey survey is that's still open if people wanted to fill it out or can i attach that to the end of the podcast as well. Yeah, please. When will this go out? This will go out probably in the next day or two, I'd say. Oh, yeah, yeah.

Okay, no, it's going to be open for another couple of weeks, I'd say, maybe. Yeah, that would be great if anyone wants to, again, if you meet that criteria that you're a man in Ireland, you try at least a couple of times a week, then you can fill in my survey. It doesn't, not that doesn't matter, but like, it doesn't, there's no exclusion about if you have eating issues or anything like that. So, yeah, that would be good if anyone's listening. listen to this and because I know you shared it already Carl so a few people did are all right fill it in at that stage but yeah the the more the Mary would you need another few so that

would be good all right brilliant well Brian listen thank you very much for your time today I really appreciate this conversation and that is I think episode 80 of the uneducated PD podcast so we're on our way to number 100 Brian thanks again for today thanks carl thanks for watching if you like that episode and you want to see more content like this make sure you're subscribe and I'll see you on the next one.