Gay and bi men are up to 12 times more likely to purge than straight guys. But no one seems to care.

Once upon a time, humans were valued based on what each of us brought to the table. Some of us were teachers, others were healers, and those physically capable were expected to hunt and bring back food. We chose a lane, and for the most part we were content with that role because at least we knew we were of value. But in today’s world our value doesn’t seem to be based on what we do, but rather how good we look doing it.

Did you know that 42 percent of men who have eating disorders identify as gay? In fact, gay and bisexual men are seven times more likely to binge, and twelve times more likely to purge than heterosexual men. One study from Columbia University points to the fact that while gay and bisexual men have a higher prevalence than straight men, there was zero difference in prevalence of eating disorders among lesbian and bisexual women versus straight women.

Eating disorders impact women and gay and bisexual men at epidemic proportions, yet no one seems to be talking about it. What's behind these high rates? According to Dr. Tyler Wooten, Medical Director of Eating Recovery Center in Dallas, “A lot of times what we say is that the genetics load the gun, but the environment pulls the trigger.” Wooten tells Plus. “There seems to be a kind of temperament that is innate and born with that makes someone susceptible to societal pressures. The temperament of these folks is sensitive, perfectionistic, pleasing, sort of driven and very interested in making other people happy… One thing that makes LGBT people susceptible to this is that we are folks that really want to be liked and accepted.”

More than 15 percent of gay and bisexual men have suffered anorexia, bulimia or binge-eating disorders at one time. These types of cases can lead to muscle loss, weakness, and severe dehydration, which can drastically affect your kidneys (especially to those taking multiple cocktail prescriptions). Bulimia in particular leads to an imbalance of electrolytes due to the loss of potassium, sodium and chloride from the body. It also leads to possible gastric rupturing. But as pointed out by ERC, its classifications aren't considered solely an unhealthy choice anymore, but rather a mental illness.

“The eating disorder brainwashes the individual,” Wooten adds. “I’ve had many patients say ‘I am my eating disorder, it’s part of who I am, my personality.’ It actually does help them. It makes them feel more self-assured, it improves their self-esteem a bit until it starts to unravel. That’s why it’s hard to let go of and to treat because it’s like telling someone we’re going to cut off your right arm. They can’t imagine themselves living without it.”

A 2012 online study showed that 71.2 percent of women over 50 were currently trying to lose weight and many were going about it in unhealthy ways, 13 percent of the women said they currently binge, purge, or practice other behaviors associated with eating disorders: for example, around 8 percent admited to vomiting or using laxatives to lose weight.

Men, in general, are visual creatures. We judge things based on what we see, and — according to a 2011 meta-analysis study — we’re more impulsive than women. Because of these qualities it may be easier for men to compare themselves with each other, and base their own value upon how they fare in that comparison.

Wooten says homophobia plays a role in how gay and bi men see themselves, too. "There’s a lot of messaging all over the world that [homosexuality] is a problem that’s unacceptable; it’s a disease, or it needs to be fixed." This external negativity may drive queer men to try and reflect a masculine ideal, which leads to efforts to improve their physical value in an unconscious desire to please the world. As a result of these pressures, some men become obsessed with reaching and maintaining that ideal.

For trans and genderqueer individuals, reaching those societal ideals can be even harder. As Plus reported, new studies reveal high rates of eating disorders among transgender college students. As ERC alum, Megan explains to Plus, “Being genderqueer [and] androgynous made weight restoration particularly difficult because as I gained weight, my body became more distinctly female. I went from having a boyish body to having breasts and hips. So I would relapse again.” In other words, recovering from an eating disorder can be doubly difficult when gaining weight means one's gender is perceived differently. The cycle of treatment, gender identity issues, and relapse ultimately put a strain on Megan's life and nine-year relationship. “We need to stop putting pressure on people to be perfect,” Megan says. “We’re expected to have perfect grades, get the perfect job, marry the perfect person, and on and on. It’s unrealistic and harmful.”

In today’s visual world, physical attractiveness has become currency. The better we look, the higher our value seems to be. And everyone wants to be next to someone of great worth. But who chooses this standard of beauty? Who decides the outline of what makes us beautiful? What does beauty even mean?

“I think as a society we have to wake up,” Wooten says, “Everything is really driven by money right now, that’s who’s in charge, that’s what is really running the show …. They’ve created marketing strategies to do just that: How can I get as many people insecure with themselves as possible? How do I continue to spin this to people so that they’ll buy the product?”

Human beings have grown accustomed to comparing ourselves with each other, and part of that process involves a clear understanding of our own value: how much am I “worth” in comparison to others? It’s a subliminal question we’re programmed to ask ourselves and it pushes us to buy the latest beauty product on the market, but at the end of the day all it does is enslave us.

The message is often invisible at first. For example, orthorexia (an obsession with purity, good foods, and health and exercise) is a more recently-identified eating disorder. While it might not look like one, it's rooted in the same idea that in order to be valuable, we must control our body.

Dr. Wooten shares with Plus a story about a young patient who was literally starving herself to death. Once, while waiting for the appointment, the girl's dad went to a vending machine and brought back a bag of Chex Mix. When he sat down, his wife snatched the bag out of his hand and said, “That’s got poisons in it, you can’t eat that!”

“I looked at him and said, ‘you have to get control of your wife,’” Wooten recalls. “We need to send completely different types of messages to our children so that our children grow up happy and healthy, and we’re not doing that. We’re doing the opposite: we’re making them sick, unhealthy and unhappy.”

Wooten suggests that kids are like the canaries in coalmines. Before there were electronic sensors, coal miners would take canaries into the mine with them to test gas levels. Whenever the bird died they knew they had to leave, otherwise they’d die from poisonous fumes.

“As a society we should be watching the children," says Wooten. "If they’re getting sicker and sicker, that should teach us the messaging that’s being taught is sick. We have to do a global change.”