Although men and boys make up an increasing percentage of the estimated 10 million Americans who struggle with eating disorders, few residential treatment centers will help them.

The four largest eating disorder clinics in Denver — ACUTE Center for Eating Disorders, Children’s Hospital Colorado, Eating Disorder Center of Denver and Eating Recovery Center — are on a very short list of U.S. programs that accept both genders for treatment of anorexia and bulimia.

Today, males make up more than 10 percent of patients with eating disorders, according to the National Association of Anorexia and Associated Disorders.

“The cultural pressure around the drive for thinness has over the years expanded beyond the target audience of women and teenagers,” said Dr. Jennifer Hagman, director of Children’s Hospital Colorado’s eating disorder program. “It’s really not leaving anyone out anymore.”

Early detection a key

The Denver centers have seen patients as young as 7 and as old as 65 in various stages of bulimia and anorexia. Catching the disorders sooner, within three to six months of onset, improves the odds of recovery, Hagman said.

“For people who move on to have a more persistent and chronic illness, two years or more of length, the news is not so good,” she said. “You start to see higher mortality rates with suicide being first and heart attacks being second.”

A study published in Archives of General Psychiatry in 2011 reported that individuals with anorexia nervosa die more frequently than people with any other mental illness. The other eating disorders weren’t far behind.

Of the 110 patients the Eating Disorder Center saw last year, 80 percent were from Colorado. Children’s Hospital saw a similar trend with 60 percent from the state.

ACUTE and Eating Recovery Center have more patients travel to Colorado for treatment. Seventy-five percent of patients treated by Eating Recovery Center came from other states in 2012. About 90 percent of ACUTE patients are from other states.

Tamara Pryor, director of Eating Disorder Center, said Colorado’s unique eating culture — with so many residents having special diets like gluten-free or vegan — contributes to the high number of local patients. “If not eating disorders, a lot of disordered eating happens,” she said.

In fact, some of the most dire cases in the country travel to ACUTE at Denver Health for treatment. These are people with dangerously low body mass index numbers. For example, a 5-foot-10 male’s normal weight ranges from 129 to 173½ pounds with a BMI ranging from 18.5 to 24.9. ACUTE patients typically have a BMI closer to 8 to 15, and weigh 56 to 104½ pounds.

Emotions tied to eating

“Patients that come to our program are some of the thinnest and sickest in the country,” said program founder Dr. Philip Mehler

. “They’re too sick to be in other programs.”

A 32-year-old math professor from Ohio being treated at ACUTE agreed to talk to The Denver Post about his treatment but did not want his name used. This is his second time being treated at ACUTE for anorexia.

“It’s not just eating,” the professor said. “The eating becomes wrapped in self-control and self-worth. It has all these feelings and emotions tied to it.”

During graduate school, the professor tried to make healthy eating decisions but ate very little and mostly the same things. He sought help only reluctantly.

“I have a stigma with mental health and being male. Not only is it a weakness, but this should be something I can handle on my own,” he said.

After being stabilized in a medically based program, like ACUTE, patients typically enter traditional eating disorder treatment centers. These programs focus on behavior modification and psychotherapy as tools to help patients overcome the disorders. Patients work individually, in groups or with family, and receive nutritional counseling and, sometimes, medication.

Males are often excluded from these treatment centers because women may be addressing male-related trauma from their past, said Pryor of the Eating Disorder Center

.

Although men and women may work through different personal issues, both genders seem to have a similar temperament and personality.

Most patients with eating disorders are like the university professor, said Dr. Jennifer Gaudiani, ACUTE’s assistant medical director

. They tend to be highly intelligent, perfectionistic, worried about negative outcomes and perform on an advanced level.

But people with personalities that drive them to excel are not destined to be anorexic or bulimic. Genes must combine with environmental stressors for the disorder to kick in, according to a psychological theory known as the diathesis-stress model.

“If the person has the genetic predisposition to the development of an eating disorder, they’re more likely to develop one,” Pryor said.

Pryor and Mehler said that athletes, models, children bullied because of weight and anyone more fixated on their personal appearance has a higher risk. Individuals who may have been overweight but drop the pounds using eating disorder behaviors — including overexercising — also have an increased risk, Pryor said.

Treatment is about getting men and women who struggle with eating disorders to address the underlying causes and learn how to avoid the behaviors once they return to their normal lives.

“People are here for a very short amount of time,” said Dr. Emmett Bishop, a founder of the Eating Recovery Center.

He said he works to get patients to see the bigger picture, visualize the life they want and be more self-directed to achieve that life.

Adrian Garcia: 303-954-1729, agarcia@denverpost.com, twitter/adriandgarcia