Yet in a culture in thrall to the god of physical attractiveness, where image, as the slogan goes, is everything, women are not alone in their vulnerability. Men, too, suffer from eating disorders, though at lower rates than women. And new research suggests that the number of men who have significant symptoms of eating disorders may be greater than was once believed: in a study of 10,000 residents of Ontario, for example, University of Toronto researchers found that 1 of every 6 people who qualified for a full or partial diagnosis of anorexia was male -- substantially more than the 1 in 10 usually reported in studies of patients in eating-disorder programs.

Some experts also suspect, though data are still scarce, that eating disorders among men are on the rise, increasing along with the pressures men feel to conform to the lean and chiseled stereotypes purveyed by Hollywood and Madison Avenue.

''We are seeing a tremendous increase in men's distress about their body shape,'' said Dr. Arnold Andersen, a professor of psychiatry at the University of Iowa College of Medicine, who specializes in eating disorders. ''I think that men are simply following a decade or two behind women in terms of being exposed to body images that are increasingly difficult to achieve.''

Women with eating disorders may be driven by their desire to be thin, but men often express their preoccupation in different terms. Instead of a low body weight, they seek well-defined muscles, sleek abs and sculptured pecs. Achieving this goal, however, usually means excising every stray ounce of fat. If the anorexic or bulimic woman's nightmare is being told that she has ''a little meat on her thighs,'' many men live in fear of being told that they ''still have a little fat on those delts.''

For example, Dr. Holbrook, who is 57, said he did not consciously worry about being overweight until 1976, when an injury forced him to stop running his customary 15 miles a day. ''When I couldn't run any more, I panicked,'' he wrote in ''Making Weight: Men's Conflicts with Food, Weight, Shape and Appearance,'' (Gurze, 2000), which he wrote with Dr. Andersen and Leigh Cohn. ''I started weighing myself every day, and even though I was not gaining weight, I started feeling fatter. For the next 12 years, I did everything I could to rid my body of 'the fat.' ''