But it is also a little-known fact that boys and young men suffer from anorexia or bulimia – and they are faced with the biggest hurdles to get the help they need.

According to a top specialist in eating disorders, based at a Leeds hospital, men suffering from the condition are often misdiagnosed, rejected for treatment and ignored.

The Invisible Man by Dr John Morgan, consultant psychiatrist at the Yorkshire Centre for Eating Disorders – which treats the most severely-affected from throughout the North and further afield – aims to highlight the issues and treatment of eating disorders in males who are increasingly suffering with eating disorders and related body image problems – the first self-help book for men suffering from eating disorders.

He explained: "Ten per cent of cases of anorexia or bulimia are men but it remains a largely hidden problem. It is generally regarded as a modern-day psychological condition but it was recognised as far back as the 1600s when half of cases described involved men. Now, 20 or 30 years since the disorder has been recognised and investigated, there are well-established clinics helping people to get better.

"But it can still be difficult for suffers to get access to the help they need. A man could find himself the only male patient on the unit. There are excellent, well-established specialist clinics in London but not many elsewhere in the UK.

"It is seen as an affront to masculity to say 'I have an eating disorder' and sufferers have encountered prejudice within the medical profession, so often by the time the illness has been diagnosed, the patient's illness is well advanced and the problem is more severe.

"The first big challenge is for someone to recognise they have an eating disorder and a lot of the book is aimed at helping men identify the problem. The next stage then is to share it with a relative or their GP."

Anorexia has the highest death rate of any psychological condition.

Services are not evenly distributed throughout the country.

Dr Morgan spent 15 years at St George's hospital in London, the largest national eating disorder clinic before moving to Leeds three years ago to establish a national service based at Seacroft hospital.

He regularly talks to schoolchildren and teenagers about eating disorders.

Part of the profits from the book will go to the eating disorder association.

Michael (not his real name) recognised he had a problem and wanted to be treated but in the area where he lived he encountered an unwillingness to treat him. Previously a high-flyer, low self-esteem drove him to over-achieve and his illness began when he began restricting food and obsessively over-exercising. In the end he needed six months in hospital to improve his health. He has since made a good recovery.

"Females with eating disorders in today's society are regularly covered within the media," Dr Morgan continued.

"But for males it is often views as a rarity or unheard of. Some have full-blown conditions including binge eating and compulsive exercising while others are distressed by slightly lesser degrees of disordered eating or over-exercise and seek ways of overcoming their problems, which many mistakenly consider a female problem."

Risk

According to the National Centre for Eating Disorders, males account for about one to five per cent of patients with anorexia although prior to puberty the risk increases and about half of sufferers are boys. The book aims to provide help for males with body image disorders as well as their families and professionals involved in their care.

The YCED has rapidly developed into the largest northern eating disorder service with both national and local services under the leadership of Dr Morgan.

The clinic provides a national service and also supports local community teams in their treatment of local patients. Teams of clinicians work with in-patients on the 20-bed unit. There is also out-patient treatment for selected patients with plans to expand. The YCED believes that quality of care is dependent on collective commitment and expertise, including service users and carers.


What is an eating disorder?


There are two inter-related types: bulimia nervosa and anorexia nervosa. The diagnosis is made in patients with low body weight, an intense fear of weight gain and distorted images of shape and weight.

Additional physical symptoms often include: fatigue, altered sleep cycle, sensitivity to cold, dizziness, psychosexual problems, dental caries, sore throat, constipation, lack of menstrual cycles in women and reduced libido in men.

Bulimia is an eating disorder in which people suffer recurrent episodes of uncontrolled over-eating, commonly called binges.

Binge eating intensifies the fear of gaining weight and causes a cycle of repeated behaviour such as self-induced vomiting, laxative misuse and fasting.

Eating disorders affect women more than men. However men are more likely to be under-diagnosed and under-referred and less likely to be referred to specialist services for treatment.

Present estimates suggest that the average GP with a list of 2,000 patients is likely to have one to two patients with anorexia and 18 with bulimia. Five to ten percent of the adolescent girls on the list will have some degree of disordered eating.

Eating disorders can run in families and personality traits of low self-esteem and pefectionism raise vulnerability.

Some people have some, but not all, of the symptoms of anorexia and bulimia described. These can be very disabling but limited resources mean that many specialist services are only able to offer treatment to the most extreme cases.

More information on eating disorders is available from the Eating Disorder Association website www.edauk.com