After downing 70 chicken wings in about an hour, Andrew Walen realized he had a problem.
Oh, he had known something was wrong over the years. Normal people don't consume 4,500 calories worth of food in one sitting, or order takeout for four when dining alone. But it took a maniacal feeding frenzy for him to finally accept the reality: He was a binge eater, and he had absolutely no control around food.
"Ultimately, it was about numbing out and self-loathing," said Mr. Walen, now 39 and a therapist in Columbia, Md. "There was this voice in my head that said, 'You're no good, worthless,' and I turned to food."
Mr. Walen is one of an estimated 8 million men and women in the United States who struggle with binge eating, defined as consuming large amounts of food within a two-hour period at least twice a week without purging, accompanied by a sense of being out of control.
While about 10 percent of patients with anorexia and bulimia are men, binge eating is a problem shared almost equally by both sexes. A study published online in October and then in the March issue of the International Journal of Eating Disorders found that among 46,351 men and women ages 18 to 65, about 11 percent of women and 7.5 percent of men acknowledged some degree of binge eating.
"Binge eating among men is associated with significant levels of emotional distress, obesity, depression, and work productivity impairment," said Richard Bedrosian, a study author and director of behavioral health and solution development at Wellness and Prevention Inc., which works with employers and health plans.
But while binge eating is challenging for women who suffer from it, the perils are perhaps greater for men, who rarely seek treatment for what many believe is a "women's disease." Unlike bulimia and anorexia, binge eating does not even have a distinct listing in the current DSM, as the diagnostic guide for mental health professionals is known.
"Guys generally don't come forward for any reason," said Ron Saxen, 49, author of The Good Eater, a memoir of his struggle with binge eating, which began when he was about 11.
At his worst, Mr. Saxen was consuming 10,000 to 15,000 calories' worth of Big Macs, french fries, chocolate milkshakes, candy bars, ice cream, and M&Ms, often within an hour-and-a-half window.
Those men who do seek treatment often have difficulty finding a facility or therapist to work with them -- even the literature is predominantly female-centric. Before Vic Avon was given a diagnosis of anorexia in 2006, for example, he scoured the Web for information relating to men and eating disorders.
"Everything I saw was written for and by women," said Mr. Avon, 29, a building contractor in Brick Township, N.J.
Mr. Avon seesawed between anorexia and binge eating (not uncommon), at one point weighing 300 pounds.
"I was so ashamed because it was a girl's illness, I thought. I didn't have any guys to look to."
Many binge-eating men do not even recognize that anything is wrong. About 70 percent of people with binge eating disorder are overweight or obese, but a higher weight is generally more culturally acceptable for men than for women.
"There's nothing wrong with a college guy eating a whole pizza by himself, but with women they would be horrified," said Roberto Olivardia, a clinical psychologist who specializes in the treatment of body image disorders and eating disorders in men and is an author of The Adonis Complex.
Even if they are disturbed by their food intake, few men make the connection between gorging and emotional distress.
"With men it's usually a disconnect," said Mr. Walen, the former binge eater turned therapist. "It's about 'I want to eat,' not 'I'm coping with an emotional trauma.'"
Adam Lamparello's binge eating was both physical and psychological, the result of the starvation that ensued during his six-year bout with anorexia, and his attempt to fill the "emptiness, loneliness, and emotional void" that he felt in his life.
"Those with binge eating disorder often do not have meaningful relationships with other people, are isolated, believe that life has no purpose, or have suffered prior traumatic events and turn to food for emotional comfort," said Mr. Lamparello, 36, a lawyer in Hasbrouck Heights, N.J., who recently published Ten-Mile Morning: My Journey Through Anorexia Nervosa.
Men like Mr. Avon and Mr. Walen often struggle to find help. But the tide may be slowly turning as awareness about men and binge eating grows. Chevese Turner, founder and chief executive of the Binge Eating Disorder Association, said about 20 percent of the calls she receives are from men, up from 5 percent when she started the organization in 2008.
In general, cognitive behavioral therapy is the most successful treatment for binge eaters, said Sarah J. Parker, the director and a founder of the Reeds Center, an outpatient mental health center in New York that treats men and women who have anxiety and eating disorders. Treatment often begins with efforts to recognize distorted, all-or-nothing thinking and to begin monitoring one's eating, sleeping, and exercise patterns. Since many binge eaters restrict food intake during the day and binge at night, the goal is to get them to eat three meals a day and a snack.
Whether or not one can be fully cured of binge eating depends on one's definition of "cured." An October, 2011, study in the Journal of Consulting and Clinical Psychology reported a 51 percent remission rate for patients a year after using cognitive behavioral therapy. Therapy did not lead to weight loss, however.
"Do people stop binge eating and basically not binge eat again? Yeah," Ms. Parker said. "Is it OK to have an episode once a month? For some people that might be a cure."
Mr. Saxen finally went to a therapist at age 40. While he no longer binges, "I'm in the camp of AA -- you're always recovering," he said. "There are times when bad things are happening, and I have my moments."
After the chicken wing incident, Mr. Walen also sought treatment. He has not had a full-on, out-of-control "big B" binge since 2006 -- but he has had "little B" moments.
"I would say that most people have 'little B' binges where they go, 'I know I over-ate, but it didn't come with a lot of guilt shame stuff.' I think almost everyone goes through that a few times a year," he said.
Perhaps the greatest challenge, experts say, is to persuade more men to come forward and seek treatment.
"You have to have alternative means of getting men to acknowledge the problem," Mr. Bedrosian said. "We need to find alternative ways for men to get screened, we have to encourage the screening for all eating disorders in primary care," with an emphasis on making sure men as well as women receive attention.
He added, "If I were training medical students today I would say, 'When you're discussing weight loss programs with an obese patient, make sure you ask them about binge eating behavior.'"