When bulimia affects male senior executives it is related to an attempt to regain a feeling of control in a life that often feels out of control, says the psychologist Dr Sandra Wheatley.

“I’ve seen a couple of them in the last year and they feel they have no control in most areas of their life. A lot of it is to do with self-image - their appearance and their power - and their concern about how they are perceived. It’s so important for them to say the right thing, they can’t afford to make a mistake. These guys who get to the top feel this continual high level of stress which makes them feel afraid and they’re looking over their shoulder as they see younger people and women coming up behind them.

“They might turn to drink or drugs, or it can be bulimia. They eat to excess, which is a comfort thing and addictive, then because they’re worried about the way they look, they get rid of it to control their weight.”

Executives who have marital difficulties are under further pressure, she says.

“A man who is having affairs may not want to leave his wife and family. He has the affair because he’s seeking attention and intimacy but if he’s afraid of being found out - because that would disrupt his life - the guilt puts him under tremendous stress.”

Wheatley has been practicing for 30 years, working with GPs in Kent and London, but did not encounter a man with bulimia until five years ago. The condition is ten times more likely to affect women than men and as awareness of it has grown, men have started to report it, Wheatley says, though she believes that few senior executives with the condition go to their doctor.

“These men are reluctant to seek help because they’re powerful and their status means they can’t admit vulnerability. Throwing up isn’t something that powerful men do and admitting they need help doesn’t support their image either. They think there’s a stigma attached to bulimia, a bit like a mental breakdown, and they don’t want that on their file.”

The process of purging is harmful in itself because it strips the body of minerals and vitamins and leads to hair loss and tooth decay. The secretive nature of the purging and these men’s simultaneous need to convince people around them that they are physically and mentally healthy, compounds their difficulties, Wheatley added.

“They get such comfort from the cycle that they don’t want to stop it. Intellectually they know they should, but emotionally they don’t want to and it can take a few years to help them.”

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