Nigel Owens, one of the top rugby referees in the world, says it was easier for him to talk about being gay than to admit he still has bulimia.

As a referee in world-class rugby, one of the most macho sports on the planet, I was the first in the sport to come out as being gay.

In the hope of reaching out to other young people struggling with mental health, I was also one of the first sportsmen to speak openly about the biggest regret of my life — a suicide attempt. …

Which brings me onto another 'first'; I've spoken about dealing with bulimia in the past but have never before revealed that to this day I continue to struggle with an eating disorder.

Since the age of 18, I have had bulimia nervosa.

Owens, 45 from Wales, talked about his eating disorder for a column he wrote this summer and for a BBC documentary he hosted on men struggling with bulimia.

Owens says his eating disorder started around the same time he realized he was attracted to other men. “In my eyes I was obese and thought ‘no-one who I find attractive was ever going find me attractive while I'm fat.’ So, I started making myself sick,” he says.

The documentary, which I saw on BBC World this weekend, explores the increase among boys and young men with eating disorders and how hard it is to control the longer it goes untreated. As he interviews one young man after another, Owens has to face the fact that he still is not in control of his own eating habits.

He recounts the intense strain he was under to get physically fit to referee the 2015 World Cup and how important it was to lose weight. “I remember looking at the mirror and thinking: ‘Damn. I could get rid of this quite quickly.’ And so the bulimia returned.”

Owens says he is being open about his disorder so others suffering can realize they are not alone and will seek help.

“I'm speaking openly about it because I know that men and boys can view it as a sign of weakness by admitting there's a problem that you can't sort out yourself,” he says. “But it's not a sign of weakness; it's a sign of great strength to do that.”