Short‐Term Treatment Outcomes and Dropout Risk in Men and Women with Eating Disorders

Abstract

This study compared treatment outcomes between men and women with eating disorders (EDs) and analysed clinical predictors of treatment outcome. Our sample consisted of 131 male and 131 female ED patients who underwent cognitive behavioural therapy treatment. ED severity, personality and psychopathology were assessed using standard instruments. We found that the risk of dropout was higher for men with bulimia nervosa (BN) than for women with BN and that men with BN and other specified feeding and EDs were more likely to obtain full remission in comparison with their female counterparts. Predictive models of treatment outcome indicated that higher scores in novelty seeking were a shared factor associated with higher risk of dropout and not obtaining full remission for both men and women with ED. However, only in men, younger age and lower scores in reward dependence predicted higher dropout. Contrastingly, higher persistence scores were predictors of full remission. This study reinforces the effectiveness of using outpatient cognitive behavioural therapy as treatment as usual for men with ED. Nonetheless, placing greater emphasis on strategies targeting gender-specific issues could enhance outcomes. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Are there differences between men and women in outcome of intensive inpatient treatment for anorexia nervosa? An analysis of routine data

“…With the absence of further notable gender differences, our results fall in line with the main conclusion from the literature search that men and women with AN present comparably and that gender unspecific treatment programs help both groups in similar ways. Accordingly, our findings concur with other studies that reported similar phenotypes at admission and treatment outcomes for men and women (e.g., Agüera et al, ; Smith et al, ). This situation seems favourable for male patients, as there is some evidence that incidence rates of AN increase in men (Javaras et al, ) and rising number of male cases are hospitalized for specialized treatment (Holland, Hall, Yeates, & Goldacre, ).…”

“…As a consequence, studies on gender effects in AN might include male subsamples that are actually atypical for this gender. This selection bias might also underlie the common finding, replicated by our study, that men and women with AN present similarly and benefit equally from specialized treatment (Agüera et al, ; Bean et al, ; Strober et al, ). Reports of specific male AN characteristics, for example, a drive for muscularity rather than thinness (Murray et al, ) and higher impulsivity (Tchanturia et al, ), are a reminder that the apparent gender‐similarity in AN needs to be interpreted with caution and that more research is needed to reveal what might be a “male” subtype of AN.…”

“…However, there is still need for additional studies examining gender differences in a range of treatment settings and approaches. Although evidence on the effectiveness of inpatient treatment for AN in men is rare, the existing studies suggest little or no gender differences (Agüera et al, ; Bean et al, ; Strober et al, ). Therefore, the aim of this study was to investigate gender differences in the presentation characteristics and the outcome of specialized inpatient treatment with regard to weight, general psychopathology, depressive symptoms, and eating disorder symptoms.…”

The Science Behind the Academy for Eating Disorders' Nine Truths About Eating Disorders

“…Available evidence also suggests that men may be less likely to seek treatment (Striegel, Bedrosian, Wang, & Schwartz, ), less likely to be diagnosed with an eating disorder even when presenting with identical symptoms as women (Currin, Schmidt, & Waller, ), and less likely to access treatment even with similar clinical severity (Austin et al, ). When they do access psychological treatment, men may be at higher risk for attrition than women (Agüera et al, ). Eating disorders occur across the lifespan. …”

Mechanisms and moderators in mindfulness‐ and acceptance‐based treatments for binge eating spectrum disorders: A systematic review

“…When examined more closely, however, relapse rates following CBT for EDs are greater than 30% (Södersten et al, ). Multiple studies have also found approximately 25% of participants enrolled in clinical trials of CBT for BN and/or BED discontinue treatment prematurely (Agüera et al, ; Grilo, Masheb, Wilson, Gueorguieva, & White, ; J. R. Shapiro et al, ). Such findings suggest significant room for improvement in treatment acceptability and outcome for BN and BED.…”