“There’s nothing there for guys”. Do men with eating disorders want treatment adaptations? A qualitative study

Abstract

PurposeMen with eating disorders may experience unique issues compared to their female counterparts, and there is a growing interest in how these differences should be addressed in clinical practice. However, the views of male patients on potential treatment adaptations remain under-explored. The purpose of this study was to explore the experiences of men who have experienced treatment for eating disorders.MethodsMen who had experienced eating disorder treatment were recruited through UK National Health Service eating disorder services and online advertising. 14 participants took part in semi-structured interviews discussing their experiences of treatment, and their views on the need for adaptations. Interviews were analysed using thematic analysis.ResultsThree main themes were identified from the analysis: a preference for person-centred, rather than gender-centred treatment, a feeling of being “the odd one out” as men in current treatment environments, and recommendations for treatment adaptations.ConclusionsParticipants described wanting to be treated as individuals and not defined by their gender. Whilst existing treatment approaches were mostly felt to achieve this individual focus, the actual treatment setting may inadvertently reinforce a perception of atypicality due to being men in a female-dominated environment. Adaptations may therefore be required to make the treatment environment more male friendly. Clinical recommendations are outlined.Level of evidenceV. Qualitative study.Electronic supplementary materialThe online version of this article (10.1007/s40519-019-00770-0) contains supplementary material, which is available to authorized users.

Men’s experiences of eating disorder treatment: A qualitative systematic review of men‐only studies

“…Two studies (Kinnaird et al., 2019; Pettersen et al., 2016) did not report participants’ sexual orientation. Additionally, all studies were conducted in the United Kingdom (Kinnaird et al., 2019; Lyons et al., 2019; Räisänen & Hunt, 2014; Robinson et al., 2012), the United States (Leichtman & Toman, 2017; Thapliyal et al., 2017, 2020), Australia (Dearden & Mulgrew, 2013; Thapliyal et al., 2020), or Europe (Pettersen et al., 2016).…”

“…In terms of data collection methods, seven studies (Kinnaird et al., 2019; Leichtman & Toman, 2017; Lyons et al., 2019; Pettersen et al., 2016; Räisänen & Hunt, 2014; Robinson et al., 2012; Thapliyal et al., 2020) utilized in‐depth or semi‐structured interviews, one used a written survey (Dearden & Mulgrew, 2013), and one examined published autobiographies (Thapliyal et al., 2017). Thematic analysis was used in the majority of studies (Dearden & Mulgrew, 2013; Kinnaird et al., 2019; Lyons et al., 2019; Thapliyal et al., 2017, 2020). Of note, one study (Dearden & Mulgrew, 2013) included representatives of healthcare organizations and professionals in addition to those with lived experience; for the purposes of the present review, only themes emerging from the latter were included.…”

“…Participants often struggled to find ED treatment, and for those who did, to find options that were tailored to their unique needs and preferences as men (Thapliyal et al., 2020). For instance, despite being admitted for inpatient treatment, one participant had to go home each night because the only inpatient unit in his area was a single sex ward (Kinnaird et al., 2019). Similarly, some men voiced frustration with the scarcity of expertise in treating men, “Some places tell me that they have a program for men, but the truth is they have no idea how to work with men…” (Thapliyal et al., 2017, p. 9).…”

“…Similarly, some men voiced frustration with the scarcity of expertise in treating men, “Some places tell me that they have a program for men, but the truth is they have no idea how to work with men…” (Thapliyal et al., 2017, p. 9). While participants generally did not feel that the ED treatments themselves needed to be altered due to their gender, they felt that treatment environments tended to be women‐dominated and thus create a feeling of atypicality or exclusion among men (Kinnaird et al., 2019).…”

“…Despite the widespread perception that eating disorders (EDs) predominantly affect women and girls, there is growing recognition that the incidence rate among men is rising (Kinnaird, Norton, Pimblett, Stewart, & Tchanturia, 2019). The prevalence of EDs among men has increased dramatically over the last two decades (Lyons, McAndrew, & Warne, 2019), and while it has been commonly cited that 10% of clinical ED cases occur in men (Nicholls, Lynn, & Viner, 2011), more recent data suggests that this number may be as high as 25% (Hudson, Hiripi, Pope, & Kessler, 2007; Madden, Morris, Zurynski, Kohn, & Elliot, 2009).…”