Treatment experiences of males with an eating disorder: a systematic review of qualitative studies

Abstract

Research has commonly examined eating disorders (EDs) predominantly in female groups. However, males are a large minority of people with EDs. In view of this, the present paper aimed to investigate and review the experience of treatment and recovery for males with an ED. We carried out a systematic search for qualitative articles focusing on the experiences of treatment and found only four papers which met inclusion criteria. Key themes identified across studies were 1) delays in seeking treatment, 2) clinical features distinctive to males such as drive for muscularity, 3) feminine and other aspects of treatment services, and 4) lack of consensus in views about relevance of sex in treatment. More studies are needed to explore male pathways through treatment and both impediments, but also facilitators, of successful engagement in and response to treatment.

Barriers to seeking treatment for eating disorders: The role of self‐recognition in understanding gender disparities in who seeks help

“…This may increase stigma associated with disclosure and help‐seeking, as lack of self‐control may be seen as a challenge to masculinity (Griffiths, Mond, Li, et al, ; Griffiths, Mond, Murray, & Touyz, ; Mond & Arrighi, ; Robinson et al, ). Acknowledging an ED also may be associated with concern about being labeled as a homosexual for men (Thapliyal & Hay, ). Finally, given that current ED treatments were designed and evaluated predominantly for women, men may believe that treatments cannot acknowledge or address their unique needs.…”

“…To reduce stigma, community programs may use contact‐based initiatives, highlighting personal narratives of those with EDs and particularly men (Doley et al, 2017). Additionally, although there is a lack of consensus regarding the importance of gendered issues in treatment (Dearden & Mulgrew, ; Robinson et al, ; Strother, Lemberg, Stanford, & Turberville, ), men with EDs have expressed a desire for services tailored to their needs in qualitative studies (Räisänen & Hunt, ; Thapliyal & Hay, ). For example, men may prefer all‐male therapeutic groups (Brown, Forney, Pinner, & Keel, ; Greenberg & Schoen, ; Strother et al ) in conjunction with general services.…”

“…Qualitative studies suggest that lack of ED self-recognition may pose an even greater problem among males than females (Räisänen & Hunt, 2014;Robinson, Mountford, & Sperlinger, 2013). Beyond limited selfrecognition, barriers to help-seeking may also include poor mental health literacy, low perceived need, preference for self-reliance, perceived stigma, and negative attitudes about treatment effectivenessall of which may be more salient for males (Ali et al, 2017;Mojtabai et al, 2011;Murray et al, 2017;Thapliyal & Hay, 2014).…”

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

“…However, these data could be underestimated because EDs are often considered as a 'female phenomenon', and this stigma might lead to men with ED being underdiagnosed and to seeking treatment with less frequency (Griffiths et al, 2015;Strother, Lemberg, Stanford, & Turberville, 2012). This could explain why this topic has received relatively little attention from researchers and why the few studies focusing on ED in men and treatment outcome have had such small sample sizes (Fernández-Aranda & Jiménez-Murcia, 2014;Thapliyal & Hay, 2014).…”

Eating disorders in men aged midlife and beyond

“…Multi-site studies are needed to ensure adequate sampling and to allow empirical investigations regarding how to improve clinical practices in screening, assessment, and differential care for older men suffering from an eating disorder. Recent qualitative research on treatment experiences has highlighted the need to raise awareness and mental health literacy about men's eating issues in both the lay public and among health professionals, and clearly outline stigma as an obstacle to help-seeking among males [73][74][75][76]. Owing to prevailing societal stereotypes of eating disorders as conditions exclusive to youth and female gender, men aged midlife and beyond might be the most stigmatized group to suffer from an eating disorder.…”