Treatment Issues and Outcomes for Males With Eating Disorders

Abstract

The aim of this article is to discuss critical issues in treating males with eating disorders, and to present assessment and treatment outcome data for 111 males who received residential treatment for moderate to severe eating disorders. Males with eating disorders are often not included in eating disorder research as the population of individuals with eating disorders has historically been predominantly female. Whether this is due to actual lower prevalence of this disorder among males or to fewer males seeking treatment is not clear. In any case, there is limited empirical research on the particular treatment issues of males, and in treatment environments males are frequently in the minority. We have found that an all-male treatment environment is helpful in allowing males to benefit from treatment with less stigma. Data are presented which characterize psychiatric co-morbidity, excessive exercise, body image, sexuality, and spirituality in males. Treatment outcomes for males in this environment are positive.

Sex differences in the relationships between body dissatisfaction, quality of life and psychological distress

“…29,30 Another possibility is that because body dissatisfaction is less common among males compared to females, the occurrence of substantial body dissatisfaction in a male may be more likely to be indicative of more general and severe psychological problems than in females. To this end, there is some evidence to suggest that males with eating disorders may exhibit greater co-morbidity than females with eating disorders, 31 including higher rates of compulsive exercise 32 and anxiety disorders, although females may be more likely to suffer from co-morbid substance use disorders. 33 The results of the current study corroborate statements by researchers that body dissatisfaction is a distinct public health problem that is separate from the eating disorders and other adverse psychological sequelae for which body dissatisfaction is commonly discussed as a risk factor.…”

The role of gendered constructions of eating disorders in delayed help-seeking in men: a qualitative interview study

“…Although evidence on gender differences in prognosis is limited, one recent cohort study found treatment outcomes in all EDs were better for men than women, when remission was measured by weight restoration and self-reported relapsing 21. Some studies suggest that men with EDs are more likely to engage in obsessive exercise15 17 19 22 and have more psychiatric morbidity as a result of an ED 15 19. Homosexuality has also been cited in some studies as a risk factor for men 15 17 23…”

Breaking the Silence

“…Despite this gap in the literature, epidemiological research on the prevalence and clinical presentation of EDs has reported that roughly 10% of patients seeking treatment for anorexia nervosa (AN) and bulimia nervosa (BN) are men, and that men account for up to 25% of cases of AN and BN in the general population (Hudson, Hiripi, Pope, & Kessler, 2007). While some studies have demonstrated that men and women with EDs report similar eating-related attitudes and behaviors (Connor, Simmons, & Cooper, 2003;Woodside, et al, 2001), others have identified significant gender differences, with men displaying greater concerns with muscularity and tone (Strother, Lemberg, Stanford, & Turberville, 2012), higher susceptibility to exercise addiction (Strother et al, 2012;Weltzin et al, 2012), and lower drive for thinness (Strother et al, 2012). Additionally, compared with women with EDs, men with EDs are more likely to have a history of being overweight (Strother et al, 2012;Weltzin et al, 2012), present to treatment at a later age, and report issues related to sexual identity and orientation (Weltzin et al, 2012).…”

“…Several authors have argued that the dearth of knowledge regarding eating pathology in men has contributed to underdiagnosis, undertreatment, and ongoing stigma and gender stereotypes that exclusively associate EDs with women (Ousley et al, 2008;Strother et al, 2012;Weltzin et al, 2012). Notably, eating pathology is associated with comparable levels of clinical distress and impairment in men and women (Striegel-Moore et al, 2009) with some studies indicating that the medical and psychiatric correlates of ED symptoms can be more severe for men (Grilo, White, & Masheb, 2009;Mehler, Sabel, Watson, & Andersen, 2008).…”

“…While some studies have demonstrated that men and women with EDs report similar eating-related attitudes and behaviors (Connor, Simmons, & Cooper, 2003;Woodside, et al, 2001), others have identified significant gender differences, with men displaying greater concerns with muscularity and tone (Strother, Lemberg, Stanford, & Turberville, 2012), higher susceptibility to exercise addiction (Strother et al, 2012;Weltzin et al, 2012), and lower drive for thinness (Strother et al, 2012). Additionally, compared with women with EDs, men with EDs are more likely to have a history of being overweight (Strother et al, 2012;Weltzin et al, 2012), present to treatment at a later age, and report issues related to sexual identity and orientation (Weltzin et al, 2012). Male college students may be at particular risk for EDs (Cain, Epler, Steinley, & Sher, 2012;McCabe & Ricciardelli, 2004), as these emerging adults reach postpubertal maturity (Cain et al, 2012) and navigate developmental changes associated with the transition from home, such as independent food selection and preparation (Marquis & Manceau, 2007).…”