Men Getting More Attention in Eating Disorder Community

Contributor: By Mark Warren, M.D., Chief Medical Officer at The Emily Program

The topic of males with eating disorders has recently moved to the forefront of conversations in our society. And that’s a crucial development, as history shows men weren’t always a part of the dialogue.

Traditionally, eating disorders were perceived as a “girl’s disease” and statistically, women dominate patients with eating disorders.

That comes as no surprise because for a long time it was believed that men did not get eating disorders and, therefore, all treatment was centered on women. In fact, all eating disorder diagnostic questionnaires were created for women and designed to be administered to women¹. Plus, virtually all research has been conducted on and for women, as men have been excluded systematically from research protocols in eating disorders.

Getting a Better Understanding of Eating Disorders in All Genders

The way eating disorders used to be defined and screened eliminated many men who might otherwise have needed treatment. But as our understanding of eating disorders as a neurobiological illness has grown, so has our understanding of how both men and women are affected.

It wasn’t until the 1980s that men actually became a recognized group within the eating disorder community — and only much more recently moved to an area of interest in the field. Thankfully today, men are more welcomed and understood in the eating disorder community.

Just look at the numbers. In the 1960s, statistics showed only 1 in 10,000 men suffered from eating disorders, but that number is closer to 1 in 4 today, and for binge eating disorder, men appear to make up as much as 40 percent of those that suffer².

Diagnostic and Treatment Differences Between Men and Women

From screening all the way to treatment, the differences between men and women are profound, including the language of the disorders, the parts of the body patients focus on and the occurrence of eating disorder behaviors.

Men tend to talk about their bodies differently than women. Men often talk about losing weight in order to decrease body fat, whereas women often talk about the need to be thin. Men talk about being lean, whereas women talk about smaller waistlines. Men want to increase muscle mass, while women want to diet.

How Men Talk About Their Eating Disorder

Because the language is so different between genders, men with eating disorders may slip through the cracks — even if they may be telling us about their disorder in their own words.

For instance, in one of the most popular screening tests used in many eating disorder centers around the country, specialists may ask questions to gather information on whether patients believe their thighs are too big or their buttocks are too large.

Men are likely to answer “no” to these questions. Screening questions centered on whether patients believe their chests are too big or they have too much body fat may gain more traction in diagnosing men.

Behavior Differences Between Men and Women

Eating disorder behaviors vary across both genders, as well. Men tend to use steroids and other supplements, and exert exercise dependence to build muscle mass. Men tend to focus on the function of their bodies, rather than appearance. In contrast, females tend to focus on being thin and use negative behaviors, such as fasting or purging, to get there³.

Yet given this picture that we know, why are men still struggling to get help and support? The field as a whole still has a ways to go in diagnosing and treating men. Below are steps that can be taken by every member at every level to help us as a community achieve this goal.

The Academic Level

At the academic level, researchers must always include men in every study. They shouldn’t assume we know what eating disorders look like in men because studies haven’t answered that question yet.

The Professional Level

At the professional level, physicians and therapists need to ask men questions about food, body image and body goals in gender-neutral language. The field may need to rethink the whole diagnostic process and include both male- and female-oriented issues in their diagnoses.

The Program Level

At the program level, facilities need to be more welcoming to men and include them in advertising. They must understand that men in general are less comfortable in psychotherapy and treatment settings. They are less likely to feel an emotional connection to therapy and less likely to share shame and other eating disorder issues with a therapist.

The Patient Level

And lastly, at the patient level, men must be aware of the illness’ history and how it’s impacted them. Men need to understand the field’s shortcomings when it comes to their gender and know the right questions to ask a facility and its professionals.

If we know our history and how it has impacted men, and we know how our sociocultural beliefs have influenced our clinical beliefs, we can create treatment systems that will lead men to healthier and happier lives.

Community Discussion – Share your thoughts here!

What are your thoughts on men getting more attention in the eating disorder treatment field? Are you seeing improvement where you live? How do you think we can improve in this area?

1. Arnold Andersen, MD, Johns Hopkins Medicine, Baltimore
2. Roberto Olivardia, PhD, Harvard Medical School, Boston
3. Marita McCabe, PhD, FAPS, Deakin University, Centre for Mental Health and Wellbeing, Australia

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on April 28th, 2015
Published on EatingDisorderHope.com