Eating Disorders: a Diagnosis to Consider in Male Population. a Case Report and Review of Current Data

Abstract

Background Although Eating Disorders (ED) are more prevalent among female population, in the last decades they are gaining importance among males. Aims The aim was to review prevalence, specific characteristics, comorbidity, diagnosis, treatment and prognosis of ED in male population. Methods We searched in MEDLINE selecting studies from 2000 until the present related to ED among males. We report a case of an 18-year old male who was hospitalized with a severe hyponatremia in the context of potomania and abuse of diuretics and laxatives and who was diagnosed with purgative Anorexia nervosa. Results Males with ED have higher rates of family history of ED and higher percentages of Substance Use Disorders and Alcohol Use Disorders. They tend to have more medical complications and comorbidity. Levels of previous overweight and subsequent malnutrition are higher, and purgative behaviours and compulsive exercise more frequent. They show significantly less desire to lose weight, express dissatisfaction with the upper rather than the lower body, and they are more concerned of muscle development. Conclusions The prevalence of ED among male population has increased in the last decades, probably due to the clinician´s underdiagnosis of malnutrition related symptoms in this group. In addition, scales and diagnostic criteria are adapted to female population, which increases the difficulty at he time of diagnosing. The clinical debut in males tends to be later and it is associated with more and severe physical complications. Clinicians should be aware of loss of weight in men and consider ED as a possible diagnosis.