Eating Disorders In Men Research Articles

Personality Traits and Risk of Eating Disorders in Men: A Cross-Sectional Study.

Eating disorders (EDs) have been understudied and misunderstood in men. Among the relevant factors in the risk, onset, and maintenance of EDs, personality stands out. Therefore, the aim of the study was to analyze the relationships between personality traits and risk variables for the development of EDs in men. A total of 443 male university students (mean = 22.16 years) who completed the Spanish versions of the Eating Disorder Inventory-3 (EDI-3) and the NEO Five-Factor Inventory (NEO-FFI) participated. Correlation analyses were performed, and in order to determine the predictive role of personality traits on risk scales, a hierarchical multiple regression was performed. The results showed that neuroticism was positively associated with drive for thinness, being its main predictor variable. In bulimia, the main relationships were positively associated with neuroticism and negatively with conscientiousness. As for body dissatisfaction, the main predictor variables were neuroticism and, in a negative sense, extraversion and openness to experience. In conclusion, personality traits are related to the risk of developing EDs in male university students, with neuroticism being the main associated trait.

Stigmatization of binge eating disorder in men: Implicit associations with weight status and femininity

BackgroundEating disorders are highly stigmatized, but stigma against binge eating disorder (BED) specifically is relatively understudied, especially in men. We compared perceptions of a male target with BED to one with alcohol use disorder (AUD), which shares the key characteristic of subjective loss of control over consumption. We also investigated how participants' eating and alcohol use behaviors and attitudes towards psychotherapy influence perceptions of these disorders. MethodsParticipants (n = 402) viewed vignettes describing a male target engaged in excess alcohol use or binge eating and rated the target on various attributes and as being responsible for or in control of their behavior and suffering from an addiction warranting treatment. Participants completed the Alcohol Use Disorders Identification Test, Binge Eating Scale, and questions about attitudes towards and experience with psychological treatment. ResultsThe BED target was rated as significantly less “thin,” more “overweight” and “obese”, and higher on several positive attributes and traits traditionally associated with femininity; the AUD target was thought more likely to be suffering from an addiction and in need of psychological treatment (all p < .05), with no differences between targets in ratings of responsibility for or control over the problematic behavior. Ratings were unrelated to participants' attitudes towards or experience with psychological treatment and personal alcohol consumption or binge eating behaviors. ConclusionsBED in men appears less stigmatized than AUD but is implicitly associated with weight status and femininity, which may increase reluctance to seek treatment. Both AUD and BED were generally recognized as pathological and warranting intervention.

Associations between household income and disordered eating differ across sex and racial identity in a population-based sample of adults.

Most research on socioeconomic status (SES) and eating disorders (EDs) has focused on young White women. Consequently, little is known regarding how SES may relate to EDs/disordered eating in older adults, men, or people with different racial identities. We examined whether associations between SES and EDs/disordered eating differed across age, sex, and racial identity in a large, population-based sample spanning early-to-later adulthood. Analyses included 2797 women and 2781 men ages 18-65 (Mage = 37.41, SD = 7.38) from the population-based Michigan State University Twin Registry. We first examined associations between SES and dimensional ED symptoms, binge eating (BE), and self-reported ED diagnoses across age and sex in the full sample. We then examined the impact of racial identity on associations by conducting within- and between-group analyses among Black and White participants. In the full sample, lower SES was associated with significantly greater odds of BE and lifetime EDs in men, but not women, across adulthood. The association between lower SES and greater BE risk was stronger for Black men than for White men, though significant in both groups. Conversely, Black women showed a positive association between SES and dimensional ED symptoms that significantly differed from effects for Black men and White women. Associations between socioeconomic disadvantage and EDs/disordered eating may be particularly robust for men in adulthood, especially men with a marginalized racial identity. Oppositely, Black women may encounter social pressures and minority stress in higher SES environments that could contribute to somewhat heightened ED risk. Little is known regarding how associations between socioeconomic status (SES) and eating disorders (EDs) may differ across age/sex or racial identity. We found lower SES was associated with greater odds of a lifetime ED or binge eating in men only, with a particularly strong association between lower SES and binge eating for Black men. Results highlight the importance of examining how SES-ED associations may differ across other aspects of identity.

Eating Disorders in Men: A Comprehensive Summary

Eating disorders (EDs) have detrimental effects on an individual’s physical and mental health, along with significant interpersonal, social and economic effects. Furthermore, men who are suffering with an ED face unique challenges with this. Men suffering with EDs have historically received little attention within ED research, diagnosis and intervention. However, the number of men suffering with these issues is significant and growing. Understanding of EDs tend to ignore male experiences, meaning many are left to suffer in silence until the ED has developed to a critical point. However, many now recognize the need to understand the issues facing men suffering with an ED. By improving our understanding, we can better improve early detection, diagnosis and treatment for those who are suffering. This paper aims to provide a comprehensive general introduction to this growing area of research and it is hoped that it will be of good use to interested researchers, students and the general public. Prevalence, presentation, history, diagnosis and more will be covered in order to provide a well-rounded understanding of EDs in men.

Men have eating disorders too: an analysis of online narratives posted by men with eating disorders on YouTube

ABSTRACT Eating Disorders (ED) among men are still surrounded by stigma and gender stereotypes, with a common misconception that ED are an exclusively female condition. This study employed a gender-sensitive approach to uncover males’ critical needs for effective treatment and recovery. We qualitatively analyzed a sample of twenty-five videos posted on YouTube by men with ED, presenting personal stories of recovery and recovery in-progress. Through thematic analysis of the narratives, we identified three common factors increasing disordered eating behaviors in men: 1) bullying, 2) drive for muscularity, and 3) self-regulation. In addition, we found three major themes related to barriers preventing men from help-seeking: 1) shame and stigma, 2) lack of knowledge and information, and 3) low level of perceived doctor-patient communication. The findings of this study can contribute to the conceptualization of future interventions and recovery programs designed to prevent and treat ED in men.

Understanding Disordered Eating Risks in Patients with Gastrointestinal Conditions

Emerging data are illuminating the connection between gastrointestinal (GI) conditions such as disorders of gut–brain interaction (DGBI), including irritable bowel syndrome (IBS), celiac disease, and inflammatory bowel disease (IBD) with disordered eating. 1 Singh P. Arora A. Strand T.A. Leffler D.A. Catassi C. Green P.H. et al. Global prevalence of celiac disease: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2018; 16: 823-836 e2 Abstract Full Text Full Text PDF PubMed Scopus (447) Google Scholar , 2 Houghton LA, Heitkemper M, Crowell M, Emmanuel A, Halpert A, McRoberts JA, et al. Age, gender and women's health and the patient. Gastroenterology. February 15, 2016 [Epub ahead of print]. Google Scholar , 3 Murray H.B. Flanagan R. Banashefski B. Silvernale C.J. Kuo B. Staller K. Frequency of eating disorder pathology among patients with chronic constipation and contribution of gastrointestinal-specific anxiety. Clin Gastroenterol Hepatol. 2020; 18: 2471-2478 Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar , 4 Harer K.N. Irritable bowel syndrome, disordered eating, and eating disorders. Gastroenterol Hepatol (N Y). 2019; 15: 280-282 PubMed Google Scholar , 5 Passananti V. Siniscalchi M. Zingone F. Bucci C. Tortora R. Iovino P. et al. Prevalence of eating disorders in adults with celiac disease. Gastroenterol Res Pract. 2013; 2013: 491657 Crossref PubMed Scopus (38) Google Scholar , 6 Hedman A. Breithaupt L. Hubel C. Thornton L.M. Tillander A. Norring C. et al. Bidirectional relationship between eating disorders and autoimmune diseases. J Child Psychol Psychiatry. 2019; 60: 803-812 Crossref PubMed Scopus (36) Google Scholar In turn, eating disorders (EDs), such as anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) can lead to alterations in GI function. 7 Hetterich L. Mack I. Giel K.E. Zipfel S. Stengel A. An update on gastrointestinal disturbances in eating disorders. Mol Cell Endocrinol. 2019; 497: 110318 Crossref PubMed Scopus (24) Google Scholar ,8 Santonicola A. Gagliardi M. Guarino M.P.L. Siniscalchi M. Ciacci C. Iovino P. Eating disorders and gastrointestinal diseases. Nutrients. 2019; 11 Crossref PubMed Scopus (27) Google Scholar In a systematic review of 94 studies with an accurate ED diagnosis, the weighted mean of lifetime ED were 8.4% (range, 3.3% to 18.6%) for women and 2.2% (range, 0.8% to 6.5%) for men. A doubling in prevalence over the study timeline was also noted; the weighted means of point ED prevalence increased from 3.5% for the 2000-2006 period to 7.8% for the 2013-2018 period. 9 Galmiche M. Dechelotte P. Lambert G. Tavolacci M.P. Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. Am J Clin Nutr. 2019; 109: 1402-1413 Crossref PubMed Scopus (246) Google Scholar It is important to interpret prevalence rates for men with caution because they are underrepresented in ED research and less likely to be screened or referred for treatment. 10 Cottrell D.B. Williams J. Eating disorders in men. Nurse Pract. 2016; 41: 49-55 Crossref PubMed Scopus (5) Google Scholar

A clinical case of typical anorexia nervosa in a prepubescent boy

IntroductionClinical case of 10-year-old patient with anorexia nervosa at the stage of severe cachexia. Features of the disease, diagnosis, treatment and methods of restoration of nutrition. Anorexia nervosa is an eating disorder (ED), severe pathology, manifested by severe complications, high disability and can cause death. ED has traditionally been perceived as a disease affecting women. However, this pathology occurs men, is 10-25% of the total number of patients with ED, or 1-2% in the population.ObjectivesDescribe the difficulties in identifying ED in men that affect diagnosis and treatment, especially if they are underage patients.MethodsPatient I. 10 years, selectivity in food from 4 years, during the week before hospitalization complete rejection of food and water. When entering the clinic height 127, weight 19 kg, BMI 11. In the clinical picture anxiety, low mood, fear of eating and weight gain. The duration of the disease for about one year. Clinical and psychopathological method.ResultsDiagnosis F50.0 anorexia nervosa in the stage of severe cachexia. Treatment: olanzapine and fluvoxamine in the age dosages, parenteral Kabiven infusion, individual and group psychotherapy. Psychoeducation of parents and Maudsley method therapy. As a result of treatment improved mood, decreased anxiety associated with eating and weight gain. At the time of discharge from the clinic height 127, weight 30 kg, BMI 18.ConclusionsThe clinical case indicates the need to increase the attention of pediatricians, psychologists, psychiatrists and other doctors in connection with the growth and rejuvenation of ED in the male population.

Peer Recognition of Disordered Eating Behaviors: Implications for Improving Awareness through Health Education

ABSTRACTBackground: Eating disorders (ED) are a concern on college campuses, yet comprehensive education and awareness is low. Few studies have investigated knowledge of disordered eating not fitting prototypical depictions or recognition of disordered eating in males. Purpose: To assess college students’ ability to identify behavioral symptoms of ED in men and women. Methods: We explored problem identification ability after reading vignettes depicting either males or females displaying ED behaviors aligned with anorexia, bulimia, and binge eating disorder, and a healthy control vignette. Ordinal logistic was used to examine the effect of vignette target gender, participant gender, and disorder depicted on identification. Results: Approximately half of the sampled students correctly categorized vignettes as EDs. Participants were most likely to correctly identify the bulimia scenario as an ED, followed by anorexia, and binge-eating, and were more likely to identify ED if the vignette target was a woman. Discussion: The findings suggest awareness of behavioral presentations of ED, particularly in males, is low. This may stem from prototypical depictions of ED in the media and existing education material. Translation to Health Education Practice: Health education can focus on observable, behavioral symptoms of ED to improve identification in college students.A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI)http://portal.shapeamerica.org/trn-Webinars

Application of network analysis to investigate sex differences in interactive systems of eating-disorder psychopathology.

Although men comprise 25% of persons with eating disorders (EDs), most research has focused on understanding EDs in women. The theoretical framework underlying common ED treatment has not been rigorously tested in men. The purpose of this study was to compare the interconnectivity among ED symptoms in men versus women. Participants (N = 1,348; 50% men) were individuals with anorexia nervosa, bulimia nervosa, binge-eating disorder, or other specified feeding or eating disorder who were users of Recovery Record, a smartphone app for monitoring ED symptoms. Participants were matched on age and duration of illness. Network analysis was used to create networks of symptoms for both sexes. Strength centrality, network stability, and bootstrapped centrality differences were tested. The network comparison test (NCT) was used to identify sex differences between networks. Key players analysis was used to compare fragmentation of each network. For both sexes, items related to binge eating and restricting emerged as highest in strength centrality. The NCT identified significant differences global strength (p = .03) but not network invariance (p = .06) suggesting that although the structure of the networks was not statistically different, the strength of the connections within the network was greater for women. Key players analysis indicated that both networks were similarly disrupted when important nodes within the network were removed. Findings suggested that there are more similarities than differences in networks of EDs in men and women. Results have important clinical implications by supporting theoretical underpinnings of cognitive-behavioral models of EDs in both men and women.

Sex-specific issues in eating disorders: a clinical and psychopathological investigation.

To highlight the characteristics of eating disorders (ED) in males, with particular attention to sex-related clinical features and psychiatric co-morbidities. Out of 280 persons, referred to our outpatients ED clinic between January 2011 and June 2014, 267 with complete information were included in this retrospective observational study. The men/women ratio was one to five (male 16.5% vs female 83.5%) with an increasing proportion of male patients over the years. The most frequent ED in males was binge eating disorder, whereas in females anorexia nervosa and bulimia nervosa prevailed. Excessive exercising and fasting were the most common compensation behaviours in males; while self-induced vomiting and laxative-diuretic abuse were more typical in females. Among women, the most represented psychiatric co-morbidities were mood and somatoform disorders, whereas among men, anxiety and psychosis spectrum disorders were the most frequent ones. Borderline and histrionic personality disorders were prevalent in female ED, while narcissistic and antisocial personality disorders prevailed in males. ED in men is a growing phenomenon. Male ED, compared to female ED, show differences in clinical presentation, symptoms and co-morbidities. Despite the use of clinical and psychometric evaluating tools targeting female patients, sex differences do exist and additional studies are required to investigate male specific issues in ED. Level of Evidence Level V, cross-sectional descriptive study.

Insights into the Experiences of Treatment for An Eating Disorder in Men: A Qualitative Study of Autobiographies.

Eating disorders are increasingly recognized as a problem for men but help-seeking is low and little is known about their treatment experiences. This paper sought to determine the treatment experiences of men who have suffered from an eating disorder using autobiographical data. Inclusion criteria were autobiographies of men who had experienced an eating disorder and sought any form of treatment for this, written in the English language, published between 1995 and 2015, and available for purchase in 2016. The search resulted in six books that were thematically analyzed. Analysis of data resulted in two broad themes (1. Positive experiences; 2. Negative experiences) with sub-themes. With regards to the first theme, factors such as concern of staff members, therapist’s expertise (in treating eating disorders in men), and a collaborative treatment approach were considered favorable for treatment. In contrast to the first theme, apathy of staff members, the authors’ own negative preconceptions, treatment providers being perceived as prioritizing financial concerns, perceived as incompetent and judgmental behavior of therapist(s), and time limitations of sessions were considered unfavorable treatment experiences. In this study, the perceived success of treatment depended on therapist’s features and the form of treatment provided. Further research examining these is indicated.

Sex-specific issues in eating disorders: A clinical and psychopathological investigation

IntroductionGender is crucial in many aspects of life, including attitude towards body image perception. Although the well-known female preponderance, recent studies demonstrate an increasing Eating Disorders (EDs) incidence in males but scant literature attention.AimsThis study aims to highlight the growing phenomenon of EDs in males and shed light on sex-related clinical features and psychiatric comorbidities.MethodOut of 280 persons aged 18–74, consecutively referred to Bologna's outpatients EDs clinic, 267 were included in this retrospective observational study.ResultsThe men/women ratio was one to five. The most frequent EDs in males was Binge Eating Disorder, whereas in females Anorexia Nervosa and Bulimia Nervosa prevailed. Excessive exercising and fasting were the most common dysfunctional behaviors in men, while self-induced vomiting and laxative-diuretic abuse were more typical in women. Mood and Somatoform Disorders were more common in women, whereas Anxiety and Psychosis Disorders in males. Within personality disorders, borderline and histrionic prevailed in female, while narcissistic and anti-social in males.ConclusionsMale compared to female EDs, show differences in clinical presentation, symptoms and comorbidities. The increased proportion of affected men should alert general practitioners, clinicians and psychologists working in non-specialized settings to be more aware of the possibilities of encountering an ED in men and of the need of exploring the eating habits in all male patients. The finding of a more pronounced physical hyperactivity in men in order to achieve an ideal body shape which is muscular and athletic suggests the need of a deeper attention to sex-different symptoms and behaviors declination.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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

ObjectivesTo understand how young men recognise eating disorder (ED) symptoms and decide to seek help, and to examine their experiences of initial contacts with primary care.DesignA qualitative interview study.SettingMen from...

Early Life Loss and Trauma

The onset of an eating disorder in middle-age men is poorly researched as are eating disorders in men generally. Therefore, life events that influence eating disorders in men, including delayed onset of an eating disorder remains unknown. Given the limited understanding of males with eating disorders and limited access to large samples of men with eating disorders, an in-depth analysis of a single case of a male in middle age with an eating disorder was chosen to gain insight and understanding into this phenomenon. A Life History approach explored the case of Joseph (pseudonym), who was diagnosed at age 44 years with an Eating Disorder Not Otherwise Specified. Data were collected through (a) life course open-ended questioning through interviews, (b) written statements, and (c) comments on transcripts. Three themes emerged, loss and unworthiness, becoming bigger, and wanting to change reflecting eating behaviors associated with attachment disruption, loss and trauma, body dissatisfaction, and negative affect. Later in life, an emotional "tipping point" precipitated an eating disorder. Results indicate traumatic loss leading to early attachment disruption as influential in Joseph's delayed onset of an eating disorder. The value of thorough narrative life histories during therapy when eating disorders occur late in life is discussed as well as the significance for men.

Measuring Eating Disorders in Men: Development of the Eating Disorder Assessment for Men (EDAM)

In a thorough review of literature of eating disorders in men, it is consistently shown that symptom presentation varies greatly by gender. However, almost all eating disorder instruments have been developed and validated on females. These critical differences between men and women in symptom presentation provoke the necessity to develop a male specific eating disorder assessment tool. The development of the EDAM is described, and in a study of 108 clients of residential treatment facilities, results of the preliminary version of the EDAM are shown. Internal consistency reliability is supported and factor analysis loadings are provided. Results from a logistical regression support the EDAM's ability to predict eating disorders in men.

Características clínicas de adolescentes de sexo masculino con trastornos de la conducta alimentaria: Estudio de casos clínicos

There is a higher prevalence of eating disorders (ED) among adolescent females. These are less common in men and there are clinical differences between genders.To describe the clinical features of adolescent males with ED.Review of 38 medical records of male patients with ED seen in an ED Unit in Chile, between 2001 and 2009.Mean age at first medical visit was 14.4 ± 2.2 years. Symptoms appeared 9.5 ± 8.9 months prior to the first visit. Anorexia nervosa (AN) of the restricting type was diagnosed in 21 patients (55.2%), with a mean weight loss of 11.2 kg ± 9.4 kg. In 37% of patients, there was a past medical history of overweight. All patients either increased or maintained weight during follow up. Sixty three percent had a psychiatric co-morbidity at first visit. After 3 months of treatment, 82% of patients remained in the program.There was a delay in diagnosis of ED in men. The high prevalence of AN found in this group is characteristic of patients recently diagnosed with ED. Overweight could be a precipitating factor. Nearly two thirds of male ED patients had a psychiatric comorbidity. This high prevalence may suggest a susceptibility to develop ED in males.

Clinical features of adolescent males with eating disorders

There is a higher prevalence of eating disorders (ED) among adolescent females. These are less common in men and there are clinical differences between genders. To describe the clinical features of adolescent males with ED. Review of 38 medical records of male patients with ED seen in an ED Unit in Chile, between 2001 and 2009. Mean age at first medical visit was 14.4 ± 2.2 years. Symptoms appeared 9.5 ± 8.9 months prior to the first visit. Anorexia nervosa (AN) of the restricting type was diagnosed in 21 patients (55.2%), with a mean weight loss of 11.2 kg ± 9.4 kg. In 37% of patients, there was a past medical history of overweight. All patients either increased or maintained weight during follow up. Sixty three percent had a psychiatric co-morbidity at first visit. After 3 months of treatment, 82% of patients remained in the program. There was a delay in diagnosis of ED in men. The high prevalence of AN found in this group is characteristic of patients recently diagnosed with ED. Overweight could be a precipitating factor. Nearly two thirds of male ED patients had a psychiatric comorbidity. This high prevalence may suggest a susceptibility to develop ED in males.

Similarities and differences between women and men on eating disorder risk factors and symptom measures

Researchers studying eating disorders in men often use eating disorder risk and symptom measures that have been validated only on women. Using a sample of 215 college women and 214 college men, we report on the validity of doing so with a set of measures chosen to reflect a wide range of risk factors and symptoms. The Bulimia Test-revised (BULIT-R), the restraint scale (RS), the three-factor eating questionnaire (TFEQ), the Eating Expectancy Inventory, and the eating attitudes test (EAT) all had the same factor structures for both genders, and tests of invariance showed that factor loadings, factor variances, and intercorrelations among factors were equivalent across gender. A modified Structured Clinical Interview for DSM-IV anorexic symptoms questionnaire did not perform adequately for either gender. Men produced slightly less reliable scores on virtually all measures, with the result that Pearson-based estimates of correlations among the measures were slightly lower for men. Men had lower scores on symptom and risk measures, but not on other eating measures.

Body fat perception in eating-disordered men.

We sought to assess the relative roles of body fat ideals and body fat perception in men with eating disorders. We compared 27 men meeting criteria for a current eating disorder (17 with anorexia nervosa and 10 with bulimia nervosa), 21 male mountain climbers, and 21 control men, using a computerized test of body image, the "somatomorphic matrix." When asked to choose the body that they "ideally would like to have," men with eating disorders selected an image with body fat closely comparable to that chosen by the control men. On perceived body fat, however, the groups differed dramatically. The eating-disordered men perceived themselves to be almost twice as fat as they actually were, whereas the control subjects showed virtually no such distortion. These findings resemble those of a previous study of women, which found that women dieters showed abnormal body fat perception, but not body fat ideals, when compared with non-dieters. These observations suggest that distorted body perception, rather than body ideal, may be central to eating disorders in men. This distinction may be important for both research and therapy.