December 10, 2012 | Posted By Jane Jankowski, LMSW, MS

Over the last thirty years or so, eating disorders have received increased attention both clinically and in the mainstream media. The apparent surge in diagnosing eating disorders has long been blamed on unrealistic social pressures, media representations equating body type and attractiveness, however, the effect on males has gone largely unnoticed until recently. A paper published in the journal Eating Disorders in 2012 offers some useful insight into the problematic gender disparities for men who have eating disorders. 

In the paper “Eating Disorders in Men: Underdiagnosed, Undertreated, and Misunderstood” by Strother, Lemberg, Stanford, and Turberville several issues that are unique to males with eating disorders. In order to address the issues specific to men, the authors propose several key topics which are notably relevant in these patients. First, understanding the patient’s weight history is presented because the research has indicated men who develop eating disorders were often overweight at one time in their life, unlike women with eating disorders who often have normal weight histories. Weight concerns for men are often associated with avoiding health problems experienced by their fathers or athletic achievement, unlike the goals of “achieving thinness” in females.

Strother et al also note the importance of understanding how trauma and sexual abuse correlates with the development of eating disorders, but that in males, these events are underreported and therefore incorrectly believed to be less frequent for boys and men.  Disordered eating may relate to issues surrounding sexuality and body image issues, and may need to be an area of clinical focus for all patients with eating disorders. The traumatic effects of bullying on male patients may contribute to the “conscious or unconscious manipulation of body shape…focused n becoming more ‘masculine’…to protect themselves from being an ongoing victim”. 

Sexual orientation, depression, and shame are features thought to contribute to the clinical picture for many patients as well, though it is unclear to what degree. Generally, the authors note that the stigma of having stereotypically feminine urges or problems may be dealt with by restricting or otherwise manipulating food intake in a disordered way to exert control over these unwanted feelings. Social pressure to mask vulnerability may contribute to the underreporting of eating disorders for men. 

Given the delayed attention given to eating disorders in men, there is a gap in the evidence based assessment tools and treatment modalities which may work best for men. The belief that eating disorders are a female problem has incorrectly perpetuated this myth to the great detriment of men. Repairing this disparity will require further research and social attention so individuals are able to receive appropriate treatment and care as just that – individuals. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

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