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Treating Eating Disorders in Boys and Men

By Emily Battaglia

Currently, there are several significant obstacles to treating men and boys with eating disorders. Traditionally, diagnostic criteria and treatment methods have been geared almost exclusively toward females. Also, because male eating disorders do not tend to fit prevailing social perceptions, men are less likely to recognize their own disorders. Social stigma around eating disorders is more intense for boys and men than it is for girls and women. For this reason, males are less likely to admit that they are suffering, and more likely worry that they will be seen as feminine for having an eating disorder.  

For those men and boys who do seek help, treatment methods that are designed to meet their needs are few; it can be difficult for a man to find a program that offers male-only group therapy and rehabilitation activities. In addition, many eating disorder treatment programs are reluctant to admit male patients at all, because female patients do not respond well to the presence of males; and male-only inpatient treatment facilities for eating disorders are exceedingly rare. 

Research shows that men and women who suffer from eating disorders tend to have similar psychological and emotional issues, however they may manifest them in different ways. Risk factors for both men and women include perfectionistic personality type, inability to cope with change, family history of mental illness, history of sexual abuse, and dysfunctional family interaction. Males, in contrast to females, tend to obsess over muscle and body fat, women over weight. Men tend to be more performance-focused, while women tend to fixate more on appearance. In general, men have a harder time giving up compulsive exercise patterns than women do, and they have a harder time deciphering the emotional roots of their disorders.  

Experts have found that eating disorders are best treated in same-sex only settings. Both men and women who suffer from eating disorders frequently show a high level of anxiety regarding sexual situations and relationships. Because of this intensely personal aspect of eating disorders, most mixed-gender treatment methods are considered to be less than optimal. In addition to the fact that disordered eaters must confront sexual issues while in treatment, emotional issues relevant to these disorders tend to be gender-specific. Both men and women may be inhibited by the presence of the opposite sex. Some experts believe that men may be particularly embarrassed to discuss their concerns in front of women, due to the fact that men naturally find it more difficult to verbalize emotion. 

A lack of gender-specific research and gender-neutral diagnostic criteria present a hindrance to diagnosing and treating men and boys with eating disorders. Currently, there are efforts to develop more comprehensive diagnostic criteria and tools. Gender-specific research, particularly for men, is being initiated to further investigate differences between male and females sufferers of eating disorders.  

Treatment components offered by some treatment centers to meet the needs of men with eating disorders are beginning include male-only therapeutic groups and programs. Another new treatment component is testosterone replacement therapy (malnourished men often suffer from a lack of adequate testosterone). In fact, a 1986 study (Andersen and Mickalide) indicated that men with anorexia may have persistent or pre-existing problems with producing testosterone. Other treatment components for men include strength-training programs, exercise and nutrition re-education components, anger-management therapy, and relationship counseling.

  
References
 

Andersen et al. Osteoporosis and osteopenia in men with eating disorders. The Lancet, Vol. 355; June 3, 2000: pp: 1967-1968 

Bernstein, Elizabeth. Men, Boys Lack Options to Treat Eating Disorders. The Wall Street Journal. April 17, 2007.

Blouin, AG, & Goldfield, GS. (1995) Body Image and Steroid Use in Male Bodybuilders. International Journal of Eating Disorders. 1995 Sep;18(2):159-65.

Michigan State University (2008, March 4). Testosterone Could Guard Against Eating Disorders. ScienceDaily. Retrieved August 15, 2008, from http://www.sciencedaily.com­ /releases/2008/03/080303164518.htm 

National Collegiate Athletic Association. (1999) Athletes and Eating Disorders: The National Collegiate Athletic Association Study. Retrieved on August 15, 2008 from http://www.csmfoundation.org/NCAA_Study.pdf