Eating Disorders in Men
"Bigorexia" is the male version of anorexia nervosa. Could you spot it in your practice? More about being a man with a "woman's disorder" in these slides.
Primary care physicians are the healthcare providers most likely to notice signs of disorders like muscle dysmorphia, or “bigorexia,” in male patients. In the slides above, pick up some background on the disorders and what to look for.
Eating disorders in men are overlooked, underdiagnosed; estimates are difficult because of gender bias in diagnostic tools.
Risk factors for eating disorders in men: Body image dissatisfaction, concern with muscularity and weight, gay and bisexual orientation, being overweight (prior to development of ED).
Societal pressures on men. Male body objectification in print, TV, movies, online. Action hero toys distort male body image.
Binge eating disorder in men. Experiencing loss of control while eating may better predict an ED than the total food eaten, but loss of control may be more common in women.[4]
Anorexia nervosa in men. Studies suggest gender differences may be narrowing [4]. Older age, lower BMI at treatment admission may predict mortality in male AN [3].
Bulimia nervosa, purging and laxative abuse in men.
Muscle dysmorphia, bigorexia, reverse anorexia in men. Associated with more psychopathology, social impairment, and suicide risk than other types of body dysmorphic disorder.
Men with eating disorders slip under the radar. Men are less likely to receive treatment for an ED, and are treated for fewer days than women. Treatment for EDs still based on psychological and emotional development of women, not men.
Symptoms in men vs women with EDs. Alcohol dependence may be more common in men with EDs, while major depression may be more common in women.
DSM 5, a step forward for men with eating disorders? DSM5 may increase specific diagnoses of EDs in men. Diagnostic criteria for eating disorders are more sex-neutral.
Take home points: Eating disorders in men
Men and boys exhibit many of the same aberrant behaviors around food and body image that women do, but their numbers have long gone unrecognized. The tide has begun to turn, however, as more research is devoted to eating disorders in men and the medical and psychiatric communities shift toward more sex-neutral diagnostic categories.
References:
1. Rhys Jones W, Morgan JF. Eating disorders in men: a review of the literature. J Public Mental Health 2010;9:23-31.
2. Sweeting H, Walker L, Maclean A, et al. Prevalence of eating disorders in males: a review of rates reported in academic research and UK mass media. Int J Mens Health. 2015;14(2).
3. Raevuori A, Keski-Rahkonen A, Hoek HW. A review of eating disorders in males. Curr Opinion Psychiatry. 2014;27:426-430.
4. Mitchison D, Mond J. Epidemiology of eating disorders, eating disordered behavior, and body image disturbance in males: a narrative review. J Eating Disorders. 2015;3:1-9.
5. Maclean A, Sweeting H, Walker L, et al. It’s not healthy and it’s decidedly not masculine: a media analysis of UK representations of eating disorders in males. BMJ Open 2015;5:e007468.
