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The following was taken from the Eating Disorder Coalition. To view the pdf file, please visit their website.
Facts About Eating Disorders: What the Research Shows
Eating disorders affect millions of Americans
• Approximately 11 million Americans suffer from an eating disorder
• Nearly half of all Americans personally know someone with an eating disorder
• Anorexia is the 3rd most common chronic illness among adolescents
• Eating disorders do not discriminate: men and women, all economic classes, young and old are affected
Eating disorders are not the patients fault
• The risk of developing an eating disorder is 50-80% determined by genetics.
• Dieting, a normalized behavior in our culture, is a risk factor for the development of an eating disorder and can trigger eating disorders in those with a genetic predisposition.
• Even young children in our society are influenced to feel bad about their bodies and encouraged to engage in unhealthy dieting behaviors.
• Our societys emphasis on appearance and idealization of thinness promotes dangerous dieting behaviors and blinds us to people suffering and in need of treatment.
• Genetic predisposition does not spell destiny. Our strongest approach is to focus on modifying the environmental factors that influence risk and perpetuate the disordered eating.
• Due to the cultural misunderstanding of eating disorders and the idealization of thinness, patients are often unable to perceive the gravity of the illness or seek assistance on their own without the assistance of family, friends, or clinicians.
Eating disorders are dangerous
• Eating disorders kill. Eating disorders have the highest mortality rate of any mental illness, upwards of 20%.
• Eating disorders can lead to major medical complications, including cardiac arrhythmia, cognitive impairment, osteoporosis, infertility, and most seriously death.
• The mental anguish of an active eating disorder is tremendous, and persists beyond the medical consequences. Eating disorders cause social isolation and emotional distress comparable to other mental conditions like depression.
• The toll of inadequately treated illness is crippling for the patient, the family, and society.
• Suicide, depression, and severe anxiety are common during the active illness and treatment.
Eating disorders are treatable
• Treatment of an eating disorder in the US ranges from $500 per day to $2,000 per day. Outpatient treatment, including therapy and medical monitoring, can cost $100,000 or more.
• Eating disorders can be successfully and fully treated to complete remission, but only 1 in 10 people with eating disorders receive treatment.
• Eating disorders affect many people before the prime of their life. Proper treatment can ensure that most sufferers will become fully contributing members of society.
• The NIH has allocated only $1.20 in research funding per affected eating disorder patient, compared to $159 per affected individual for schizophrenia.
• Treatment can take months to years, but early intervention with evidence-based care is improving the prognosis for a new generation of patients.
• Expert, skilled clinical support is essential to diagnose, treat, and support eating disorder recovery, but eating disorder specialists are not available in many communities and lack coordinated protocols.
Millions of Americans suffer from eating disorders, known as anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified (EDNOS). An estimated 90% + are adolescent and young women, though men and adults suffer from eating disorders as well. Eating disorders have serious mental and physical health consequences including death. In fact anorexia has the highest mortality rate of any mental illness -- up to 20%.
National Household Survey: Results are Unvieled
Eating Disorders Often Untreated, Often Impair Lives
WASHINGTON January 29, 2007 - The first nationally representative study of eating disorders in the United States appears in the February 2007 edition of Biological Psychiatry. The National Comorbidity Survey Replication (NCS-R) is a nationally representative survey of the U.S. population that was administered face-to-face to a sample of 9,282 English-speaking adults ages 18 and older between February 2001 and December 2003. Among the results:
Lifetime prevalence of individual eating disorders is 0.6-4.5%.
Lifetime prevalence of anorexia nervosa is .9% in women, .3% in men.
Lifetime prevalence of bulimia nervosa is 1.5% in women, .5% in men.
Lifetime prevalence of binge eating disorder is 3.5% in women, 2.0% in men.
Eating disorders frequently impair the sufferer's home, work, personal, and social life.
Binge eating is more common than anorexia or bulimia and is commonly associated with severe obesity.
Eating disorders display substantial comorbidity with other mental health disorders.
While eating disorders often coexist with other mental health disorders, eating disorders often go undiagnosed and untreated. A low number of sufferers obtain treatment for the eating disorder.
Researchers found a surprisingly high rate of anorexia and bulimia among men, representing approximately one fourth of the cases of each disorder.
The EDC points out that survey included people 18 and older, which would exclude children and teens struggling with the disorder. Also, the survey authors note that they may have missed sufferers with severe anorexia, regardless of age. The EDC notes that the actual percentages of people with eating disorders may be higher than the study's findings.
James I. Hudson, Eva Hiripi, Jr., Harrison G. Pope, & Ronald C. Kessler. (2007). "The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication," Biological Psychiatry, 348-358.
Other Facts about Eating Disorders
• Doubled since 1960s
• Increasing in younger age groups, as young as 7 years
• Occurring increasingly in diverse ethnic and sociocultural groups
• 40-60% of high school girls diet
• 13% of high school girls purge
• 30-40% of junior high girls worry about weight
• 40% of 9-year-old girls have dieted
• 5-year-old girls are concerned about diet
Source: Journal of the American Academy of Child and Adolescent Psychiatry
Mortality
Anorexia Nervosa has the highest mortality rate of any psychiatric disorder, as high as 20%. Death can occur after severe bingeing in bulimia nervosa as well.
Treatment Can Work
With early detection and intervention
Treatment must be as complex as the illness including attention to the following
• Nutritional
• Medical
• Psychiatric
• Psychotherapy with patient, family
Rates of Recovery
• 1/3 recover after initial episode
• 1/3 fluctuate with recovery and relapse
• 1/3 suffer chronic deterioration
If patients do not receive adequate treatment then multiple re-hospitalizations are common.
Health Consequences
Anorexia Nervosa Bulimia Nervosa
• Heart Muscle Shrinkage
• Slow and Irregular Heart Beats
• Heart Failure
• Amenorrhea
• Kidney Stones and Kidney Failure
• Lanugo (Development of Excessive Fine Body Hair on Face, Arms and Legs)
• Muscle Atrophy
• Delayed Gastric Emptying, Bowel Irritation
• Constipation
• Osteoporosis
• Death
• Electrolyte imbalance, heart arrhythmia, heart failure
• Teeth erosion and cavities
• Irritation and tears in the throat, esophagus and stomach
• Laxative dependence
• Emetic Toxicity
Males and Eating Disorders:
(Original Document - National Eating Disorders Association)
Compiled by: Tom Shiltz, MS, CADIII, Rogers Memorial Hospital, Oconomowoc, WI
Prevalence of Eating Disorders Among Males:
- Approximately 10% of eating disordered individuals coming to the attention of mental health professionals are male (Wolf, 1991; Fairburn & Beglin, 1990).
- There is a broad consensus, however, that eating disorders in males are clinically similar to, if not indistinguishable from, eating disorders in females (Margo 1987; Schneider & Agras, 1987; Crisp et al., 1986; Vandereycken & Van der Broucke, 1984).
Gender Differences Regarding Dieting and Body Shape:
- A national survey of 11,467 high school students and 60,861 adults revealed the following gender differences (Serdula et al., 1993):
**Among the adults, 38% of the women and 24% of the men were trying to lose weight.
** Among high school students, 44% of the females and 15% of the males were attempting to lose weight.
- Based on a questionnaire administered to 226 college students (98 males and 128 females) concerning weight, body shape, dieting, and exercise history, the authors found that 26% of the men and 48% of the women described themselves as overweight. Women dieted to lose weight whereas men usually exercised (Drewnowski & Yee, 1987).
- A sample of 1,373 high school students revealed that girls (63%) were four times more likely than boys (16%) to be attempting to reduce weight through exercise and caloric intake reduction. Boys were three times more likely than girls to be trying to gain weight (28% versus 9%). The cultural ideal for body shape for men versus women continues to favor slender women and athletic, V-shaped muscular men (Rosen &
Gross, 1987).
- In general, men appear to be more comfortable with their weight and perceive less pressure to be thin than women. A national survey indicated that only 41% of men are dissatisfied with their weight as compared with 55% of women; moreover, 77% of underweight men liked their appearance as opposed to 83% of underweight women. Males were more likely than females to claim that if they were fit and exercised regularly, they felt good about their bodies. Women were more concerned with aspects of their appearance, particularly weight (Cash, Winstead, & Janda, 1986).
Occupational Hazards:
Gymnasts, runners, body builders, rowers, wrestlers, jockeys, dancers, and swimmers are particularly vulnerable to eating disorders because their sports necessitate weight restriction (Andersen, Bartlett, Morgan, & Brownell, 1995). It is important to note, however, that weight loss in an attempt to improve athletic success differs from an eating disorder when the central psychopathology is absent.
Media:
Nemeroff, Stein, Diehl, and Smolak (1994) suggest that males may be receiving increasing media messages regarding dieting, and ideal of muscularity, and plastic surgery options (such a pectoral and calf implants).
- DiDomenico and Andersen (1988) found that magazines targeted primarily to women included a greater number of articles and advertisements aimed at weight reduction (e.g., diet, calories) and those targeted at men contained more shape articles and advertisements (e.g., fitness, weight lifting, body building, or muscle toning). The magazines most read by females ages 18-24 had 10 times more diet content than those most popular among men in the same age group.
Sexual Attitudes, Behaviors and Endocrine Dysfunction:
- Males with anorexia display a considerable degree of anxiety with regard to sexual activities and relationships. Fichter and Daser (1987) compared males and females with anorexia and found that males displayed significantly more sexual anxieties than did females. The authors noted that 80% of the males in their study grew up in families that regarded sex as a taboo subject. Corresponding with the reported sexual anxiety, low levels of sexual activity among the males with anorexia were also noted.
- Burns and Crisp (1984) found that males with anorexia in their study admitted “obvious relief” at the diminution of their sexual drive during the acute phase of their disease.
- Eating-disordered males differed significantly from eating-disordered females in terms of sexual experience in a study conducted by Herzog et al. (1984). Males with eating disorders were significantly less likely to have had sexual relations before the onset of their eating disorder, or to be involved in a sexual relationship at the time of evaluation than were females with eating disorders. Males with bulimia, however, appear to be more sexually active than males with anorexia, both before and during of their illness (Pope et al., 1986).
- A study by Andersen and Mickalide (1983) suggest that a disproportionate number of males with anorexia may have a persisting or preexisting problems in testosterone production.
Gender Dysphoria and Homosexuality:
- Fichter and Daser (1987) found that males with anorexia saw themselves and were seen by others as more feminine than other men, both in attitudes and behavior. In general the males with anorexia appeared to identify more closely with their mothers than with their fathers.
- Homosexuals are over-represented in many samples of eating disordered men. While the proportion of male homosexuals in the general population cross-culturally is estimated to be 3%-5% (Whitman, 1983), samples of eating-disordered men are commonly twice as high or greater (Fichter & Daser, 1987).
Several authors have noted that homosexual conflict preceded the onset of an eating disorder in up to 50% of male patients (Scott, 1986; Dally, 1969; Crisp, 1967).
- Conflict over gender identity or over sexual orientation may precipitate the development of an eating disorder in many males (Crisp, 1983). It may be that by reducing their sexual drive through starvation, patients can temporarily resolve their sexual conflicts (Crisp, 1970).
- Homosexual men may be at an increased risk for developing an eating disorder because of cultural pressures within the homosexual community to be thin (Schneider & Agras, 1987). Herzog et al., (1990) found that homosexual men weighed significantly less than heterosexual men, were more likely to be underweight and to desire an underweight ideal weight. Compared to the heterosexuals, homosexual men were less satisfied with their body build, and scored significantly higher on the “Drive for Thinness” scale of the Eating Disorders Inventory (EDI).
Family Influences and Personality Variables:
Kearney-Cooke and Steichen-Asch (1990) found that men with eating disorders tend to have dependent, avoidant, and passive-aggressive personality styles, and to have experienced negative reactions to their bodies from their peers while growing up. They tend to be closer to their mothers than their fathers. The authors concluded that “in our culture, muscular build, overt physical aggression, competence at athletics, competitiveness, and independence generally are regarded as desirable for males, whereas dependency, passivity, inhibition of physical aggression, smallness, and neatness are seen as more appropriate for females. Boys who later develop eating disorders do not conform to the cultural expectations for masculinity; they tend to be more dependent, passive, and non-athletic, traits which may lead to feelings of isolation and disparagement of body.”
References
Andersen, A.E., & Mickalide, A.D. (1983). Anorexia nervosa in the male: An underdiagnosed disorder. Psychosomatics, 24,
1067-1075.
Andersen, R.E., et al. (1995). Weight loss, psychological and nutritional patterns in competitive male body builders. International
Journal of Eating Disorders, 18, 49-57.
Andersen, R.E. (1995). Eating Disorders in Males. In K. Brownell, K. & Fairburn, C.G., (Eds.), Eating Disorders and Obesity: A
comprehensive Handbook. New York: Guilford Publications, Inc.
Burns, T. & Crisp, A.H. (1984). Outcome of anorexia nervosa in males. British Journal of Psychiatry, 145, 319-328.
Cash, T.F., Winstead, B.A., & Janda, L.H. (1986). The great American shape-up. Psychology Today, April, 30-37.
Crisp, A.H. (1967). Anorexia Nervosa. Hospital Medicine, 1, 713-718.
Crisp, A.H. (1970). Anorexia nervosa, “feeding disorder,” “nervous malnutrition,” or “weight phobia?” World Review of Nutrition
and Dietetics, 12, 452-504.
Crisp, A.H. (1983). Some aspects of the psychopathology of anorexia nervosa. In P.L. Darby et al., (Eds.), Anorexia Nervosa:
Recent Developments in Research (pp. 15-28). New York: Alan Liss.
Crisp, A.H., et al. (1986). Primary anorexia nervosa in the male and female: A comparison of clinical features and prognosis.
British Journal of Medical Psychology, 59, 123-132.
Dally, P. (1969). Anorexia Nervosa. London: Heinemann Medical Books.
DiDomenico, L., & Andersen, A.E. (1998). Sociocultural considerations and sex differences in anorexia nervosa. In A. Andersen
(Ed.), Males with Eating Disorders (p. 31). New York: Brunner/Mazel.
Drewnowski, A., & Yee, D.K. (1987). Men and body image: Are males satisfied with their body weight? Pscyhosomatic
Medicine, 49, 626-634.
Fairburn, C.G., & Beglin, S.J. (1990). Studies of the epidemiology of bulimia nervosa. American Journal of Psychiatry, 147,
401-408.
Fichter, M.M. & Daser, C. (1987) Symptomatology, psychosexual development and gender identity in 42 anorexic males.
Psychological Medicine, 17, 409-418.
Herzog, D.B., et al. (1984). Sexual conflict and eating disorders in 27 males. American Journal of Psychiatry, 141, 989-990.
Herzog, D.B., et al. (1990). Sexuality in Males with Eating Disorders. In A. Andersen (Ed.), Males with Eating Disorders (p. 47).
New York: Brunner/Mazel.
Kearney-Cooke, A.,& Steichen-Asch, P. (1990). Men, Body Image, and Eating Disorders. In A. Andersen (Ed.), Males with
Eating Disorders (p. 47). New York: Brunner/Mazel.
Margo, J.L. (1987). Anorexia nervosa in males: A comparison with female patients. British Journal of Psychiatry, 151, 80-83.
Nemeroff, C.J., et al. (1994). From the Cleavers to the Clintons: Role choices and body orientation as reflected in magazine article
content. International Journal of Eating Disorders, 16, 167-176.
Pope, H.G., et al. (1986). Bulimia in men. A series of fifteen cases. The Journal of Nervous and Mental Disease, 174, 117-119.
Rosen, J.C. & Gross, J. (1987). Prevalence of weight reducing and weight gaining in adolescent girls and boys. Health
Pscyhology, 6, 131-147.
Schneider, J.A., & Agras, W.S. (1987). Bulimia in males: A matched comparison with females. International Journal of Eating
Disorders, 6, 235-242.
Scott, D.W. (1986). Anorexia nervosa in the male: A review of the clinical, epidemiological and biological findings.
International Journal of Eating Disorders, 5, 799-819.
Schiltz, T. (1997). Eating Concerns Support Group Curriculum. Greenfield, WI: Community Recovery Press.
Vandereycken, W., & Van der Broucke, S. (1984). Anorexia nervosa in males. Acta Psychiatrica Scandinavica, 70, 447-454.
Whitman, F.L. (1983). Culturally invariable properties of male homosexuality: Tentative conclusions from cross-cultural research.
Archives of Sexual Behavior, 12, 207-226.
Wolf, N. (1991). The Beauty Myth. New York: William Morrow.
Source - NEDA - Eating Disorders & Males
