Breaking the Silence- Gender, Sex & Eating Disorders
The client who experienced an uphill battle during his eating disorder recovery…not only struggling with severe bulimia, but also with being kicked out of his home when he came out to his parents…
The male client whose wife just didn’t understand his struggles with food and body image…
Another male client, struggling with binge eating, who experienced flashbacks of his father telling him to “man up” and constantly critiquing his body…
A transgender client who had never felt comfortable in their skin, hating their body, and had no one to talk to about it…
These are just some of the recollections that come to mind when thinking about my work in the eating disorder field and its intersection with gender and sex. Most discussions pertaining to both eating disorders and body image predominantly revolve around women. In fact, most eating disorder research focuses on women, and the diagnostic criteria for these conditions have historically focused on females as well. And yet, this is not fully representative of the individuals suffering. It is crucial to recognize that these challenges also affect men, as well as LGBTQIA+ populations, and that their experiences are frequently overlooked and stigmatized.
Consider these statistics:
Men account for 17-43% of individuals in eating disorder clinics (American Psychiatric Association, 2013)
2-18% of transgender individuals suffer from an eating disorder (Hartman-Munick et al., 2021), compared to 1-5% of the general population (American Psychiatric Association, 2013)
Gay and bisexual men and boys experience significantly higher body dissatisfaction and a higher propensity to engaging in both dieting and binging behaviors (Calzo et al., 2018)
Additionally, for men specifically, consider these differences in clinical presentations:
Men are more likely to experience body image concerns related to muscularity and to struggle with overtraining (Coehlo et al., 2021)
Men are more likely to be diagnosed with Other Specified Feeding or Eating Disorder (OSFED) or Unspecified Feeding or Eating Disorder (UFED)
Men are less likely to seek treatment; however, when they do seek help their symptoms are often more severe and they have increased comorbidities (Ridout et al., 2021)
As an eating disorder specialist and mental health provider for close to twenty years, I know the importance of providing safe spaces where individuals can heal. Let’s break the silence. We must shed light on the fact that eating disorders affect all people, and every single person is worthy and deserving of the highest quality of care.
If you, or someone you love, is suffering from an eating disorder, and is part of a marginalized gender or sex in this field, here are some resources to help:
The Trevor Project
Center of Excellence LGBTQ+ Behavioral Health Equity
Eating Disorders in Men and Boys- National Eating Disorder Assocation
National Association of Anorexia Nervosa and Associated Disorders
References:
American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
Calzo, J. P. , Austin, S. B. , & Micali, N. (2018). Sexual orientation disparities in eating disorder symptoms among adolescent boys and girls in the United Kingdom. European Child & Adolescent Psychiatry, 27(11), 1483–1490.
Coelho, J. S. , Suen, J. , Marshall, S. , Burns, A. , Geller, J. , & Lam, P. Y. (2021). Gender differences in symptom presentation and treatment outcome in children and youths with eating disorders. Journal of Eating Disorders, 9(1), 113.
Hartman‐Munick, S. M. , Silverstein, S. , Guss, C. E. , Lopez, E. , Calzo, J. P. , & Gordon, A. R. (2021). Eating disorder screening and treatment experiences in transgender and gender diverse young adults. Eating Behaviors, 41, 101517.
Ridout, S. J. , Ridout, K. K. , Kole, J. , Fitzgerald, K. L. , Donaldson, A. A. , & Alverson, B. (2021). Comparison of eating disorder characteristics and depression comorbidity in adolescent males and females: An observational study. Psychiatry Research, 296, 113650.