Abstract: Men have Eating Disorders too: A Qualitative Study of Perspectives from Men with Eating Disorders.

◆ Ekaterina Malova, University of Miami
◆ Victoria Orrego Dunleavy, University of Miami

Background: Eating disorders in men are surrounded by stigma and gender stereotypes (Strother, Lemberg, Stanford, & Turberville, 2012). From 1999 to 2009, the number of men hospitalized for an eating disorder-related cause increased by 53% (Zhao & Encinosa, 2006). Males represent 25% of individuals with anorexia nervosa, and they are at a higher risk of dying, in part because they are often diagnosed later since many people assume that eating disorders are exclusively female conditions (Mond, Mitchison, & Hay, 2014). In addition, binge eating, purging, laxative abuse, and fasting for weight loss are almost equally common for males and females (Mond et al, 2014). However, less than one percent of research has focused on eating disorders among males (NEDA, 2019). A gender-sensitive approach with recognition of different needs for males is critical in effective treatment (Bunnell & Maine, 2014). Hence, this study addresses this lack of attention and advances research on eating disorders among males by examining factors triggering the development of eating disorders as well as barriers preventing men from seeking help.
Method: We conducted textual analysis of twenty-four YouTube videos posted online by males with eating disorders where they directly communicated their experiences. The selected data was transcribed, coded, and then analyzed with thematic analysis method. Analysis of narratives illuminates the perceptions of people about health and illness (Hyden, 1997). It is especially useful for marginalized and hard to reach populations like men with eating disorders.
Results and Conclusions: Our thematic analysis revealed three major themes related to triggering factors: 1) coping, 2) drive for masculinity, and 3) self-regulation and two themes related to barriers preventing men from help seeking: 1) shame and stigma and 2) lack of knowledge and services.
First, we confirm previous research that shame in men with eating disorders is a prevailing emotion and originates from the stigmatization of eating disorders as “female disorders” (Sernec & Brecelj, 2019). Second, our results are consistent with existing literature on coping mechanisms, including coping with bullying (Brewerton, 2007). Third, previous research found drive for masculinity to be a strong predictor for eating disorders among men but focused mostly on media influence (Morrison, Morrison, & Hopkins, 2003). Conversely, we found that drive for masculinity, promoting eating disorders, was mostly triggered by the lack of relationship satisfaction with romantic partners and peers. Forth, previous research found that men with eating disorders were attracted to extensive physical activities in attempt to regulate every aspect of their lives (Pope et al., 2000). Our findings refined this theme by adding knowledge on how ability to stay in control of their own desires and regulate their needs by means of food denial gave men with eating disorders the feeling of superiority and security. Lastly, we found that in addition to shame, the barriers preventing men from seeking help included lack of knowledge and services for men with eating disorders and poor doctor-patient communication. These results can be valuable for implementation of educational and recovery programs for men and effective doctor-patient communication design.