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Abstract
CONTEXT Eating disorders (EDs) in male athletes are potentially debilitating disorders with significant medical, psychological, and athletic performance consequences. EVIDENCE ACQUISITION Searches were performed across PubMed, EBSCOhost, and PSYCinfo from 1990 to 2019. Keywords searched were eating disorder, male, athlete, anorexia nervosa, bulimia nervosa, muscularity, muscle dysmorphia, and sports. Search results included articles written in the English language and encompassed reviews, empirical studies, and theoretical articles. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 3. RESULTS EDs among male athletes may lead to serious negative outcomes, including increased susceptibility to injury, inconsistent performance, problematic recovery, muscle deficiencies, impairment of optimal athletic functioning, and medical, social, and emotional problems. Male athletes with EDs may be more difficult to identify and diagnose for a variety of reasons related to differential presentation of symptoms, secretiveness or shame around behaviors, and sex-related stigma. CONCLUSION Professionals working closely with athletes are uniquely positioned to identify and screen those who may require further evaluation and treatment.
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Affiliation(s)
- Madison Eichstadt
- West Virginia University School of Medicine, Morgantown, West Virginia
| | - Jessica Luzier
- West Virginia University School of Medicine-Charleston Division.,Department of Behavioral Medicine and Psychiatry, West Virginia University
| | - Daniel Cho
- Department of Behavioral Medicine and Psychiatry, West Virginia University.,Charleston Area Medical Center, Charleston, West Virginia
| | - Chantel Weisenmuller
- West Virginia University School of Medicine-Charleston Division.,Department of Behavioral Medicine and Psychiatry, West Virginia University
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Peckmezian T, Paxton SJ. A systematic review of outcomes following residential treatment for eating disorders. EUROPEAN EATING DISORDERS REVIEW 2020; 28:246-259. [PMID: 32196843 PMCID: PMC7216912 DOI: 10.1002/erv.2733] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 02/05/2020] [Accepted: 03/05/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Residential centres for the treatment of eating disorders are becoming increasingly common, yet data following residential care are scarce. We reviewed outcomes of residential treatment for eating disorders across all diagnoses, age groups and genders. A secondary goal was to identify treatment elements and patient characteristics that predicted a greater response to treatment. METHOD Peer-reviewed studies published in the last 20 years were identified through a systematic search of the electronic databases PubMed and Cochrane Library. RESULTS Nineteen open-label studies reporting changes between admission and discharge were included in this review. Most took an eclectic approach to treatment, integrating elements from several different techniques without a unifying theoretical framework. All studies reported improvements in most outcomes at discharge, including changes in eating disorders psychopathology, weight, depression, anxiety and quality of life. Eight studies reported outcomes at some interval after discharge, with largely positive outcomes. CONCLUSIONS While residential care was associated with consistently positive outcomes, the variability in program characteristics and poor quality of research designs prevent firm conclusions from being drawn about their efficacy. Future research should include controlled studies that evaluate specific theoretical approaches and program elements, include long-term follow-up, and compare residential care to other treatment settings.
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Affiliation(s)
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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3
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Coelho JS, Lee T, Karnabi P, Burns A, Marshall S, Geller J, Lam PY. Eating disorders in biological males: clinical presentation and consideration of sex differences in a pediatric sample. J Eat Disord 2018; 6:40. [PMID: 30534377 PMCID: PMC6260897 DOI: 10.1186/s40337-018-0226-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 10/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The growing body of research on eating disorders among male adolescents reveals some sex differences in clinical presentation. The current study set out to replicate and extend recent research on the clinical and medical characteristics of male youth with eating disorders, and examine sex differences between biological males and females in a tertiary pediatric eating disorder treatment setting. METHODS A retrospective chart review was conducted with all biological males who were admitted to the Eating Disorders Programs at British Columbia Children's Hospital (2003-2015) or the Looking Glass Residence (2011-2015). Clinical data, including demographics, percentage of median body mass index (% mBMI), and psychiatric diagnoses, were recorded along with medical data (i.e., vital signs, basic biochemistry investigations, and bone mineral density). A comparison group of females with eating disorders who received treatment at British Columbia Children's Hospital in the inpatient or outpatient streams (2010-2015) were included, to examine sex differences with males who were admitted during the same period. RESULTS A total of 71 male youth were included in the chart review. Males had significant medical complications, with 26.5% of the sample presenting with a heart rate of less than 50 beats per minute and 31.4% presenting with a bone mineral density z-score for the lumbar spine ≤ - 1. Sex differences between the subset of males who were treated between 2010 and 2015 (n = 41) and the females (n = 251) were examined. Females were more likely than were males to have a diagnosis of anorexia nervosa or bulimia nervosa, and to be underweight (< 95% mBMI) at admission. Males were younger than females, but no differences emerged in the duration of the eating disorder symptoms. No sex differences emerged relating to medical instability (e.g., bradycardia). CONCLUSIONS A large proportion of male children and youth with eating disorders are medically compromised at admission. Males were younger than females, and were less likely than females to have a diagnosis of anorexia nervosa or bulimia nervosa. Males who were underweight at admission had also lost a lower percentage of body weight in comparison to females. The current study replicates previous sex differences reported in pediatric samples.
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Affiliation(s)
- Jennifer S. Coelho
- Provincial Specialized Eating Disorders Program for Children & Adolescents, British Columbia Children’s Hospital, Box 178, 4500 Oak St., Vancouver, BC V6H 3N1 Canada
- Department of Psychiatry, University of British Columbia, Vancouver, BC Canada
| | - Tiffany Lee
- Provincial Specialized Eating Disorders Program for Children & Adolescents, British Columbia Children’s Hospital, Box 178, 4500 Oak St., Vancouver, BC V6H 3N1 Canada
| | - Priscilla Karnabi
- Provincial Specialized Eating Disorders Program for Children & Adolescents, British Columbia Children’s Hospital, Box 178, 4500 Oak St., Vancouver, BC V6H 3N1 Canada
| | - Alex Burns
- Provincial Specialized Eating Disorders Program for Children & Adolescents, British Columbia Children’s Hospital, Box 178, 4500 Oak St., Vancouver, BC V6H 3N1 Canada
| | - Sheila Marshall
- School of Social Work, University of British Columbia, Vancouver, BC Canada
- Division of Adolescent Health & Medicine, Department of Pediatrics, University of British Columbia, Vancouver, BC Canada
| | - Josie Geller
- Department of Psychiatry, University of British Columbia, Vancouver, BC Canada
- Eating Disorders Program, St. Paul’s Hospital, Vancouver, BC Canada
| | - Pei-Yoong Lam
- Provincial Specialized Eating Disorders Program for Children & Adolescents, British Columbia Children’s Hospital, Box 178, 4500 Oak St., Vancouver, BC V6H 3N1 Canada
- Division of Adolescent Health & Medicine, Department of Pediatrics, University of British Columbia, Vancouver, BC Canada
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4
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Valente S, Di Girolamo G, Forlani M, Biondini A, Scudellari P, De Ronchi D, Atti AR. Sex-specific issues in eating disorders: a clinical and psychopathological investigation. Eat Weight Disord 2017; 22:707-715. [PMID: 28853004 DOI: 10.1007/s40519-017-0432-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/14/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To highlight the characteristics of eating disorders (ED) in males, with particular attention to sex-related clinical features and psychiatric co-morbidities. METHOD Out of 280 persons, referred to our outpatients ED clinic between January 2011 and June 2014, 267 with complete information were included in this retrospective observational study. RESULTS The men/women ratio was one to five (male 16.5% vs female 83.5%) with an increasing proportion of male patients over the years. The most frequent ED in males was binge eating disorder, whereas in females anorexia nervosa and bulimia nervosa prevailed. Excessive exercising and fasting were the most common compensation behaviours in males; while self-induced vomiting and laxative-diuretic abuse were more typical in females. Among women, the most represented psychiatric co-morbidities were mood and somatoform disorders, whereas among men, anxiety and psychosis spectrum disorders were the most frequent ones. Borderline and histrionic personality disorders were prevalent in female ED, while narcissistic and antisocial personality disorders prevailed in males. DISCUSSION ED in men is a growing phenomenon. Male ED, compared to female ED, show differences in clinical presentation, symptoms and co-morbidities. Despite the use of clinical and psychometric evaluating tools targeting female patients, sex differences do exist and additional studies are required to investigate male specific issues in ED. Level of Evidence Level V, cross-sectional descriptive study.
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Affiliation(s)
- Stefano Valente
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy.
| | - Giulia Di Girolamo
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy
| | - Martina Forlani
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy
| | - Anna Biondini
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy
| | - Paolo Scudellari
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy
| | - Diana De Ronchi
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy
| | - Anna Rita Atti
- Department of Biomedical and NeuroMotor Sciences-Psychiatry, University of Bologna, Viale Pepoli n 5, Bologna, Italy
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Lavender JM, Brown TA, Murray SB. Men, Muscles, and Eating Disorders: an Overview of Traditional and Muscularity-Oriented Disordered Eating. Curr Psychiatry Rep 2017; 19:32. [PMID: 28470486 PMCID: PMC5731454 DOI: 10.1007/s11920-017-0787-5] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW There is growing recognition that eating disorder (ED) symptoms, particularly those of a muscularity-oriented nature, are more common in men than previously understood. The purpose of the current review is to describe contemporary directions and implications of research on traditional and muscularity-oriented ED symptoms among males. RECENT FINDINGS Evidence indicates that ED symptoms occur in a substantial minority of men. Importantly, recent research has focused on muscularity-oriented body image and disordered eating in males, demonstrating the prevalence, correlates, and consequences of maladaptive muscularity-oriented attitudes and behaviors. A growing number of assessments are available to measure these constructs in males, and preliminary treatment considerations have begun to be addressed in the literature. Research on male EDs and body image is increasingly focusing on muscularity-oriented manifestations. Continued empirical work will be critical to improve our understanding of the onset, maintenance, and treatment of muscularity-oriented disordered eating in males.
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Affiliation(s)
- Jason M Lavender
- Eating Disorders Center for Treatment & Research, Department of Psychiatry, University of California, San Diego, 4510 Executive Drive, Suite 315, San Diego, CA, 92121, USA.
| | - Tiffany A Brown
- Eating Disorders Center for Treatment & Research, Department of Psychiatry, University of California, San Diego, 4510 Executive Drive, Suite 315, San Diego, CA, 92121, USA
| | - Stuart B Murray
- Department of Psychiatry, University of California, San Francisco, 3333 California Street, San Francisco, CA, 94118, USA
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Agüera Z, Sánchez I, Granero R, Riesco N, Steward T, Martín-Romera V, Jiménez-Murcia S, Romero X, Caroleo M, Segura-García C, Menchon JM, Fernández-Aranda F. Short-Term Treatment Outcomes and Dropout Risk in Men and Women with Eating Disorders. EUROPEAN EATING DISORDERS REVIEW 2017; 25:293-301. [PMID: 28474473 DOI: 10.1002/erv.2519] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/17/2017] [Accepted: 03/20/2017] [Indexed: 12/20/2022]
Abstract
This study compared treatment outcomes between men and women with eating disorders (EDs) and analysed clinical predictors of treatment outcome. Our sample consisted of 131 male and 131 female ED patients who underwent cognitive behavioural therapy treatment. ED severity, personality and psychopathology were assessed using standard instruments. We found that the risk of dropout was higher for men with bulimia nervosa (BN) than for women with BN and that men with BN and other specified feeding and EDs were more likely to obtain full remission in comparison with their female counterparts. Predictive models of treatment outcome indicated that higher scores in novelty seeking were a shared factor associated with higher risk of dropout and not obtaining full remission for both men and women with ED. However, only in men, younger age and lower scores in reward dependence predicted higher dropout. Contrastingly, higher persistence scores were predictors of full remission. This study reinforces the effectiveness of using outpatient cognitive behavioural therapy as treatment as usual for men with ED. Nonetheless, placing greater emphasis on strategies targeting gender-specific issues could enhance outcomes. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Zaida Agüera
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, University Hospital of Bellvitge - IDIBELL, Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, University Hospital of Bellvitge - IDIBELL, Barcelona, Spain
| | - Roser Granero
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nadine Riesco
- Department of Psychiatry, University Hospital of Bellvitge - IDIBELL, Barcelona, Spain
| | - Trevor Steward
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, University Hospital of Bellvitge - IDIBELL, Barcelona, Spain
| | - Virginia Martín-Romera
- Departament de Psicologia Clínica i Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, University Hospital of Bellvitge - IDIBELL, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Xandra Romero
- Department of Psychiatry, University Hospital of Bellvitge - IDIBELL, Barcelona, Spain
| | - Mariarita Caroleo
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Cristina Segura-García
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy.,Ambulatory for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - José Manuel Menchon
- Department of Psychiatry, University Hospital of Bellvitge - IDIBELL, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.,CIBER Salud Mental (CIBERSAM), Instituto Salud Carlos III, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, University Hospital of Bellvitge - IDIBELL, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
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de Araújo AA, Rebouças Barbosa RAS, de Menezes MSS, de Medeiros IIF, de Araújo RF, de Medeiros CACX. Quality of Life, Family Support, and Comorbidities in Institutionalized Elders With and Without Symptoms of Depression. Psychiatr Q 2016. [PMID: 26195233 DOI: 10.1007/s11126-015-9386-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The institutionalization of elders can decrease the health status and quality of life in this population. The aim of this study was to analyze the socio-demographic, quality of life, family support, and comorbidities variables in institutionalized elders with and without symptoms of depression. This was a cross-sectional study in institutions for long permanence for the elderly in the State of Rio Grande do Norte, Brazil. Two institutionalized elderly groups were compared (138 elders: 69 with and 69 without depressive symptoms). The instruments used were: mini-mental state examination, geriatric depression scale in the reduced version, socio-demographic questionnaire, quality of life (World Health Organization Quality of Life abbreviated-WHOQOL-bref), and inventory of perception of family support. Elders with depressive symptoms had inferior quality of life than those without depressive symptoms. Other factors that negatively influenced the quality of life in this population include: low economic conditions, occurrence of comorbidities, and deficient family assistance. These results have important implications in the decision making process with regard to strategies for improving the health status of institutionalized elders.
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Affiliation(s)
- Aurigena Antunes de Araújo
- Post Graduation Program of Public Health and Pharmaceutical Science, Department of Biophysics and Pharmacology, Center of Biosciences, Federal University of Rio Grande do Norte UFRN, Senador Salgado Filho Avenue, S/N - Lagoa Nova, Natal, RN, 59078-900, Brazil
| | | | | | | | - Raimundo Fernandes de Araújo
- Post Graduation Program in Functional and Structural Biology/Post Graduation Program Health Science, Department of Morphology, Federal University of Rio Grande do Norte/UFRN, Natal, RN, Brazil
| | - Caroline Addison Carvalho Xavier de Medeiros
- Department of Biophysical and Pharmacology, Federal University of Rio Grande do Norte/UFRN, Natal, RN, Brazil. .,Post Graduation Program in Health and Society/UERN, Mossoró, RN, Brazil.
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Wagner G, Zeiler M, Berger G, Huber WD, Favaro A, Santonastaso P, Karwautz A. Eating Disorders in Adolescents with Celiac Disease: Influence of Personality Characteristics and Coping. EUROPEAN EATING DISORDERS REVIEW 2015; 23:361-70. [PMID: 26100655 DOI: 10.1002/erv.2376] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 04/30/2015] [Accepted: 05/18/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Patients suffering from celiac disease (CD) have a higher risk of developing disturbed eating behaviour. METHOD In a multi-centre study, 259 female adolescents with CD and without a chronic condition were analysed regarding their eating disorder (ED) status, depression, personality, coping strategies and quality of life. RESULTS Patients with CD and comorbid EDs were older and more often non-compliant with their diet and had a higher body mass index (BMI) and higher levels of depression. Differences in personality features disappear when controlling for age and depression. Higher ill-being and lower joy in life were reported by patients with CD and ED compared with patients without EDs, even when controlling for age and depression levels. No differences between patients (with CD) with and without EDs in coping strategies were found. BMI and lower self-directedness predicted ED status. CONCLUSIONS Early identification of EDs in patients with CD is suggested and should include BMI and personality factors.
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Affiliation(s)
- Gudrun Wagner
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Michael Zeiler
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Gabriele Berger
- Gastroenterology Unit, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
| | - Wolf-Dietrich Huber
- Gastroenterology Unit, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
| | - Angela Favaro
- Department of Neurosciences, University of Padova, Italy
| | | | - Andreas Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
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