Sexual conflict and eating disorders in 27 males

Are there differences between men and women in outcome of intensive inpatient treatment for anorexia nervosa? An analysis of routine data

OBJECTIVE

Anorexia nervosa (AN) in men is rare and understudied. We compared admission characteristics and response to specialized inpatient treatment between men and women with AN.

METHOD

One hundred sixteen consecutive male patients with AN were matched to 116 female patients. Patients completed the self-rating Structured Inventory for Anorexic and Bulimic Syndromes (SIAB-S) at admission and discharge. Differences at admission and in treatment response were examined with independent samples t-tests and ANOVA for repeated measures, respectively.

RESULTS

Men had lower body mass index (BMI)-percentiles (Cohen's d = -0.55), higher levels of weight suppression (d = 0.65), and higher scores in the SIAB-S general psychopathology and social integration scale (d = 0.47) at admission. There were no differences in response to treatment except for changes in BMI-percentile (F = 4.49, p = 0.035).

CONCLUSIONS

There were more similarities than differences between genders in AN. Because this similarity might be confounded with traditionally "feminine" conceptualizations of AN, further studies of male AN are needed.

Body Image and Eating Disorders Among Lesbian, Gay, Bisexual, and Transgender Youth

Adolescence is a crucial period for emerging sexual orientation and gender identity and also body image disturbance and disordered eating. Body image distortion and disordered eating are important pediatric problems affecting individuals along the sexual orientation and gender identity spectrum. Lesbian, gay, bisexual, transgender (LGBT) youth are at risk for eating disorders and body dissatisfaction. Disordered eating in LGBT and gender variant youth may be associated with poorer quality of life and mental health outcomes. Pediatricians should know that these problems occur more frequently in LGBT youth. There is evidence that newer treatment paradigms involving family support are more effective than individual models of care.

Sex and Eating: Relationships Based on Wanting and Liking

Sex and eating may have behavioral and psychological relationships and have cortical regions in common. This research investigated the general relationship between sex and eating from a reward perspective among the general population. Two-hundred and sixty-one Chinese participants were recruited via the internet (136 males, 125 females, mean age 30.46 years) to fill in questionnaires about wanting and liking for sex and eating. The results revealed that first, there was a positive correlation between wanting for sex and wanting to eat only for males. Second, the relationship between liking for sex and eating was also positive for males and not significant in females. Third, the correlation between sociosexual orientation and wanting to eat was significant only in females, and there was no significant correlation between sociosexual orientation and liking for eating. Fourth, emotional sex cravings (or emotional sexual activity) was positively correlated with emotional food cravings (or emotional eating behavior), with a higher magnitude correlation in males than females. Finally, analysis of wanting (liking) models of sex and eating for males and females revealed three models for wanting among females: high wanting, low wanting for eating, and low wanting for sex; and two models for wanting among males: high wanting and low wanting. Liking for sex and eating among females consisted of two types of model: high liking and low liking; whereas three type models existed for males: high liking for sex, high liking for eating, and low liking. In general, our research revealed that, as with other natural reward, sex and eating have considerable commonality and are related in numerous ways.

Diverging eating psychopathology in transgendered eating disorder patients: a report of two cases

This report documents two transgendered biological males who met criteria for an eating disorder, who interchangeably reported periods of endorsing masculine and feminine gender identities, allowing an exploration of how their preferred gender orientation impacted their eating disorder psychopathology. This report suggests that the divergence of body image psychopathology amongst men may be impacted by gender role orientation, which is consistent with a developing body of research.

Masculinity and femininity in the divergence of male body image concerns

BACKGROUND

Given recent assertions suggesting that gender role endorsement may be relevant in the divergence of male body image concerns, this study examined the self-reported gender role endorsement in opposing dimensional extremes of male body image disorders, namely, muscle dysmorphia and anorexia nervosa. This study further examined the relationship between gender role endorsement and eating disordered and muscle dysmorphia disorder pathology.

METHODOLOGY

Participants were 21 male muscle dysmorphia patients, 24 male anorexia nervosa patients, and 30 male gym-using controls from Australia, the United Kingdom, and the United States. All participants completed multidimensional measures of masculinity and femininity, and measures of eating disorder and muscle dysmorphia symptomatology.

RESULTS

Patients with muscle dysmorphia reported significantly elevated adherence to masculine (but not feminine) norms relative to control gym-using men and men with anorexia nervosa, whereas patients with anorexia nervosa exhibited elevated feminine (but not masculine) gender role endorsement relative to control gym-using men and men with muscle dysmorphia.

CONCLUSIONS

Masculine and feminine gender role endorsement appear to be associated with the divergence of body image concerns towards muscularity and thinness-oriented ideals respectively.

The impact of relationships on the association between sexual orientation and disordered eating in men

OBJECTIVE

Robust evidence supports that bisexual and gay (BG) men have increased eating pathology compared to heterosexual men. BG men may be at greater risk due to pressure to attract a male partner; however, the related implication that relationships serve as protective factors for BG men remains untested.

METHOD

BG (n = 42) and heterosexual men (n = 536) completed surveys to determine whether relationship status and satisfaction moderate sexual orientation's effect on disordered eating.

RESULTS

Single BG men had increased restrictive disordered eating compared to single heterosexual men, while few differences were found between BG and heterosexual men in relationships. Relationship satisfaction was not related to restrictive disordered eating; however, low relationship satisfaction was associated with increased bulimic symptomatology in BG men compared to heterosexual men.

DISCUSSION

Being in a relationship, independent of whether or not the relationship is satisfying, may be a protective factor for restrictive disordered eating in BG men.

An examination of medical and psychological morbidity in adolescent males with eating disorders

The objective of this study was to examine the clinical profile of adolescent male patients presenting for eating disorder (ED) assessment over a 17-year period. A retrospective cohort study was completed. A total of 52 patients (8% of the total sample) were included in the study. The average age of patients was 14.7 years and the most common diagnosis observed was Eating Disorder Not Otherwise Specified (EDNOS). Rates of concurrent depression and anxiety were very high, as were rates of medical co-morbidity, including osteoporosis. Our study supports findings documented in previously published reports of males with eating disorders and adds to the limited knowledge base which targets adolescents specifically. Multi-center controlled trials are required to further investigate male-specific ED symptomatology, treatment courses, and outcomes.

An overview of anorexia nervosa in males

This article presents an integrative overview of existing research on anorexia nervosa (AN) in adolescent males. AN is commonly thought of as a female disorder. Even though as much as 25% of the clinical population is male, research on AN in males is limited. Additionally, most conceptualizations of male AN emphasize a single etiological factor and, therefore, produce treatments that fail to address it as a global phenomenon. In contrast, an integrative understanding that incorporates research on the familial, biological, cultural, and psychodynamic elements involved in male AN encourages treatment that comprehensively addresses the disorder.

Comorbidity and age of onset of eating disorders in gay men, lesbians, and bisexuals

This study examines the prevalence of psychiatric disorders among lesbian, gay, and bisexual (LGB) men with eating disorders. A total of 388 white, black, and Latino LGB men and women were sampled from community venues. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnoses of anorexia, bulimia, and binge eating disorder were assessed using the World Health Organization's Composite International Diagnostic Interview. Gay and bisexual men with eating disorders were more likely to have an anxiety or substance abuse disorder than gay and bisexual men without eating disorders, whereas lesbian and bisexual women with eating disorders were more likely to have a mood disorder than lesbian and bisexual women without an eating disorder. For individuals diagnosed with an eating and anxiety or major depressive disorder, the onset of the psychiatric disorder was more likely to precede the onset of the eating disorder. Researchers should study potential explanations of the relationship between eating and psychiatric disorders among LGB men and women.

Revisiting Gay Men's Body Image Issues: Exposing the Fault Lines

For over 25 years the varying idealizations of gay men's bodies and the behaviors associated with achieving such bodies has been the focus of an increasingly large body of research. What first constituted an idealized body in this research, in the 1980s, was a thin and youthful image, which evolved into a muscular ideal in the 2000s with thinness translated into lean muscle mass and a small waist. To account for the emergence of both body image dissatisfaction and eating disorders, researchers in both paradigms have tended to either pathologize gay men or speculate about the contribution of a range of social-cultural and psychological factors. These include the role of the gay community, being effeminate or less masculine, and internalized homophobia. HIV and the “wasted” body is claimed to have also influenced the purported recent emergence of the muscular ideal. The underlying driver for both paradigms is the proposition that gay men are universally fixated on their appearance and presenting an idealized body to other men. This critical review examines the fault lines in both paradigms that can be found within prevalence studies, the methodology, data analysis, and the contradictory and problematic theorizing that arise as a result. It concludes that the prevalence and the truth of gay men's body image issues are overstated.

Body dissatisfaction, abnormal eating behaviours and eating disorder attitude in homo- and heterosexuals

OBJECTIVE

The primary aim of this study was to investigate the relationship between sexual orientation and disordered eating attitudes and behaviours in a sample of homosexuals and heterosexuals subject.

METHODS

We screened 110 homosexuals (85 males and 25 females) and 121 heterosexuals (85 males and 36 females) by means of: a) an ad hoc socio-demographic schedule; b) the Eating Disorders Inventory 2 (EDI 2); the Eating Disorders Inventory 2 - Symptom Checklist (EDI-SC); the Body Uneasiness Test (BUT).

RESULTS

Male homosexuals obtained much higher scores than male heterosexuals on the EDI 2 Drive for thinness, Bulimia, Ineffectiveness, Interoceptive awareness, Impulse regulation scales and on all the BUT subscales. Similarly, with regard to eating behaviours, a significantly higher frequency in the use of strategies to compensate weight increase was observed. On all these scales the sample of homosexual males did not show any significant differences from the group of hetero- and homosexual women. The male homosexuals who claimed they were not in a stable relationship scored higher in all the variables considered.

DISCUSSION

Our findings seem to suggest that homosexual orientation is associated with greater body dissatisfaction and abnormal eating behaviours in males, in particular among those who claimed they were not in a sentimental relationship.

Intrasexual Competition and Eating Restriction in Heterosexual and Homosexual Individuals

Restrictive eating attitudes and behaviors have been hypothesized to be related to processes of intrasexual competition. According to this perspective, within-sex competition for status serves the adaptive purpose of attracting mates. As such, status competition salience may lead to concerns of mating desirability. For heterosexual women and gay men, such concerns revolve around appearing youthful and thus, thinner. Following this logic, we examined how exposure to high-status and competitive (but not thin or highly attractive) same-sex individuals would influence body image and eating attitudes in heterosexual and in gay/lesbian individuals. Results indicated that for heterosexuals, intrasexual competition cues led to greater body image dissatisfaction and more restrictive eating attitudes for women, but not for men. In contrast, for homosexual individuals, intrasexual competition cues led to worse body image and eating attitudes for gay men, but not for lesbian women. These findings support the idea that the ultimate explanation for eating disorders is related to intrasexual competition.

Eating disorders in men: current features and childhood factors

BACKGROUND

Disturbed interactions with one's body and with other persons are two major features in eating disorders. This study was designed to assess current and childhood characteristics of eating-disordered men.

METHODS

The authors interviewed 32 men with eating disorders (anorexia nervosa: N=9, bulimia nervosa: N=15, eating disorders not otherwise specified: N=8) and 43 control participants with no such history similar in age and educational status. The Structured Clinical Interview for DSM-IV was used to assess Axis I disorders and a self-designed interview to assess actual social and sexual characteristics and childhood body-focused and social behaviors including sexual and physical abuse.

RESULTS

The two groups differed significantly with regard to clinical, sexual and social features, with a three times higher rate of psychiatric disorders, fewer sexual and social relationships in the index group than in the controls. Eating-disordered men differed significantly from controls on most measures of body-focused and social behaviors, displaying higher rates of thumb sucking, nail biting, auto-aggressive behavior, and nudity as a familial taboo during childhood, as well as less parental bodily caressing than did controls. The index group reported significantly poorer relationships to their parents, fewer friends and persons of trust, and more often had adjustment problems at school than did their counterparts.

CONCLUSIONS

Our data show that disturbed interactions with one's body and with other persons in eating-disordered men are associated with a body-denying and distant family climate and an auto-aggressive, anxious and inhibited social behavior during childhood.

Physical development and sexual orientation in men and women: an analysis of NATSAL-2000

In the present study, three physical development characteristics-weight, height, and age of menarche-were examined for their relation to sexual orientation. Participants were men and women comprising the National Survey of Sexual Attitudes and Lifestyles-2000 (N > 11,000). Participants completed self-report measures of sexual orientation, height, weight, and, for women, age of menarche. Results indicated that gay/bisexual men were significantly shorter and lighter than heterosexual men. There were no significant differences between lesbians and heterosexual women in height, weight, and age of puberty. The results add to literature suggesting that, relative to heterosexual men, gay/bisexual men may have different patterns of growth and development because of early biological influences (e.g., exposure to atypical levels of androgens prenatally). However, the present results do not support a number of studies suggesting that lesbian/bisexual women are taller and heavier than heterosexual women.

Sexual identity development and self-esteem as predictors of body image in a racially diverse sample of gay men

The current study examined the relationship between sexual identity development and body image, as well as the potential mediating effect of self-esteem, in a community sample of gay men. A diverse group of participants (N = 172), recruited through listservs and flyers, completed an online survey. Regression analyses were conducted to assess the relationships between identity development and self-esteem, identity development and body image, self-esteem and body image, and the mediating role of self-esteem. As predicted, significant relationships were identified between each pair of variables, and self-esteem was found to be a mediator when the sample was considered as a whole. When participants of color were compared to those who were White, however, between-group differences emerged; identity stage did not predict self-esteem or body image for participants of color, nor did the mediated relationship exist. Self-esteem did predict body image in both groups. The sociocultural context of these findings is considered.

The simulacra effect: the effect of media simulations on eating disorder symptomology in gay men

Researchers have uncovered a disturbing trend in the gay community: Gay men are at an increased risk for disordered eating. Researchers in this area generally support the existence of a sociocultural component to this phenomenon; however, these assertions have not been experimentally tested. We attempted to demonstrate that media representations targeted toward gay men have the potential to affect disordered eating and self-perception. Results showed that contrary to the hypothesis, the experimental group did not show an increase in eating disorder symptomology; in some cases, the opposite occurred. Implications of the importance of identifying with media images are discussed.

Childhood abuse and eating disorders in gay and bisexual men

OBJECTIVE

This study examines the association between eating disorders and a history of childhood abuse in gay and bisexual men, and how substance abuse and depression might impact this relationship.

METHOD

193 white, black, Latino gay, and bisexual men were sampled from community venues. DSM-IV diagnoses of anorexia, bulimia, and binge eating disorder were assessed using the World Health Organization's Composite International Diagnostic Interview.

RESULTS

Men with a history of childhood sexual abuse are significantly more likely to have subclinical bulimia or any current full-syndrome or subclinical eating disorder compared with men who do not have a history of childhood sexual abuse. A history of depression and/or substance use disorders did not mediate this relationship.

CONCLUSION

Researchers should study other potential explanations of the relationship between a history of childhood abuse and eating disorders in gay and bisexual men. Clinicians working with gay and bisexual men who have a history of childhood abuse should assess for disordered eating as a potential mechanism to cope with the emotional sequelae associated with abuse.

Eating disorders in diverse lesbian, gay, and bisexual populations

OBJECTIVE

This study estimates the prevalence of eating disorders in lesbian, gay, and bisexual (LGB) men and women, and examines the association between participation in the gay community and eating disorder prevalence in gay and bisexual men.

METHOD

One hundred and twenty six white heterosexuals and 388 white, black, Latino LGB men and women were sampled from community venues. DSM-IV diagnoses of anorexia, bulimia, and binge eating disorder were assessed using the World Health Organization's Composite International Diagnostic Interview.

RESULTS

Gay and bisexual men had significantly higher prevalence estimates of eating disorders than heterosexual men. There were no differences in eating disorder prevalence between lesbian and bisexual women and heterosexual women, or across gender or racial groups. Attending a gay recreational group was significantly related to eating disorder prevalence in gay and bisexual men.

CONCLUSION

Researchers should study the causes of the high prevalence of eating disorders among gay and bisexual men.

Body image, eating behaviors, and attitudes toward exercise among gay and straight men

Gay men tend to be more dissatisfied with their bodies and may be at greater risk for symptoms of eating disorders compared to heterosexual men. However, the majority of research conducted with gay and heterosexual men has implemented instruments designed to assess eating disorder symptomatology in women. The present study assessed differences between gay and heterosexual men using the Male Eating Behavior and Body Image Evaluation (MEBBIE), an instrument designed to assess attitudes and behaviors related to eating, exercise and body image specifically in men. Analyses of MEBBIE scale means with body mass index (BMI) as the covariate indicated that, relative to their heterosexual counterparts, gay men diet more, are more fearful of becoming fat, and are more dissatisfied with their bodies in general as well as with their degree of muscularity. Gay men were also more likely than heterosexual men to hold distorted cognitions about the importance of having an ideal physique. Contrary to hypotheses, however, gay and straight men did not differ in the degree to which they exercised or felt guilty about missing a workout. Results are discussed in light of previous findings, and implications for clinical practice and future research are considered.

Transtorno alimentar e cirurgia bariátrica: relato de caso

OBJETIVO: Os autores discutem, a partir de um relato de caso e de uma revisão da literatura, as implicações de uma operação bariátrica sobre o comportamento alimentar. MÉTODO: É apresentado o caso clínico de uma paciente submetida a uma operação bariátrica e que apresentou alterações comportamentais alimentares semelhantes às de uma anorexia nervosa, mas não apresentando peso abaixo do normal, o que levou a um diagnóstico de transtorno alimentar não especificado. Este caso é analisado em comparação com situações semelhantes na literatura. DISCUSSÃO: Os dados da literatura são discutidos de acordo com aqueles apresentados no caso relatado e procura-se, a partir daí, obter uma conduta prudente frente aos candidatos à cirurgia bariátrica e no seguimento pós-operatório, analisando os possíveis riscos envolvidos.

Muscularity and the gay ideal: body dissatisfaction and disordered eating in homosexual men

The present study investigated body concerns in a community sample of 52 homosexual men, as well as two comparison groups comprising 51 heterosexual men and 55 heterosexual women. Gay men were found to score significantly more highly than heterosexual men on all measures of disordered eating, and did not differ significantly from women on Drive for Thinness or Bulimia. They also scored significantly more highly than heterosexual men and women on Drive for Muscularity (a scale developed for this study), suggesting that the gay 'ideal' involves not only being thin, but also being muscular. Interestingly, however, gay men did not differ significantly from heterosexual men on body esteem, with both groups scoring higher than the women. While body esteem was found to be related to self-esteem for all of the groups, for gay men only self-esteem was negatively related to the importance to others of appearance, weight, and muscularity, perhaps reflecting increased pressure within the gay community to attain the ideal body shape.

Gender identity disorder and eating disorders

We report three cases of transsexual patients who are suffering from an eating disorder: a biological male patient diagnosed with anorexia nervosa (AN), a biological male patient with bulimia nervosa (BN), and a biological female patient with AN as well as a severe alcohol dependence. The relationship between eating behavior, gender identity, sexual orientation, and body dissatisfaction is discussed.

Adolescents with eating disorders. Primary care screening, identification, and early intervention

The identification and treatment of eating disorders in adolescents is a challenging and time-consuming commitment. Early identification and treatment requires a multi-disciplinary team of health care professionals and provides an improved prognosis for these complex conditions. Nurses in all levels of practice are in ideal positions to influence early detection through careful screening (identification of risk factors, patient history, and physical exam), close follow-up, and prompt specialty referral with disease progression.

Homosexuality as a specific risk factor for eating disorders in men

OBJECTIVE

The current study examined whether homosexuality is a specific risk factor for disordered eating in men.

METHOD

Men (64 heterosexual and 58 homosexual) completed the Beck Depression Inventory (BDI), the Rosenberg Self-Esteem Scale (RSE), the Masculinity and Femininity scales of the Bem Sex-Role Inventory (BSRI), the Bulimia Test-Revised (BULIT-R), the Eating Attitudes Test (EAT-26), and the Body Shape Questionnaire (BSQ).

RESULTS

Homosexual men had more pathological scores on the BDI, RSE, BULIT-R, EAT-26, and BSQ. Additionally, homosexual men reported greater discomfort with sexual orientation. After controlling for differences in depression, self-esteem, and comfort with sexual orientation, sexual orientation continued to account for significant variance in BULIT-R, EAT-26, and BSQ scores.

DISCUSSION

Future research may benefit from exploring aspects of homosexuality that may contribute specifically to risk for disordered eating in men.

Personality features differentiate late adolescent females and males with chronic bulimic symptoms

OBJECTIVE

The authors examined gender differences in bulimia-related personality variables among late adolescents with chronic bulimic symptoms.

METHOD

Ninety-seven females and 14 males were included in the study. They participated in surveys in 1982, and again in 1992, and at each session reported elevated bulimic symptoms. Each respondent completed subscales of the Eating Disorders Inventory (Bulimia, Drive for Thinness, Perfectionism, and Interpersonal Distrust).

RESULTS

Even compared to males with similar levels of chronic bulimic symptoms, females with chronic bulimic symptoms reported more drive for thinness; compared to females with chronic bulimic symptoms, males with chronic bulimic symptoms reported more perfectionism and interpersonal distrust.

DISCUSSION

Late adolescent males and females with chronic bulimic symptoms can be distinguished on the basis of personality features. These findings have implications for theory, as well as for clinical assessment and therapeutics.

More males seek treatment for eating disorders

OBJECTIVE

This study compares males and females with DSM-IV-defined eating disorders who were admitted to the inpatient eating disorders service at The New York Hospital, Cornell between 1984 and 1987.

METHODS

During this period, 51 males and 693 females presented for their first admission. Demographic information, questionnaires, and SCID interviews were used to compare the male and female samples.

RESULTS

Males were significantly more likely than females to have a later onset of their eating disorder (20.56 vs. 17.15 years), and to be involved in an occupation or sport in which weight control influences performance. There were no significant gender differences in other characteristics or comorbid diagnoses. Males constituted an increasing percentage of total admissions between 1984 and 1997 (r = .692, p = .009).

DISCUSSION

The similarities of core eating disorder psychopathology and comorbid illness in male and female patients encourage the continued use of similar detection and treatment strategies with both groups.

National lesbian health care survey

Abstract This article presents demographic, lifestyle, and mental health information about 1,925 lesbians from all 50 states who participated as respondents in the National Lesbian Health Care Survey (1984-1985), the most comprehensive study on U.S. lesbians to date. Over half the sample had had thoughts about suicide at some time, and 18% had attempted suicide. Thirty-seven percent had been physically abused as a child or adult, 32% had been raped or sexually attacked, and 19% had been involved in incestuous relationships while growing up. Almost one third used tobacco on a daily basis, and about 30% drank alcohol more than once a week, 6% daily. About three fourths had received counseling at some time, and half had done so for reasons of sadness and depression. Lesbians in the survey also were socially connected and had a variety of social supports, mostly within the lesbian community. However, few had come out to all family members and coworkers. Level of openness about lesbianism was associated with less fear of exposure and with more choices about mental health counseling.

Biodemographic comparisons of homosexual and heterosexual men in the Kinsey Interview Data

Relations between sexual orientation and several biodemographic variables previously reported to differentiate between homosexual and heterosexual men were examined. Subjects were 4948 white, postpubertal males, who were never reared in foster homes, orphanages, or other institutions, and were never arrested or convicted on criminal charges. These were dichotomously classified as homosexual (n = 844) or heterosexual (n = 4104). Data came from survey interviews conducted by staff members of The Kinesey Institute for Research in Sex, Gender, and Reproduction from 1938 to 1963. Results extended previous findings that, compared with heterosexual controls, homosexual men have a later birth order, an earlier onset of puberty, and a lower body weight. Sexual orientation was weakly related or unrelated to height, paternal age, and sibling sex ratio. A more detailed analysis of the late birth order of the homosexual group showed that homosexual men have a greater number of older brothers than do heterosexual men, but they do not have a greater number of older sisters, once their number of older brothers has been taken into account.

Comparison of height and weight in homosexual versus nonhomosexual male gender dysphorics

The authors' clinical impression that homosexual gender-dysphoric males are physically smaller than nonhomosexual gender-dysphoric males was tested. Subjects were 176 homosexual and 246 nonhomosexual male outpatients, ages 16 to 65, who complained of discontent with their biological sex. Compared with the nonhomosexual male gender dysphorics, the homosexual gender dysphorics were shorter, lighter, and lighter in proportion to their height. The homosexual gender dysphorics were also shorter than men in the general population, whereas the nonhomosexual gender dysphorics were not. The smaller physiques of homosexual gender-dysphoric men may partly explain the clinical observation that these patients are somewhat more successful in passing as women.

Sexual function in altered physiological states: comparison of effects of hypertension, diabetes, hyperprolactinemia, and others to "normal" aging in male rats

In this review, we examine the changes in sexual function that accompany deviations from "normal" physiological states. We propose that the changes one observes in many altered physiological states should not be viewed in isolation. We describe our paradigms for assessing sexual function, and proceed to evaluate how sexual function changes with hormonal deprivation and aging, in rat models for hypertension, in severe hyperprolactinemia, in streptozotocin-induced diabetes, after chronic alcohol intake, after chronic morphine administration, and after exposure to the heavy metal, cadmium. We will provide evidence for the involvement of adrenergic transmitters and two neuropeptides, neuropeptide Y and somatostatin, in the neuroendocrine regulation of sexual behavior. Finally, we compare and contrast the changes observed relative to the changes seen in "normal" aging in rats. The sequence of age-related changes in sexual function is distinct. The first change observed is a decrement in ex copula erectile reflexes. Next are decreases in ejaculatory threshold, followed shortly by increases in initiation and reinitiation of copulation after ejaculation. This is followed by a decrement in the number of males copulating to ejaculation. Finally, there is a failure to initiate the copulatory process. This sequelae is relatively common, being evident after castration, with hyperprolactinemia, and after exposure to cadmium. The data available for sexual function in hypertension is incomplete and modified by the etiology, but a suggestion for this sequelae is seen in SHR. In contrast, sexual dysfunction associated with chronic morphine administration appears to be due to an initial deficit in motivational aspects. Testosterone reverses sexual dysfunction associated with castration, but not with idiopathic sexual inactivity, nor with sexual dysfunction associated with aging, diabetes, or chronic morphine administration. Comparing sexual function in rat models for hypertension, diabetes and chronic ethanol leads to the conclusion that increases in blood pressure, like decreases in testosterone, cannot be the primary causal factor for sexual dysfunction. Age, hormonal history of the subject, and the age at castration influence changes in sexual function. Age-related sexual dysfunction appears to be contributed to by changes in adrenergic-neuropeptidergic, to include sympathetic, systems. Site-specific administration of NPY induces alterations in parameters of copulatory behavior which mimic those seen in aging and the retention of ejaculatory behavior with aging is associated with site-selective attenuation (or reversal) of age-associated changes in NPY content. Yohimbine enhances copulatory activity in castrated and aging rats, and attenuates or reverses the antisexual effects of clonidine, epinephrine and somatostatin.(ABSTRACT TRUNCATED AT 400 WORDS)

Sexual orientation as a factor in risk for binge eating and bulimia nervosa: a review

Research on binge eating and bulimia nervosa among lesbians and gay men is reviewed. The thesis that the different value pot on physical appearance in these groups may function as a mediator of risk for eating problems is considered. Studies indicate that gay men focus on their appearance more than heterosexual men and may be at higher risk. Lesbians, who are arguably less invested in societal norms of attractiveness, may be at lower risk than heterosexual women, but the findings are mixed. Implications for conceptual models of risk for bulimia nervosa, and for awareness of lesbian and gay experiences by therapists, are discussed.