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Riva A, Pigni M, Albanese ND, Falbo M, Di Guardo S, Brasola E, Biso F, Nacinovich R. Eating Disorders in Children and Adolescent Males: A Peculiar Psychopathological Profile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11449. [PMID: 36141722 PMCID: PMC9517020 DOI: 10.3390/ijerph191811449] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Eating Disorders (EDs) are severe psychiatric disorders with high rates of mortality, multiple medical and psychiatric comorbidities associated, and often chronic illness. Historically, EDs are among the most gendered of psychiatric illnesses, and male presentations have been perceived as rare and unusual. This perception resulted in the systematic underrepresentation of males in research on Eds, and as consequence, in a scarcity of research investigating clinical and psychological features in this population. (2) Methods: The present study aims to evaluate clinical and psychopathological features in a sample of 287 children and adolescents, 27 males and 260 females with EDs, in order to identify similarities and differences. (3) Results: Males were younger than females, with similar medical and clinical conditions, but a different distribution of typology of EDs in middle childhood and middle adolescents. The Eating Disorders Inventory-3, TAS-20 for alexithymia and CDI for depressive symptoms' profiles are similar, while males showed higher scores at the global indexes of Symptom Checklist 90-Revised test in early adolescence. (4) Conclusions: Results suggest gender-specific similarities and differences in clinical and psychological features in children and adolescent males, which may require specific diagnosis and treatment.
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Affiliation(s)
- Anna Riva
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| | - Maria Pigni
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| | - Nunzia Delia Albanese
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| | - Mariella Falbo
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| | - Simona Di Guardo
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| | - Eleonora Brasola
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
| | - Francesco Biso
- Department of Business Engineering, Tor Vergata University of Rome, 00133 Rome, Italy
| | - Renata Nacinovich
- Child and Adolescent Mental Health Department, ASST Monza University of Milano-Bicocca, 20900 Monza, Italy
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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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Akgül S, Akdemir D, Kara M, Derman O, Çetin FÇ, Kanbur N. The understanding of risk factors for eating disorders in male adolescents. Int J Adolesc Med Health 2016; 28:97-105. [PMID: 25781520 DOI: 10.1515/ijamh-2014-0078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/17/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The study aimed to describe the medical, psychiatric, and cultural features of adolescent males with an eating disorder (ED). MATERIALS AND METHODS This retrospective evaluation took place at Hacettepe University, İhsan Doğramacı Children's Hospital, Ankara, Turkey, and covered a 4-year period between 2010 and 2013. Sixty adolescents were diagnosed with an ED during this period, 47 (78.3%) were females and 13 were males (21.7%) male. All 13 male patients who met full criteria for an ED according to the DSM criteria were included. Medical and psychiatric records of male patients treated for an ED were re-evaluated. RESULTS The most striking finding of the study was that the female to male ratio became 3.6:1, with the increasing number of male adolescents with an ED. In our study, medical findings and complications of males with ED were similar to those seen in females. However, the most predominant gender difference was the co occurrence of a comorbid physical or mental illness. CONCLUSION It is imperative to raise awareness of EDs in males. Although the medical findings of the study suggest that male and female adolescents with EDs are clinically similar to each other, the understanding of certain gender-specific risk factors shown in our study, such as a medical illness and/or obesity and co-morbid psychiatric diagnosis, are essential in raising suspicion. Further studies that especially evaluate cultural and social factors that affect parenting styles for boys are important in addessing possible risk factors for the development of EDs in males within different societies.
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Does Sex Matter in the Clinical Presentation of Eating Disorders in Youth? J Adolesc Health 2016; 58:410-416. [PMID: 26830976 PMCID: PMC4808325 DOI: 10.1016/j.jadohealth.2015.11.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 11/15/2015] [Accepted: 11/19/2015] [Indexed: 11/23/2022]
Abstract
PURPOSE Eating disorders (EDs) impact both males and females, but little is known about sex differences in ED psychopathology and overall clinical presentation. This study compared demographic and clinical characteristics of child and adolescent males and females who presented for ED treatment. METHODS Participants included 619 youth (59 males and 560 females) ages 6-18 years who presented for treatment between 1999 and 2011. RESULTS Males presented for ED treatment at a significantly younger age (p < .001), earlier age of onset (p = .004), and were more likely to be nonwhite (p = .023). Females showed more severe ED pathology across the Eating Disorder Examination subscales (weight concern: p < .001; eating concern: p < .001; restraint: p = .001; and shape concern: p = .019) and global score (p < .001). Males were more likely to present with an ED other than anorexia nervosa or bulimia nervosa (p = .002). Females presented with significantly higher rates of mood disorders (p = .027) and had a lower average percent of expected body weight (p = .020). Males and females did not differ in duration of illness, prior hospitalization or treatment, binging and purging episodes, anxiety disorders, behavioral disorders, or self-esteem. All analyses were controlled for age. CONCLUSIONS Results indicate that further exploration into why the sexes present differently may be warranted. Developing ED psychopathology assessments that better capture nuances particular to males and reevaluating criteria to better categorize male ED diagnoses may allow for more targeted treatment.
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Welch E, Ghaderi A, Swenne I. A comparison of clinical characteristics between adolescent males and females with eating disorders. BMC Psychiatry 2015; 15:45. [PMID: 25885652 PMCID: PMC4359485 DOI: 10.1186/s12888-015-0419-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 02/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating disorders (ED) are serious disorders that have a negative impact on both the psychological and the physiological well-being of the afflicted. Despite the fact that ED affect both genders, males are often underrepresented in research and when included the sample sizes are often too small for separate analyses. Consequently we have an unclear and sometimes contradictory picture of the clinical characteristics of males with ED. The aim of the present study was to improve our understanding of the clinical features of adolescent males with eating disorders. METHODS We compared age at presentation, weight at presentation, history of significantly different premorbid weight and psychiatric (Attention Deficit Hyperactivity Disorder (ADHD)) and somatic comorbidity (celiac disease and diabetes) of 58 males to 606 females seeking medical care for eating disorders at the Children's Hospital in Uppsala, Sweden during the years 1999-2012. As all boys were diagnosed with either AN or Other Specified Feeding or Eating Disorder (OSFED) atypical AN, the age and weight comparisons were limited to those girls fulfilling the diagnostic criteria for AN or OSFED atypical AN. RESULTS There was no significant difference in age at presentation. Differences in weight at presentation and premorbid weight history were mixed. A significantly higher percentage of males had a history of a BMI greater than two standard deviations above the mean for their corresponding age group. As well, there was a higher prevalence of ADHD among the males whereas celiac disease and diabetes only was found among the females. CONCLUSIONS A better understanding of the clinical characteristics of males with ED at presentation should improve our ability to identify males with ED and thereby aid in tailoring the best treatment alternatives.
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Affiliation(s)
- Elisabeth Welch
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Ata Ghaderi
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Ingemar Swenne
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Abstract
PURPOSE OF REVIEW Research in eating disorders in males has been active lately compared to the past. This review aims to provide an overview of the recently published studies of eating disorders in males. RECENT FINDINGS Publication of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition has outlined more sex-neutral diagnostic criteria for eating disorders. Data of socioeconomic factors, prenatal influences, clinical characteristics, assessment, and mortality for eating disorders have been reported independently for males. Unlike in females, higher parental education showed no association with eating disorders in males, but twin or triplet status and lower gestational age at birth had an independent association with anorexia nervosa in males. Contrary to earlier suggestions, no differences in eating disorder symptoms such as binging, vomiting, or laxative abuse were observed between the sexes. Yet, males tended to score lower on eating disorder symptom measures than females. High rates of premorbid overweight and higher BMIs at various stages of eating disorders have been confirmed repeatedly. Higher age and lower BMI at admission, and restrictive anorexia nervosa subtype predicted fatal outcome for anorexia nervosa in males. SUMMARY Contemporary research provides grounds for improved recognition, diagnosis, and treatment for males suffering from eating disorders.
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Forsén Mantilla E, Bergsten K, Birgegård A. Self-image and eating disorder symptoms in normal and clinical adolescents. Eat Behav 2014; 15:125-31. [PMID: 24411765 DOI: 10.1016/j.eatbeh.2013.11.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 10/28/2013] [Accepted: 11/20/2013] [Indexed: 11/19/2022]
Abstract
Eating disorders (ED) are psychiatric disorders of multifactorial origin, predominantly appearing in adolescence. Negative self-image is identified as risk factor, but the association between self-image and ED in adolescents or sex differences regarding such associations remains unclear. The study aimed to investigate the relationship between specific self-image aspects and ED symptoms in normal and clinical adolescents, including sex differences. Participants included 855 ED patients (girls=813, boys=42) and 482 normal adolescents (girls=238, boys=244), 13-15 years. Stepwise regression demonstrated strong associations between self-image and ED in normal adolescents (girls: R(2)=.31, boys: R(2)=.08), and stronger associations in patients (girls: R(2)=.64, boys: R(2)=.69). Qualitative sex differences were observed in patients. Connections between specific self-image aspects and ED have implications for clinical management of ED. The strong link between self-image variables and ED symptoms in normal girls, but not boys, is discussed in terms of the continuity-discontinuity hypothesis.
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Affiliation(s)
- Emma Forsén Mantilla
- Karolinska Institute, Dept. of Clinical Neuroscience, Resource Center for Eating Disorders, Norra Stationsgatan 69, Plan 7, 113 64 Stockholm, Sweden.
| | - Katja Bergsten
- Uppsala University, Dept. of Psychology, S:t Olofsgatan 10B, 753 12 Uppsala, Sweden.
| | - Andreas Birgegård
- Karolinska Institute, Dept. of Clinical Neuroscience, Resource Center for Eating Disorders, Norra Stationsgatan 69, Plan 7, 113 64 Stockholm, Sweden.
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Norris ML, Apsimon M, Harrison M, Obeid N, Buchholz A, Henderson KA, Spettigue W. An examination of medical and psychological morbidity in adolescent males with eating disorders. Eat Disord 2012; 20:405-15. [PMID: 22985237 DOI: 10.1080/10640266.2012.715520] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
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.
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Affiliation(s)
- Mark L Norris
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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Darcy AM, Doyle AC, Lock J, Peebles R, Doyle P, Le Grange D. The Eating Disorders Examination in adolescent males with anorexia nervosa: how does it compare to adolescent females? Int J Eat Disord 2012; 45:110-4. [PMID: 22170022 PMCID: PMC3241004 DOI: 10.1002/eat.20896] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2010] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The study aimed to explore the Eating Disorder Examination (EDE) for adolescent males with eating disorders (EDs) compared with adolescent females with EDs. METHOD Data were collected from 48 males and matched on percent median body weight (MBW) and age to 48 females at two sites. RESULTS Adolescent males with anorexia nervosa-type presentation scored significantly lower than matched females on Shape Concern, Weight Concern, and Global score. They also scored lower on a number of individual items. DISCUSSION The EDE has clinical utility with adolescent males with anorexic-type presentation although males' scoring ranges are consistently lower than those from adolescent females with similar clinical presentations. Males scored significantly lower on a number of items representing core symptoms such as desire to lose weight. More research is needed to gain a better understanding of the experience of adolescent males with EDs, particularly in relation to the nature of shape concern.
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Affiliation(s)
- Alison M. Darcy
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California,Correspondence to: Alison Darcy; Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305.
| | - Angela Celio Doyle
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medical Center, Chicago, Illinois
| | - James Lock
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Rebecka Peebles
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University School of Medicine, Mountain View, California
| | - Peter Doyle
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medical Center, Chicago, Illinois
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medical Center, Chicago, Illinois
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Núñez-Navarro A, Agüera Z, Krug I, Jiménez-Murcia S, Sánchez I, Araguz N, Gorwood P, Granero R, Penelo E, Karwautz A, Moragas L, Saldaña S, Treasure J, Menchón JM, Fernández-Aranda F. Do men with eating disorders differ from women in clinics, psychopathology and personality? EUROPEAN EATING DISORDERS REVIEW 2011; 20:23-31. [PMID: 21823213 DOI: 10.1002/erv.1146] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine if male and female eating disorders differ in clinics, psychopathology and personality traits when compared with a healthy group. METHODS Sixty male and 60 female eating disorder individuals (16% anorexia nervosa, 42% bulimia nervosa and 42% eating disorder not otherwise specified), matched for age and diagnostic, were compared with 120 healthy-eating participants (60 male and 60 female participants). All were diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Assessment measures included Eating Disorder Inventory--2, Symptom Checklist--Revised and Temperament and Character Inventory--Revised, as well as other clinical and psychopathological indices. RESULTS Male eating disorder participants reported significant lower laxative abuse (p = 0.020) and significant higher vomiting episodes (p = 0.019) than female eating disorder participants. Differences on drive for thinness, body dissatisfaction and some Symptom Checklist--Revised scales were found across genders in eating disorder participants. Male eating disorder participants scored significantly lower than female participants with eating disorders on harm avoidance, reward dependence and cooperativeness. CONCLUSIONS Although eating disorder clinical features were similar across genders, male eating disorder participants had less body image concern and general psychopathology than female eating disorder participants.
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Affiliation(s)
- Araceli Núñez-Navarro
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
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Støving RK, Andries A, Brixen K, Bilenberg N, Hørder K. Gender differences in outcome of eating disorders: a retrospective cohort study. Psychiatry Res 2011; 186:362-6. [PMID: 20826003 DOI: 10.1016/j.psychres.2010.08.005] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Revised: 08/06/2010] [Accepted: 08/12/2010] [Indexed: 11/19/2022]
Abstract
Eating disorders (EDs) are uncommon in males. The majority of outcome studies on ED have not presented gender-specific results, mostly because of small study samples or exclusion of males. Furthermore, psychometric tools and outcome criteria used in ED have mainly been validated for females only. The objective of this study was to evaluate gender differences in weight restoration in different EDs. We studied the male representation and outcome in a large retrospective single centre cohort, the Funen Anorexia Nervosa Study (FANS). A total of 1015 patients were included in the study. A total of 356 (35%) patients were diagnosed with anorexia nervosa (AN), 298 (29%) with eating disorder not otherwise specified (EDNOS) and 361 (36%) with bulimia nervosa (BN). The male fractions in AN and EDNOS were similar, but significantly lower in BN. When remission was defined as body weight restoration to at least 85% of ideal body weight (IBW) and no self-reported binge or purgative behaviors in six months, the median time from onset to remission for patients with AN was significantly shorter for males: 7 years for females vs. 3 years for males. Among patients with a 5 years history of disease, remission rates in AN were 39% for females vs. 59% for males. The median time to remission for patients with EDNOS was similar to that of AN: 6 years for females vs. 3 years for males. In patients with EDNOS, 45% of the females remitted within 5 years vs. 77% of the males. With regard to body weight restoration and remission of purging behavior, this study suggests a better outcome for males than for females.
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Baker JH, Maes HH, Lissner L, Aggen SH, Lichtenstein P, Kendler KS. Genetic risk factors for disordered eating in adolescent males and females. JOURNAL OF ABNORMAL PSYCHOLOGY 2009; 118:576-86. [PMID: 19685954 DOI: 10.1037/a0016314] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The etiologic role of genetic and environmental factors on disordered eating was examined in a sample of 15- to 17-year-old female-female, male-male, and opposite-sex twin pairs. Also assessed was whether a single factor is underlying 3 facets (body dissatisfaction, drive for thinness, bulimia) of disordered eating, including the possible importance of sex differences. Univariate model-fitting analyses indicated that genetic factors are more important for girls and environment more important for boys for body dissatisfaction and drive for thinness. A multivariate common factor analysis indicated that a single factor accounted for the association among these 3 facets of disordered eating in both sexes. However, only 50% of the genetic risk for this factor is shared between the sexes.
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Affiliation(s)
- Jessica H Baker
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA.
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Gadalla TM. Psychiatric comorbidity in eating disorders: a comparison of men and women. JOURNAL OF MENS HEALTH 2008. [DOI: 10.1016/j.jomh.2008.06.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sepulveda AR, Carrobles JA, Gandarillas AM. Gender, school and academic year differences among Spanish university students at high-risk for developing an eating disorder: an epidemiologic study. BMC Public Health 2008; 8:102. [PMID: 18373852 PMCID: PMC2387144 DOI: 10.1186/1471-2458-8-102] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2007] [Accepted: 03/28/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to assess the magnitude of the university population at high-risk of developing an eating disorder and the prevalence of unhealthy eating attitudes and behaviours amongst groups at risk; gender, school or academic year differences were also explored. METHODS A cross-sectional study based on self-report was used to screen university students at high-risk for an eating disorder. The sample size was of 2551 university students enrolled in 13 schools between the ages of 18 and 26 years. The instruments included: a social-demographic questionnaire, the Eating Disorders Inventory (EDI), the Body Shape Questionnaire (BSQ), the Symptom Check List 90-R (SCL-90-R), and the Self-Esteem Scale (RSE). The sample design is a non-proportional stratified sample by academic year and school. The prevalence rate was estimated controlling academic year and school. Logistic regression analysis was used to investigate adjusted associations between gender, school and academic year. RESULTS Female students presented unhealthy weight-control behaviours as dieting, laxatives use or self-induced vomiting to lose weight than males. A total of 6% of the females had a BMI of 17.5 or less or 2.5% had amenorrhea for 3 or more months. In contrast, a higher proportion of males (11.6%) reported binge eating behaviour. The prevalence rate of students at high-risk for an eating disorder was 14.9% (11.6-18) for males and 20.8% (18.7-22.8) for females, according to an overall cut-off point on the EDI questionnaire. Prevalence rates presented statistically significant differences by gender (p < 0.001) but not by school or academic year. CONCLUSION The prevalence of eating disorder risk in university students is high and is associated with unhealthy weight-control practices, similar results have been found in previous studies using cut-off points in questionnaires. These results may be taken into account to encourage early detection and a greater awareness for seeking treatment in order to improve the diagnosis, among students on university campuses.
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Affiliation(s)
- Ana R Sepulveda
- School of Psychology, Autonomous University of Madrid, Spain.
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Bonci CM, Bonci LJ, Granger LR, Johnson CL, Malina RM, Milne LW, Ryan RR, Vanderbunt EM. National athletic trainers' association position statement: preventing, detecting, and managing disordered eating in athletes. J Athl Train 2008; 43:80-108. [PMID: 18335017 PMCID: PMC2231403 DOI: 10.4085/1062-6050-43.1.80] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To present recommendations for the prevention, detection, and comprehensive management of disordered eating (DE) in athletes. BACKGROUND Athletes with DE rarely self-report their symptoms. They tend to deny the condition and are often resistant to referral and treatment. Thus, screenings and interventions must be handled skillfully by knowledgeable professionals to obtain desired outcomes. Certified athletic trainers have the capacity and responsibility to play active roles as integral members of the health care team. Their frequent daily interactions with athletes help to facilitate the level of medical surveillance necessary for early detection, timely referrals, treatment follow-through, and compliance. RECOMMENDATIONS These recommendations are intended to provide certified athletic trainers and others participating in the health maintenance and performance enhancement of athletes with specific knowledge and problem-solving skills to better prevent, detect, and manage DE. The individual biological, psychological, sociocultural, and familial factors for each athlete with DE result in widely different responses to intervention strategies, challenging the best that athletics programs have to offer in terms of resources and expertise. The complexity, time intensiveness, and expense of managing DE necessitate an interdisciplinary approach representing medicine, nutrition, mental health, athletic training, and athletics administration in order to facilitate early detection and treatment, make it easier for symptomatic athletes to ask for help, enhance the potential for full recovery, and satisfy medicolegal requirements. Of equal importance is establishing educational initiatives for preventing DE.
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Guerdjikova AI, McElroy SL, Kotwal R, Keck PE. Comparison of obese men and women with binge eating disorder seeking weight management. Eat Weight Disord 2007; 12:e19-23. [PMID: 17384521 DOI: 10.1007/bf03327777] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE This study examined whether obese males with binge eating disorder (BED) seeking weight loss treatment differed significantly from obese females with BED seeking weight loss treatment in developmental variables, weight loss history, current and lifetime prevalence of psychiatric disorders, and metabolic abnormalities. METHODS Psychiatric (using the Structural Clinical Interview for DSM-IV), medical, and laboratory assessments of 44 obese males with BED were compared with assessments from 44 age- and race-matched obese females with BED seeking weight loss treatment. RESULTS High rates of mood disorders, anxiety disorders, and metabolic syndrome were observed in the population as a whole. Obese males with BED had attempted significantly fewer diets, medications and supplements for weight loss before seeking weight loss treatment. The two genders did not differ significantly in any other of the examined variables. CONCLUSIONS Our results suggest that while obese men and women with BED who present for weight management are very similar, males had fewer previous attempts at weight loss, possibly related to their less pronounced body dissatisfaction or fewer help-seeking behaviors as compared to females. Our results also support findings of substantial comorbidity among obesity, BED, mood and anxiety disorders, and metabolic syndrome in weight loss seeking populations, in men as well as women.
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Affiliation(s)
- A I Guerdjikova
- Psychopharmacology Research Program, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0559, USA.
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17
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Abstract
OBJECTIVE The current study investigates the background and outcome of anorexia nervosa (AN) in young men. METHOD All (N = 61) men, born in 1968-1977 with hospital care in Sweden between 1987 and 1992 due to AN, were compared with the general population. Information about socioeconomic background, health-related outcome (hospital care for AN, other psychiatric diagnoses, abuse of alcohol/drugs and/or suicide attempt), and social outcome (major income from sick leave/sick pension or > or = 6 months social welfare, living with birth parents, and living with child and partner; education level) was taken from national registers. RESULTS On a group level, the findings suggest some differences between male patients with AN and the male population without AN concerning social background, capacity to support oneself, and living with partner and child. Mental ill-health outcome was almost the same for men with AN as for the general population. CONCLUSION Male gender in AN--on a group level--suggests a good psychiatric prognosis.
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Affiliation(s)
- Frank Lindblad
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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18
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Strober M, Freeman R, Lampert C, Diamond J, Teplinsky C, DeAntonio M. Are there gender differences in core symptoms, temperament, and short-term prospective outcome in anorexia nervosa? Int J Eat Disord 2006; 39:570-5. [PMID: 16937384 DOI: 10.1002/eat.20293] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective of this study was to compare symptoms, premorbid personality phenotypes, and short-term outcome between males and females with anorexia nervosa. METHOD Symptom and personality ratings were obtained at the time of hospital admission, and outcome was assessed at discharge and again 1 year later. RESULTS Gender effects were negligible at admission, with the exception of greater weight concern among females. Lifetime anxiety disorders and personality traits implicated in liability for anorexia nervosa were common among patients of both genders. Females had greater persistence of symptom morbidity over the 1-year follow-up. CONCLUSION Although gender has little effect on the clinical features of anorexia nervosa, the illness runs a more protracted early course in females. Possible mechanisms underlying greater persistence of morbidity in females include sexual dimorphisms in brain neurotransmission, gender differences in attitudes regarding ideal body weight, and anxiety-related personality phenotypes associated with anorexia nervosa.
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Affiliation(s)
- Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, and Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California 90024-1759, USA.
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19
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McVey GL, Davis R, Kaplan AS, Katzman DK, Pinhas L, Geist R, Heinmaa M, Forsyth G. A community-based training program for eating disorders and its contribution to a provincial network of specialized services. Int J Eat Disord 2005; 37 Suppl:S35-40; discussion S41-2. [PMID: 15852317 DOI: 10.1002/eat.20114] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Ontario Community Outreach Program for Eating Disorders is a pilot training project within the eating disorder programs at the University Health Network--Toronto General Hospital (TGH) and the Hospital for Sick Children. This system provides ongoing training, consultation, and research evaluation in areas ranging from prevention through to tertiary care, in the hopes of increasing the capacity of practitioners to respond to the healthcare pressures of those experiencing eating disorders. A total of 3,315 health care practitioners and educators in Ontario participated in community-based training workshops. A pre-post analysis of participants' self-report evaluations was conducted using chi-square analyses. The findings revealed that there was a statistically significant increase in participants' (a) knowledge of eating disorders and of body image issues and (b) level of comfort to either treat clients with eating disorders or teach a curriculum on body image. The contribution of the training program to the development of a provincial network of specialized eating disorder services, designed to promote the public's access to timely and appropriate care for the full spectrum of eating disorders, are discussed.
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Affiliation(s)
- Gail L McVey
- Community Health Systems Resource Group, The Hospital for Sick Children, Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada.
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20
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Gila A, Castro J, Cesena J, Toro J. Anorexia nervosa in male adolescents: body image, eating attitudes and psychological traits. J Adolesc Health 2005; 36:221-6. [PMID: 15737778 DOI: 10.1016/j.jadohealth.2004.02.039] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2003] [Revised: 02/06/2004] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate body image and its relationship with psychological and behavioral traits associated with anorexia nervosa in male patients. METHODS Thirty male adolescents with anorexia nervosa (AN) were compared with 421 male adolescents from the general population. Body image was evaluated with the Subjective Body Dimensions Apparatus. Eating attitudes were evaluated by the Eating Attitudes Test in its 26-item version (EAT-26). In 19 AN patients and 200 boys from the comparison group, the Eating Disorders Inventory (EDI) was also administered. RESULTS AN patients had higher mean scores in the EAT-26 and the Body Dissatisfaction scale on the EDI, but not on the other EDI scales. Both groups overestimated all parts of their bodies but AN patients presented a greater overestimation of shoulders (p = .007), hips (p = .01) and thighs (p = .019). Correlations in the anorexic group were high and negative between body overestimation and body mass index and also high but positive between overestimation and the EAT and the Drive for Thinness scale on the EDI. Overestimation did not correlate significantly with other EDI scales. CONCLUSIONS Male patients with anorexia nervosa overestimate some parts of their bodies more often than controls; this overestimation is related to body mass index, abnormal eating attitudes and drive for thinness, but not to other psychological traits evaluated by the EDI.
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Affiliation(s)
- Araceli Gila
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic Universitari of Barcelona, Barcelona, Spain
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21
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Fernández-Aranda F, Aitken A, Badía A, Giménez L, Solano R, Collier D, Treasure J, Vallejo J. Personality and psychopathological traits of males with an eating disorder. EUROPEAN EATING DISORDERS REVIEW 2004. [DOI: 10.1002/erv.603] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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22
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Abstract
HEALTH ISSUE: Eating disorders are an increasing public health problem among young women. Anorexia and bulimia may give rise to serious physical conditions such as hypothermia, hypotension, electrolyte imbalance, endocrine disorders, and kidney failure. KEY ISSUES: Eating disorders are primarily a problem among women. In Ontario in 1995, over 90% of reported hospitalized cases of anorexia and bulimia were women. In addition to eating disorders, preoccupation with weight, body image and self-concept disturbances, are more prevalent among women than men.Women with eating disorders are also at risk for long-term psychological and social problems, including depression, anxiety, substance abuse and suicide. For instance, in 2000, the prevalence of depression among women who were hospitalized with a diagnosis of anorexia (11.5%) or bulimia (15.4 %) was more than twice the rate of depression (5.7 %) among the general population of Canadian women. The highest incidence of depression was found in women aged 25 to 39 years for both anorexia and bulimia. DATA GAPS AND RECOMMENDATIONS: Hospitalization data are the most recent and accessible information available. However, this data captures only the more severe cases. It does not include the individuals with eating disorders who may visit clinics or family doctors, or use hospital outpatient services or no services at all. Currently, there is no process for collecting this information systematically across Canada; consequently, the number of cases obtained from hospitalization data is underestimated. Other limitations noted during the literature review include the overuse of clinical samples, lack of longitudinal data, appropriate comparison groups, large samples, and ethnic group analysis.
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Affiliation(s)
- Enza Gucciardi
- University Health Network Women's Health Program, University of Toronto, 657 University Avenue, Toronto, Canada
| | - Nalan Celasun
- University Health Network Women's Health Program, University of Toronto, 657 University Avenue, Toronto, Canada
| | - Farah Ahmad
- University Health Network Women's Health Program, University of Toronto, 657 University Avenue, Toronto, Canada
| | - Donna E Stewart
- University Health Network Women's Health Program, University of Toronto, 657 University Avenue, Toronto, Canada
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Anderson CB, Bulik CM. Gender differences in compensatory behaviors, weight and shape salience, and drive for thinness. Eat Behav 2004; 5:1-11. [PMID: 15000949 DOI: 10.1016/j.eatbeh.2003.07.001] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2003] [Indexed: 10/27/2022]
Abstract
Gender differences in compensatory behaviors, weight and shape salience, and drive for thinness have rarely been examined in nonclinical samples. The present study examines gender differences in a sample of 1111 male and 1510 female twins responding to a questionnaire on eating attitudes and behaviors. Logistic regression using generalized estimating equations (GEE) tested the extent to which gender could be predicted from compensatory behaviors, weight and shape salience, and drive for thinness. The results indicated that use of compensatory behaviors predicted female gender for all except exercise and "other," where no gender differences were found. Greater importance of weight and shape also predicted female gender, as did drive for thinness. Findings with respect to exercise use and "other" compensatory behaviors have nosological implications for the eating disorders, especially as regards eating disorders in males. These findings suggest that both the nature and function of compensatory behaviors may differ by gender.
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Affiliation(s)
- Charles B Anderson
- Department of Psychiatry, CB#7160, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7160, USA
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Muise AM, Stein DG, Arbess G. Eating disorders in adolescent boys: a review of the adolescent and young adult literature. J Adolesc Health 2003; 33:427-35. [PMID: 14642705 DOI: 10.1016/s1054-139x(03)00060-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Although a number of studies have investigated eating disorders in adolescence and the topic has been thoroughly reviewed, these studies have typically focused on females, only to state that the approach and treatment should be similar in males. Recently, there have been a number of studies that have explored gender differences in eating disorders. In this article, we review the literature pertaining to two DSM-IV-defined disorders (anorexia nervosa and bulimia nervosa), a DSM-IV-defined research disorder (binge eating disorder), and two DSM-PC-defined disorders (dieting/body image and purging/binge-eating behaviors), highlighting those findings that pertain to disordered eating in adolescent boys.
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Affiliation(s)
- Aleixo M Muise
- Department of Paediatrics, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada.
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25
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Abstract
OBJECTIVE This study examined gender differences in patients with binge eating disorder (BED). METHOD Participants were 182 adults (35 male, 147 female) who were consecutively evaluated for outpatient clinical trials and met criteria for BED as outlined in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders. They were administered a battery of measures to examine developmental, eating and weight-related disturbances, and psychological features associated with BED. RESULTS Men and women did not differ significantly on several developmental variables (age at first overweight, age at first diet, age at onset of regular binge eating, or number of weight cycles). Men had significantly higher current body mass index (BMI), highest adult BMI, and were significantly more likely to be classified as obese. Men and women did not differ significantly on measures of current eating disorder features (binge eating, eating concerns, weight or shape concerns) but women reported significantly greater body image dissatisfaction and drive for thinness. Men and women did not differ significantly on current depression or self-esteem but men reported a greater frequency of past drug abuse problems. DISCUSSION Although men and women who present for treatment for BED show many similarities in current eating disorder features, we observed a number of gender differences on important developmental and physical variables as well as associated psychological features.
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Affiliation(s)
- Declan T Barry
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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