The Eating Disorders Review recently send out this review of ICED in Montreal. A very insightful look at how necessary it is to consider all variebles leading up to and including the treatment of a patient struggling with an eating disorder.
A few key topics highlighted below:
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A Transdisgnostic Approach
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Emotions Role in Eating Disorders
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Men with Eating Disorders
Reprinted from Eating Disorders Review
July/August Volume 24, Number 4
©2013 Gürze Books
Taking a New Look at Old Boundaries in Eating Disorders
The International Conference on Eating Disorders (ICED) in May offered a program filled with practical and research-oriented presentations. Following this year’s theme, “Crossing Disciplinary Boundaries in Eating Disorders,” sessions included a keynote address reminding the audience about the challenges of overlap and similarities among eating disorders, a look at how emotions can drive eating disorders, and an analysis of why male patients are so infrequently involved in eating disorders treatment.
Developing a Transdiagnostic Approach
In his keynote address, David Barlow, PhD, ABPP, professor of psychology and psychiatry, and founder and director emeritus of the Center for Anxiety and Related Disorders at Boston University, told audience members that a transdiagnostic approach to psychiatric and psychologic disorders is slowly but surely developing.
“We have thousands of protocols,” Dr. Barlow noted, adding that the “time has passed for one protocol after another with only a slight twist.” There is no way that such an approach can ultimately be useful, he said. At the present time there may be effective treatment but there is plenty of room for improvement, he said, adding that there are still too many protocols and manuals, and these protocols are still relatively complex, which interferes with effective dissemination.
He also pointed to work by Dr. Chris Fairburn and colleagues a decade ago, which marked the beginnings of taking a transdiagnostic approach to eating disorders. By honing in on overvaluation of shape and weight and control, the researchers hypothesized that the remaining disorders follow this same pattern. Research on the comorbidity of anxiety with bulimia nervosa is another example. Various researchers showed a high comorbidity rate of anxiety with bulimia nervosa.
Intolerance of uncertainty (IU) is a characteristic predominantly associated with generalized anxiety disorder (GAD); however, emerging evidence indicates that IU may be a shared element of emotional disorders, Dr. Barlow said. He explained that a synergy of several types of vulnerabilities leads to stress, and in turn to generalized anxiety, and depression. It is thought that the vulnerabilities come together, perhaps triggered by stress, to find their phenotypical outlet as anxiety and/or depression, the flip side of generalized anxiety, he said. Dr. Barlow said that emotions are not meant to be suppressed; instead, they are present to motivate us to engage in certain behaviors. If the vulnerability is not present, mood recovers naturally and more quickly in response to stress, he said.
Dr. Barlow also shared a unified protocol approach illustrating the principal of transdiagnostic unified treatment for anxiety. This approach features eight treatment modules, including: motivation enhancement for treatment engagement; psychoeducation and treatment rationale; emotional awareness training; cognitive appraisal and reappraisal; interoceptive awareness and tolerance; situational exposures; and relapse prevention.
Dr. Barlow also addressed a question about the interdependence between biological vulnerability and psychological vulnerability. Splitting apart biological and psychological vulnerability does have empirical support, he said because there are recognizable differences in the brain. The fact that specific brain circuits are activated is an argument for keeping disorders separate, as in the case of obsessive-compulsive disorders. However, he added, his group wonders if these vulnerabilities are continually influencing each other.
Emotion’s Role in Eating Disorders
In a plenary session, Steve Wonderlich, PhD, Director of Clinical Research at the Neuropsychiatric Institute, Fargo, ND, said that the study of emotion may be very important to the diagnosis and treatment of persons with eating disorders. The role of emotion in eating disorders is still being debated, and “emotion” is a slippery term, Dr. Wonderlich said. Very significant questions have to do with the possible functional relationship between emotion and eating disorder behaviors. Do emotions precipitate or modulate disordered eating behaviors?
Dr. Wonderlich, a Past President of the Academy for Eating Disorders and a member of the EDR Editorial Advisory Board, described a technique, ecological momentary assessment (EMA), that his group and others have used to collect data about patients in a real-world environment. Patients use a handheld computer or a cell phone to record current states, events, and emotions and thus are able to record events as they occur.
To gain a richer view of a patient’s life, the device signals the patient to record their behavior and emotions 6 to 10 times a day. Thus binges, components of meals, and emotions can be recorded at or near the time they occur. According to Dr. Wonderlich, the real beauty of such devices is that the connection between emotion and behavior can be studied at a very precise point in time, which will help establish whether emotions are driving the behavior, or vice versa. This method also establishes a record of emotions and behaviors for longitudinal study. In a 2007 study of 131 adult female volunteers diagnosed with DSM-IV criteria for BN, 90% of the time patients responded within 45 minutes or less. Other researchers who examined the trajectories of emotion before and following the bulimic behavior found that during the 6 hours before a binge episode, a steady increase in negative affect occurred, and culminated in a binge.
Do different emotions have specific relationships to bulimic behavior? Dr. Wonderlich also briefly described the work of Dr. Kelly C. Berg et al., who explored the connection between four negative emotions--guilt, fear, sadness, and hostility-- and bulimic behavior. Guilt was linked to the highest degree of negative affect, and was significantly associated with binge eating; this was not the case with the other emotions. Another question concerned individual differences, and whether certain characteristics of people with specific forms of disordered eating made them more vulnerable to behaviors triggered by negative affect. Increasing evidence suggests that negative emotional states may play a role in precipitating eating disorders behavior across diagnoses, he said.
What are the implications for treatment? Some implications for treatment include:
- Consider treatments that directly reduce the intensity of emotion (example, psychotropic drugs).
- Promote more adaptive regulation of high-risk emotion moments. This may be accomplished by targeting events that increase negative affect in persons with eating disorders and\or to enhance their ability to clarify, accept, and tolerate negative affect states (distress tolerance), and...
- Promote inhibition of impulsive behavior, especially in times of heightened negative affect.
Does it matter if the eating disorder behavior reduces the negative affect or produces negative reinforcement? Dr. Wonderlich quoted B. F. Skinner, who said, “Although antecedent conditions help to establish a behavior, consequences maintain it.” However, Dr. Wonderlich asked, if this is true, why does a person who pursues low weight engage in behaviors such as binge-eating, which directly interfere with attaining the goal of low weight? Biologically induced binge eating counteracts a physiological state connected with starving, as Ancel Keys noted.
Binge eating and other disordered eating behaviors are maintained because they help the person escape from or avoid the precipitating negative emotional states. If eating disorder behaviors actually function to reduce/avoid a negative emotional state, clinicians have two treatment options, he said. The first would be to identify and help patients develop alternative behaviors that promote the same emotional reward; the second option would be extinction of the behavior.
He described a 2008 study evaluating extinction as a functional treatment for binge eating (Behavior Modification 2008; 32:556). Dr. Ray Miltenberger and colleagues at the University of South Florida trained bulimic patients first in the lab and then at home. Patients listened to a tape recording they had made after a previous binge, one that made them feel badly about the binge. As a result, some of the trainees became abstinent and remained so, Dr. Wonderlich said. He also cited a very recent paper by Dr. Tim Walsh and colleagues that described AN as a well-entrenched habit and reported that with habit acquisition, rather than reward, the brain shifts. Thus, habit formation appears to be critical to the persistence of the dieting behavior. (Am J Psychiatry. 2013; 170:477-484. doi:10.1176/appi.ajp.2012.12081074 ).
Finally, Dr. Wonderlich offered several conclusions about emotion and eating disorders. First, emotion variables and eating disorder behaviors co-vary at a momentary level. Next, antecedent emotional states may be meaningful clinical targets for eating disorders treatment, but the impact of eating disorder behaviors on emotional states still needs much study. Finally, he noted that eating disorder treatment interventions may benefit from a greater focus on specific situations, affects and actions that occur in a momentary timeframe and promote conditioning or reinforcement that perpetuates eating disorder behaviors.
Where Are All the Men?
Men face a number of barriers to obtaining treatment, according to two clinicians who specialize in treating men with eating disorders. In a special plenary session on eating disorders in men, Roberto Olivardia, PhD, and Mark Warren, MD, PhD, FAED, explored some of the reasons that men with eating disorders are often overlooked or never seek treatment.
First, there is a misperception that only women have eating disorders. According to Dr. Olivardia, clinical instructor of psychology at Harvard Medical School and co-author of one of the first books to deal with eating disorders in men, The Adonis Complex, there is a wide misperception that eating disorders only affect women; another misperception is that eating disorders affect only gay men. Sexual orientation can be a huge issue, he said, noting that shame and secrecy also keep many young men from seeking help for an eating disorder. Gay men are more likely to discuss their disorders with peers, while heterosexual men are far more secretive, and even their spouses are often unaware of the problem.
When men do seek help, they may find themselves in treatment centers that cater to women, and they may have problems dealing with a female physician as well. And, since so many treatment centers cater primarily to women, treatment may not be available for men, even if they do want help.
Dr. Olivardia noted that eating disorders can appear in boys as young as 9 or 10, and disorders very often focus on muscle mass rather than with weight alone. They may see themselves as too thin and scrawny, and seek anabolic steroids to “bulk up.” Just as with women, cultural influences are powerful-- muscularity is seen as a core element of masculinity, dominance, and attractiveness. For example, in the 1980s, a shift in the movies occurred at which time bigger bodies became important commodities and important currency; this was accompanied by an explosion of “muscle magazines,” men’s fitness magazines, and even video games stressing male bulk. He pointed to an extreme example of newer action figures, wherein even Star Wars action figures were re-mastered to be much more muscular. It is estimated that from 4 to 6 million males are affected, and the onset of these disorders is around the time of puberty. He added that much more data are needed about incidence, race, and socioeconomic status.
Men are less likely to seek treatment because of shame about having what is “a female disorder,” according to Dr. Olivardia. Males with eating disorders are often self-conscious and find themselves in settings with few other male patients. The good news is that once these men get into treatment, they do as well if not better than do women, he said.
Men need to be included in the conversation about eating disorders. Dr. Warren, Medical Director of the Cleveland Center for Eating Disorders, traced the history of eating disorders in men, noting that the first two reported cases of anorexia nervosa involved one female and one male. Our culture focuses on gender, food, and bodies, he said. For example, even the story of Adam and Even featured nakedness and food and how genders are affected. He added that men have been excluded from the current narrative of eating disorders because the criteria, screening tools, and treatment have all been based upon the histories of women patients. He added, “For men to be included in the conversation, we have made many attempts to distinguish how eating disorders are different in men. We need to accept that men have eating disorders and then to find how biology and genetics exist to present a different clinical picture in men.”
Dr. Warren also said that there are compelling reasons to improve studies of eating disorders in men; these problems are serious, potentially life-threatening conditions that are extremely challenging to diagnose and treat and they are increasing. He praised Dr. Arnold Andersen, a longtime member of EDR’s Editorial Board, for his pioneering work in the treatment of men with eating disorders. Dr Warren also shared with the audience that he himself had anorexia nervosa in his teens and knew nothing about the disease at the time. He said that his recovery was a matter of luck and that even now most men recover as a matter of luck rather than as a result of clear diagnosis and treatment. Men started “disappearing from the equation when the focus turned to amenorrhea and “hysteria,” neither of which applied to men. In the late 1970s, Dr. Gerald Russell’s work on bulimia brought men back into the eating disorders world, Dr. Warren said. However, even today most research articles are written exclusively about women, he said, showing that we have not progressed in the way we might want to.
What else can be done? Dr. Warren told the audience that one positive step in the future would be to always include men in every eating disorders study. Clinicians can also ask themselves what it is like to be a man with an eating disorder. In most treatment centers, male patients only see women patients, and a woman clinician typically asks a male patient to discuss his body, feeding, and intake. He added that most males are asked if they are gay before they are asked if they are afraid their illness will kill them.
Shame is such a powerful emotion, he said, which keeps men with eating disorders from seeking help. Health care providers can be more mindful and sensitive to eating disorders in males. They can remember to ask male patients more about their body goals and use gender-neutral language. Treatment centers can be more welcoming, for example, by including men in their ads. Men also need to know about the history and sociocultural beliefs that underlie eating disorders and how culture affects us all, he said. Having a male clinician to talk with and to be validated by is also a powerful way to help a man with eating disorder feel more comfortable about seeking treatment and sticking with it. The chemistry of the treatment team is extremely important, Dr. Warren said.
Full article here...
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The following story recently ran in the L.A. Times covering the growing number of males struggling with anorexia and the added challenges they face in seeking treatment.
Excerpt...
A survey shows that L.A. male high school students are about as likely as females to use diet aids or laxatives or vomiting to lose weight. The numbers challenge old assumptions.
Bryan Piperno was just 9 years old when he began keeping his secret.
The Simi Valley youngster tossed out lunches or claimed he ate elsewhere. As he grew older, he started purging after eating. Even after his vomiting landed him in the emergency room during college, he lied to hide the truth.
Piperno, now 25, slowly fended off his eating disorder with time and care, including a stay in a residential treatment facility. But surveys show a rising number of teenage boys in Los Angeles now struggle with similar problems.
High school boys in Los Angeles are twice as likely to induce vomiting or use laxatives to control their weight as the national average, with 5.2% of those surveyed saying they had recently done so, according to the most recent survey data gathered by the Centers for Disease Control and Prevention and the Los Angeles Unified School District. They are also more likely to have used diet pills, powders or liquids than boys nationwide.
The numbers challenge old assumptions that boys are immune to a problem better known to afflict teenage girls. Girls still exceed boys in fasting to lose weight, but the latest data, from 2011, showed that Los Angeles boys were nearly as likely as girls to purge through vomiting or laxatives. They were also as likely as girls to use diet pills, powders or liquids without the advice of a doctor — 6.2% said they recently used such substances, compared with 6.1% of girls.
Some experts say boys are starting to face the pressures long placed on girls, as buff, bare men proliferate in pop culture. Boys today watch Channing Tatum strip as "Magic Mike" or weigh themselves against the muscular Dwayne Johnson. The nonstop chatter of Twitter and Facebook has amplified those messages, therapists say.
"Boys are growing up now with the billboard of the guy with perfect pecs and biceps," said Roberto Olivardia, a clinical instructor in the Harvard Medical School psychiatry department. "You just didn't see that years ago."
Teenage boys say abs are prized and ogled. Andrew Shrout, a 19-year-old junior at UC Berkeley, said boys felt they needed to be very lean at his former high school in Long Beach. "Men are pressured to have as little fat as possible — but you've got to pretend like you don't watch what you eat," Shrout said.
He decided to lose weight for his health but also because another guy on the water polo team used to grab his stomach and jiggle it. "I can see why a lot of younger kids get sucked into a vortex and end up doing bad things," Shrout said.
Steroid use is also on the rise among Los Angeles teen boys, the survey found, with roughly one out of 20 saying they have used steroids — only a slightly smaller percentage than those who had recently turned to diet pills, powders or liquids.
Sports can pile on more pressure. Wrestlers, for instance, often aim to lose enough weight to grapple with lighter opponents. For some competitors, throwing up or downing laxatives can be a gateway to a disorder that lasts beyond the sporting event, said Dawn Theodore, clinical director of the Eating Disorder Center of California in Brentwood.
Los Angeles isn't the only city where boys have been increasingly likely to purge or turn to diet substances, with higher-than-average rates also seen in Chicago, Houston, Charlotte, N.C., and elsewhere. Government estimates show that the number of males hospitalized for eating disorders rose 53% between 1999 and 2009. Some experts say they are unsure whether more boys and men are in fact suffering such disorders or whether more are now willing to seek help.
Females remain much more likely to be hospitalized for eating disorders than boys and men, who made up 12% of such hospital stays as of four years ago, the government estimates show. However, researchers say that because men fear coming forward, the rates among males might be higher than the numbers suggest.
When they finally get help, the boys' cases "tend to be especially severe," said clinical psychologist Jennifer Henretty, who directs intensive outpatient programs at the Center for Discovery, a national system of eating disorder programs headquartered in Orange County. "People don't look until it's really out of hand."
Experts say part of the problem is that traditional methods of detecting disorders were made with girls and women in mind.
Benjamin O'Keefe, 18, remembers Googling the word "anorexia" and finding a website that said it halts menstruation. "There was nothing targeted at me," said O'Keefe, who struggled with the disorder in high school in Florida.
He exercised constantly and sometimes ate only a cheese sandwich for days at a time. He suffered massive headaches, slept incessantly and fainted onstage while rehearsing for a play.
While he weakened, "people were saying, 'Wow, you look great,' " O'Keefe remembered.
He began talking about his past struggle with anorexia upon launching a petition earlier this yearurging Abercrombie & Fitch — known for its shirtless models — to carry larger sizes.
Men who battled anorexia or bulimia as teens told The Times that other problems often drove their disorders. Piperno, the Simi Valley man, said it began as a way of exerting control over his body after suffering sexual abuse.
Matthew, a 20-year-old who faced anorexia as a teen in the Pasadena area, first avoided eating to "numb out" the alcoholism of his father and stepmother.
Read full article here...
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Fairwinds Treatment Center is a dual-diagnosis eating disorder facility. We offer personalized treatment for men and adolescent males who are struggling with anorexia nervosa. For more information or to discuss your situation, contact our admissions team at 727-447-0300 or through our website here.
This article written by Sharon Stephenson for the New Zealand website Stuff.co.nz explains the work of eating disorder therapist Victoria Marsden and how eating disorders and body image issues can affect people of all ages and status.
"Marsden, who has worked with patients from age nine to their late 60s, says older women suffering from eating disorders generally fall into three categories: those whose illness has gone untreated since adolescence; those whose disorder may have gone into remission, only to resurface later in life; and those who may have developed an eating disorder in their 30s, 40s, 50s, even 60s."
Excerpt:
It was the lemon slice that did it. Biscuity layers of butter and condensed milk, swaddled in icing so sweet it could crack your teeth.
While the rest of us gobbled them down as though in the shadow of a famine, it was too much for Andrea, a former colleague. "Please stop bringing fattening food to work," she shouted, slicing through the calorific coma that made Monday mornings bearable.
"You should be ashamed of yourselves for eating such bad food." And so ended Baking Mondays.
What makes Andrea's behaviour unusual is that she isn't a 20-year-old desperate for thin thighs and a pert bottom, or an unfortunate 14-year-old trapped on the ferris wheelof anorexia. She is a 46-year-old, university educated, high-achieving, property-owning consultant.
Attractive and successful, she's the kind of woman whose good-luck thermostat has never been out of whack. Hardly the poster girl for eating disorders? You'd be surprised, says Auckland body image and eating-issue therapist Victoria Marsden.
"Most attention is given to adolescent eating issues, but they by no means discriminate by age. Eating disorders can happen to anyone at any stage of their lives," she says. Due to a lack of age-related research data on disordered eating in New Zealand, it's difficult to say if older women are the new face of eating disorders, but statistics from the United States indicate a 42 percent spike in the past five years of older women seeking treatment.
These include patients suffering from anorexia, where excessive or compulsive dieting, starvation and over-exercising can result in dramatic weight loss, as well as bulimia, which is characterised by excessive binge eating followed by purging with vomiting or laxatives.
Marsden, who has worked with patients from age nine to their late 60s, says older women suffering from eating disorders generally fall into three categories: those whose illness has gone untreated since adolescence; those whose disorder may have gone into remission, only to resurface later in life; and those who may have developed an eating disorder in their 30s, 40s, 50s, even 60s.
Blame life's major and often unexpected events - divorce, redundancy, illness, retirement and empty nest syndrome, among others - for propping open the door for middle-age eating disorders. "As women get older, they tend to be loaded with responsibilities - raising children, paying off a mortgage, caring for ageing parents - as well as having to navigate some of life's big career and relationship changes. Society assumes that by 40, a woman should have her life sorted, she should be so busy caring for family, working and running a home that she shouldn't have the time or energy to worry about how much she's eating or how slim she looks," says Marsden.
But while women may not be able to control what's going on around them, they can control what goes into their mouths. Wellington-based Andrea has spent more than 30 years doing this. "I've struggled with weight and food issues since I was 13. I believe that if I can control my eating, then I can control my life. The minute stress hits me, my first thought is, how can I restrict my food intake?"
At her worst, Andrea survived on less than 500 calories a day. "Some days I would eat only 30 grapes. A blow-out day would be a cup of plain pasta or a Diet Coke." If she tried to eat more, Andrea's stomach would clench until she vomited. Her periods stopped and she couldn't brush her hair without losing clumps of it. At one stage Andrea's elderly labrador weighed almost as much as she did.
However, turning 40 proved somewhat of a lifeline: Andrea paid off her mortgage, landed her dream job and let go of some of what she calls her "craziness about kai". "For the first time in my life I was able to go to restaurants and eat, rather than just pushing the food around my plate. I felt normal."
But six months ago, the trifecta of a high-pressure career, unrelenting perfectionist tendencies and the death of her father pushed Andrea "back down the road of previous coping strategies".
"At a certain point, you cross that line and can't stop what you're doing. Sometimes it feels as though this illness owns me.''
One of the biggest culprits of disordered eating for women - and men - of all ages is society's obsession with body image. On any given day, around 60 percent of women are on a diet.The weight-worry gun is loaded early: in New Zealand, it's estimated as many as 10 percent of adolescent girls go through a mild phase of anorexia. And it would appear that there is no age at which we learn to love our bodies: an Austrian study of 475 women aged 60 to 70 years revealed that 60 percent were dissatisfied with their bodies, while four percent were diagnosed with an eating disorder.
Here in New Zealand, Weight Watchers reports 13,000 members over 40, with their oldest member being 79 years old. Marsden says that the necessity to maintain a certainweight is particularly critical if a woman's identity and self-esteem is wrapped up in her appearance.
"This may lead her to seek a thin, youthful body through unhealthy behaviours, such as food restriction, diet pills, extreme exercise, drugs, laxatives or purging." Throw in the weight gain caused by hormonal fluctuations in menopause and the stage is set for eating disorders.
Jenna was 38 when she first stuck a finger down her throat. "The feeling of wanting to be slim doesn't go away just because you get older," she says. When her husband of 10 years announced he was leaving her for a younger woman, his parting words included an insult about her weight.
Read full article here...
Eating disorders affect people of all ages and gender. If you feel you have an unhealthy body image that controls your life and eating habits, contact Fairwinds Treatment Center to discuss your situation with one of our admissions counselors - 800-226-0301 or through our website here. You can get better. We can help.
British beauty’s tragic demise sheds light on dangerous eating disorder and addiction.
This article by Tracy Miller recently ran in the New York Daily News shows how gripping an eating disorder like anorexia can be and how fast it can end a life.
Gold medal child skier Georgia Willson-Pemberton, nearly 6 feet tall, wasted away to a skelatal 105 pounds from severe anorexia and died from ‘multiple organ dysfunction caused by laxative abuse.
The death of a 26-year-old former ski champion brings to light a devastating addiction of the dangerously thin.
Georgia Willson-Pemberton had it all: beauty, a prestigious education and the best of everything. But she was also battling anorexia and a laxative addiction.
Willson-Pemberton, once a gold medal child skier, took more than 80 laxative pills in a week, causing serious stomach and bowel damage. Her death on December 7 was ruled a "multiple organ dysfunction caused by laxative abuse," The Sun reports.
The 5'10" woman had wasted away to 105 pounds at the time of her death.
Willson-Pemberton, who lived in West London, had been struggling with anorexia for four years. She received treatment for her eating disorder at some of the top clinics in Britain and the U.S., including The Priory, but to no avail.
She once hid up to 200 pills in padded bras, counfounding her doctors and specialists.
Her parents found thousands of pills in her apartment after her death, they said.
“The world was her oyster, she could have done anything," her tearful father Robert Willson-Pemberton said in court during the inquest into her death.
"The disease consumed her. It was all she thought about."
Laxative pills can become addictive as the body builds up a tolerance, requiring more and more pills to achieve the same effect.
The loss of water from the body may cause electrolyte imbalance, muscle spasms and irregular heartbeat. Abusing the pills can also seriously damage the intestines.
Read full story here...
There are up to 24 million individuals suffering with eating disorders in the United States. Eating disorders have the highest mortality rate of any other mental illness. Fairwinds Treatment Center is a dual-diagnosis treatment facility, offering specialized care for patients with eating disorders and co-occuring mental illnesses that can attribute to these diseases. If you or a loved one are struggling with an eating disorder, such as anoexia, please contact Fairwinds Treatment Center today. our councelors are here to help find the best treatment options for your particular needs. Call 727-449-0300 or through our website here.
This recent article by Nina Bahadur with the Huffington Post covers a recent study that links Muscle Dysmorphia and Male Anorexia to gender roles. With male eating disorders on the rise, studies like this will help in understanding the root causes for such disorders, in-turn assisting in the improvement of treatment for males who are suffering with anorexia, bulimia and muscle dysmorphia.
excerpt below:
Muscle Dysmorphia And Male Anorexia Linked To Gender Role Endorsements, Study Finds
Men suffering from eating disorders are typically aiming for one of two things: to make themselves smaller, or to make themselves as muscular as possible, according to the National Association of Anorexia Nervosa and Associated Disorders. New research out of the University of Sydney investigates what causes that divergence -- what makes men turn to anorexia or bulimia to make themselves smaller, versus the disordered eating and over-exercising behaviors that are seen in people with muscle dysmorphia?
One hypothesis is that these eating disorders are related to gender roles -- that anorexia sufferers might be more likely to endorse "feminine" gender tropes like sexual fidelity, modesty, domesticity, and investment in appearance, whereas muscle dysmorphia sufferers might be more likely to endorse "masculine" gender tropes like risk-taking, winning, self-reliance and emotional control.
Clinical psychologists Stuart B. Murray. Elizabeth Rieger, Lisa Karlov and Stephen Touyz worked with 24 male anorexia nervosa patients, 21 male muscle dysmorphia patients and a control group of 30 gym-going men. They asked participants to complete four self-administered tests: the Conformity to Masculine Norms Inventory (CMNI), Conformity to Feminine Norms Inventory (CFNI), Muscle Dysmorphia Disorder Inventory (MDDI) -- a questionnaire used to diagnose muscle dysmorphia -- and the Eating Disorders Examination Questionnaire (EDE-Q).
The study, published Thursday in the Journal of Eating Disorders found that muscle dysmorphia sufferers reported "significantly greater adherence" to masculine gender roles when compared with anorexia sufferers and the control group. In turn, anorexia sufferers reported greater adherence to feminine gender roles than the muscle dysmorphia sufferers or the control group.
So, what does all this mean? In a press release Murray stated that the results do not indicate "that the men with anorexia were any less masculine, nor that the men with muscle dysmorphia were less feminine than the control subjects recruited. It is however an indication of the increasing pressures men are under to define their masculinity in the modern world."
Read the full article...
Fairwinds Treatment Center is a dual-diagnosis facility, specializing in male eating disorders. We treat both adolescent and adult male clients to recover from eating disorders such as anorexia, bulimia and compulsive overeating. As a dual-diagnosis facility, we treat mental health issues as well including depression, anxiety and trauma, which can all play a roll in developing an eating disorder or muscle dysmorphia.
If you or someone you know is suffering from an eating disorder, take action and call our admissions department to discuss your situation. Call 727-449-0300 or contact via web here.