There’s a new article released by Trends in Urology and Men’s Health. It’s a salient, speedy read that covers the essentials and it’s aimed primarily at clinician practitioners to help impart immediate info and raise awareness.
The piece has many strengths – it gives some instantly identifiable findings in its Key Points, and it compiles a list of current relevant support. It’s accessible and the author is a GP so it’s written by a professional for other healthcare specialists. It promotes the idea that practitioners need to ask the right questions and they also need to know that there are services that men can, and should, access.
However, there are 3 things that sprang to mind as soon as I read it.
- It places sexuality at the very top of the list or risk factors.
- It states that treatments are well-evidenced.
- It states that eating disorders in males are on the increase.
Let me, briefly albeit, take each in turn.
- Professor John Morgan, the only UK psychiatrist to have authored a text about men with eating disorders, body image issues and bigorexia, is very clear in this and other work that we have been somewhat over-estimating the significance of non-heterosexuality in the development of eating disorders (Jones & Morgan 2010; Morgan & Arcelus 2009). This does not seem to have been taken to account here and outdated presumptions continue to prevail. Why does good ED research take so long to catch up with itself?
- Treatments, broadly, do indeed have a weight of evidence behind them. But there that statement ends. Almost all treatment models have been designed around females and we simply have scant evidence of what works best with male patients. Indeed, as soon as we look at male stories of treatment, instead of results from clinical data, the picture looks quite different and it becomes clear that reliable, male-centred treatment is enormously variable – some men have had pretty awful experiences – such as being a male interloper on a female ward, and being excluded from therapy groups. My research on male stories evidences this.
- Sweeting et al. (2015) have a very different picture to offer about the issue of prevalence. they investigated the currently perennial problem: are MEDs actually increasing or do we just think they are. They examined reported scientific data on prevalence and compared this with media and 3rd sector organisations reported stats. What they found was relatively inconclusive, at best. This is the most recent publication devoted to prevalence, yet it is not cited here.
What do I take from this? When we write about male eating disorders we need to examine certain key researchers – their work needs to feature. And we also need to make sure that we (researchers and clinicians) are not the ones perpetuating misconceptions – something that is difficult to do.
Finally, we need more research on men-in-treatment and male-focused treatments – not less, so claiming that treatments are, in essence, ‘sorted’ is unhelpful given the battle that most men report in accessing services that actually understand and respond to them.
Jones, W., & Morgan, J. (2010). Eating disorders in men: A review of the literature. Journal of Public Mental Health, 9(2), 23-31.
Morgan, J. F., & Arcelus, J. (2009). Body image in gay and straight men: a qualitative study. European Eating Disorders Review, 17(6), 435-443.
Sweeting, H., Walker, L., MacLean, A., Patterson, C., Räisänen, U., & Hunt, K. (2015). Prevalence of eating disorders in males: a review of rates reported in academic research and UK mass media. International journal of men’s health, 14(2).