Eating disorders in males. An update

Abstract

Objective
Despite the ever-increasing number of cases of Eating Disorders (EDs) detected in the male gender, almost all the literature review is focused on the female population. Therefore, the main aim of this research is to offer a valuable and updated contribution to the literature about the contemporary overview of EDs in male subjects, in order to activate more focused clinical reflections on specific differences with the female gender so as to provide guidance to professionals toward a better diagnostic and therapeutic understanding.
Methodology
In order to achieve the objective of the present study, an investigation of the computerized scientific literature has been conducted through the analysis of some major databases, among which PubMed, PsycINFO, and ResearchGate. A set of key words has thus been identified: “males,” “eating disorder,” “anorexia nervosa,” “bulimia nervosa,” “binge eating disorder,” and “muscle dysmorphia”. Studies showing similarities and differences with the female gender in terms of epidemiology, clinical specifications, diagnostic, and therapeutic features have been extrapolated with the aim of providing a theoretical-clinical update on the topic examined.
Results
From an epidemiological point of view, ED cases in males, although showing a lower incidence than in females, have been steadily increasing in recent years. Although they share some clinical aspects, ED in males differ from those found in females with respect to some concepts like the body ideal, the use of compensatory methods, and, more generally, severity and comorbidity with other psychiatric disorders. Several studies have also found that homosexual and bisexual males tend to develop ED more easily than both heterosexual males and the female population as a whole. Some studies, moreover, have also recorded the presence of ED in males in non-Western populations, highlighting how the prevalence affects more and more geographical areas. With regard to treatment, the few studies realized agree in highlighting the overlap of therapeutic strategies for both sexes, both quantitatively and qualitatively. Indeed, the guidelines suggest for both males and females a multidisciplinary approach consisting of psychotherapeutic, nutritional, medical, and pharmacotherapeutic interventions. There also does not seem to be significant differences in the course of the disorder, except for a slightly more favorable trend in the male subject.
Conclusions
Despite the fact that literature review on ED in males has considerably grown in recent years, it is of utmost importance to continue to investigate it, since several aspects still remain to be deepened by future research. Among them, in addition to specific diagnostic indications, some areas related to gender differences at the level of phenomenology, of onset, of symptom manifestations, of comorbidity, and of outcome are still under-investigated. In addition, specific psychodiagnostic tools exclusively designed for the male population are still lacking. Similarly, it might also be appropriate to think about specific ED males-calibrated treatments. Finally, most studies on eating disorders in males have focused almost exclusively on the Western population, and far fewer have considered other ethnicities, although some research has found high rates of ED among other foreign populations.