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Call for better care for men with eating disorders

GPs urged to spot growing cases of male eating disorders

Adrian O'Dowd

Wednesday, 09 April 2014

GPs should try harder to identify and help men with eating disorders which are not only a problem for women, concludes a study published online today in the journal BMJ Open.

The small study said a common perception that only women have eating disorders was preventing men with these problems from getting the help and support they needed.

It is estimated that around 1 in 250 women and 1 in 2,000 men in the UK have anorexia nervosa, one of the four recognised types of eating disorder - the others being bulimia nervosa; binge eating disorder; and eating disorder not otherwise specified (EDNOS).

However, the incidence of eating disorders is rising amongst men, with some estimates suggesting that men now account for one in four cases.

The authors from University of Oxford’s Nuffield Department of Primary Care Health Sciences and University of Glasgow’s Social and Public Health Sciences Unit, said poor recognition of the signs and symptoms of eating disorders in men could mean the true prevalence was higher than currently thought.

They interviewed 39 young people between the ages of 16 and 25, 10 of whom were men, about their experiences of eating disorders, in a bid to gauge the impact of gender on diagnosis, treatment, and support.

All the men took time to realise that their experiences and behaviours were potential signs and symptoms of an eating disorder during which time these became entrenched.

Their behaviours included going days without eating; purging; and obsessive calorie counting, exercise, and weighing. Some also self-harmed and increasingly isolated themselves from others.

One of the main reasons given as to why it took them so long to understand what was happening was the perception that eating disorders were a women’s problem, particularly young women.

None of the men were aware of the symptoms of an eating disorder, and friends, family, and teachers were also slow to recognise symptoms.

The man said they delayed seeking help because they feared they would not be taken seriously by healthcare professionals, or did not know where to go for support.

The researchers said GPs and other primary healthcare professionals played a “pivotal role” in recognising early symptoms of eating disorders (EDs) and early referral for specialist care.

However, the men's accounts of the readiness and capability of GPs to provide relevant and appropriate information about disorders varied.

One participant said his GP had been helpful and willing to offer support, but admitted that there were no services available to which she could refer him.

“Several men described having to go to the GP repeatedly before they felt they were being taken seriously or referred, and in a few instances an ED had been missed or misdiagnosed,” says the study.

One participant was told he was “going through a teenage fad” until his mother intervened and he was eventually referred to a Child and Adolescent Mental Health Service (CAMHS).

“Men with eating disorders are underdiagnosed, undertreated and under researched,” said the authors.

“Our findings suggest that men may experience particular problems in recognising that they may have an eating disorder as a result of the continuing cultural construction of eating disorders as uniquely or predominantly a female problem.”

DOI:10.1136/bmjopen-2013-004342

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