Eating disorders in males: a report on 135 patients.

OBJECTIVE The goal of this study was to better understand the etiology, clinical characteristics, and prognosis of eating disorders in males. METHOD All males with eating disorders who had been treated at Massachusetts General Hospital from Jan. 1, 1980, to Dec. 31, 1994, were identified. Hospital charts and psychiatric departmental records were reviewed to verify that the eating disorders met DSM-IV criteria and to abstract demographic and clinical data. RESULTS One hundred thirty-five males with eating disorders were identified, of whom 62 (46%) were bulimic, 30 (22%) were anorexic, and 43 (32%) met criteria for an eating disorder not otherwise specified. There were marked differences in sexual orientation by diagnostic group; 42% of the male bulimic patients were identified as either homosexual or bisexual, and 58% of the anorexic patients were identified as asexual. Comorbid psychiatric disorders were common, particularly major depressive disorder (54% of all patients), substance abuse (37%), and personality disorder (26%). Many patients had a family history of affective disorder (29%) or alcoholism (37%). CONCLUSIONS While most characteristics of males and females with eating disorders are similar, homosexuality/bisexuality appears to be a specific risk factor for males, especially for those who develop bulimia nervosa. Future research on the link between sexual orientation and eating disorders would help guide prevention and treatment strategies.

[1]  M. Wheeler,et al.  Reproductive hormone profiles in male anorexia nervosa before, during and after restoration of body weight to normal. A study of twelve patients , 1982 .

[2]  E. Haller.  Eating disorders. A review and update. , 1992, The Western journal of medicine.

[3]  T. Burns,et al.  Primary anorexia nervosa in the male and female: a comparison of clinical features and prognosis. , 1986, The British journal of medical psychology.

[4]  山中 学.  「大学生男子の摂食障害」, Olivardia R, Pope HG Jr, Mangweth B, et al, Eating disorders in college men. Am J Psychiatry 152,1279-1285,1995 , 1996 .

[5]  J. Brooks-Gunn,et al.  Co-morbidity of eating disorders and substance abuse review of the literature. , 1994, The International journal of eating disorders.

[6]  P. Lavori,et al.  Psychiatric comorbidity in treatment-seeking anorexics and bulimics. , 1992, Journal of the American Academy of Child and Adolescent Psychiatry.

[7]  P. Robinson,et al.  Bulimia nervosa in the male: a report of nine cases , 1986, Psychological Medicine.

[8]  D. Herzog,et al.  Body Image Dissatisfaction in Homosexual and Heterosexual Males , 1991, The Journal of nervous and mental disease.

[9]  D. Hatsukami,et al.  What are atypical eating disorders? , 1986, Psychosomatics.

[10]  C. Shapiro,et al.  Clinical presentation of anorexia nervosa in males: 24 new cases. , 1994, The International journal of eating disorders.

[11]  M. Fichter,et al.  Symptomatology, psychosexual development and gender identity in 42 anorexic males , 1987, Psychological Medicine.

[12]  F. Vaz-Leal,et al.  Sexual adjustment and eating disorders : differences between typical and atypical anorexic adolescent females , 1992 .

[13]  R. L. Skok,et al.  Characteristics common to females who exhibit anorexic or bulimic behavior: a review of current literature. , 1991, Journal of clinical psychology.

[14]  A. Crisp,et al.  REPRODUCTIVE HORMONE CHANGES DURING WEIGHT GAIN IN MALE ANORECTICS , 1983, Clinical endocrinology.

[15]  T. Burns,et al.  The clinical presentation of anorexia nervosa in males , 1983 .

[16]  S. Levay,et al.  A difference in hypothalamic structure between heterosexual and homosexual men , 1991, Science.

[17]  C. A. Camargo,et al.  Review of bulimia nervosa in males. , 1991, The American journal of psychiatry.

[18]  Toward an understanding of risk factors for bulimia. , 1986 .

[19]  G. Szmukler,et al.  Anorexia nervosa: a psychiatric case register study from Aberdeen , 1986, Psychological Medicine.

[20]  J. Rodin,et al.  Men and their bodies: a comparison of homosexual and heterosexual men. , 1989, Psychosomatic Medicine.

[21]  A. Lemaire,et al.  Gonadal hormones in male anorexia nervosa , 1983 .

[22]  H G Pope,et al.  Eating disorders in college men. , 1995, The American journal of psychiatry.

[23]  S. Seidman,et al.  A review of sexual behavior in the United States. , 1994, The American journal of psychiatry.

[24]  J. Yager,et al.  Behaviors and attitudes related to eating disorders in homosexual male college students. , 1988, The American journal of psychiatry.

[25]  H. Pope,et al.  Is bulimia nervosa a heterogeneous disorder? Lessons from the history of medicine , 1988 .

[26]  J. Mitchell,et al.  Bulimia in male patients. , 1984, Psychosomatics.

[27]  H. Pope,et al.  BRIEF COMMUNICATION: Bulimia in Men: A Series of Fifteen Cases , 1986, The Journal of nervous and mental disease.

[28]  P. Lavori,et al.  Patterns and predictors of recovery in anorexia nervosa and bulimia nervosa. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[29]  J. Delahunt,et al.  Anorexia nervosa in the male: clinical features and follow-up of nine patients. , 1985, Journal of psychiatric research.

[30]  H. Koppeschaar,et al.  The paradoxical nature of sexuality in anorexia nervosa. , 1993, Journal of sex & marital therapy.

[31]  D. Herzog,et al.  Sexual conflict and eating disorders in 27 males. , 1984, The American journal of psychiatry.

[32]  W. Agras,et al.  Bulimia in males: A matched comparison with females , 1987 .