Caring for eating disorders in males: a marathon not a sprint

Eating disorder diagnoses in boys and men are on the increase. Some estimates are that 1 in 4 adults with an eating disorder is male. It can no longer be considered a ‘rare or unusual diagnosis’ and good treatments are available, as is self-help, via online and third sector resources.

The risk factors for boys and men can differ significantly from those for females, and we should be aware of not only the possibility of an eating disorder such as bulimia or anorexia, but also who is at higher risk. Sporty and athletic men are at higher risk, and ‘muscle dysmorphia’ is essentially a ‘male’ symptom, a feeling of being less muscular than you really are. Non-heterosexual men are another higher risk group.

As clinicians, the biggest challenge may be how to bring the topic up in a sensitive way. People rarely present with the eating disorder as the presenting complaint, and we must be confident to gently enquire about eating habits and body image. It can take time to build that trust with your patient, and the initial consultation may just open that door, in a non-judgemental way, allowing future consultations to explore further, or to discuss referral to an appropriate colleague.

Anorexia has the highest mortality of any psychiatric condition, which puts additional responsibility onto clinicians not to ignore potential signs and symptoms. Rapid weight loss, frequent vomiting after meals, haemodynamic changes in pulse and BP, and abnormal blood results should be taken extremely seriously and specialist advice sought.

As a clinician ask yourself if you ever try to avoid asking that challenging question, opening a potential can of worms, about someone’s eating habits or weight? Might it not actually be a huge relief to them that someone has finally asked them to talk about this thing that is taking over their life? Do you feel able to offer them some hope of treatment, support and recovery, even if the first step is just getting the patient to recognise there is a problem? Eating disorders are usually treatable, don’t be afraid to ask.

Read Dominique Thompson’s article here.

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