Eating Disorders are psychological disorders that result from a drive to be thin. They are broken down into three categories, anorexia nervosa, bulimia nervosa, and binge-eating disorder. Anorexia nervosa is diagnosed according to the DSM-III-R in individuals with body weight that is significantly lower than the norm, extremely concerned with weight and shape, distorted self-image, and an absence of three consecutive menstrual periods, in women. Bulimia Nervosa is diagnosed according to the DSM-III-R in individuals who have recurrent binge eating episodes, have weight and shape concerns, have a lack of control over such behavior, and have compensatory behaviors (e.g., vomiting, fasting, misuse of laxatives, or excessive exercise). Binge eating disorder has much of the same criteria as Bulimia Nervosa with the exception of the compensatory behaviors.
This study has several goals. First, the authors compare men with eating disorders to women with eating disorders, specifically to find clinical similarities. Because eating disorders are considered rare in men, the authors set out to investigate the differences between the two sexes. Second, the authors wanted to find differences in men with eating disorders and normal men. The authors also set out to find a representative sample that would provide the greatest validity. Concentrating on men with eating disorders, the authors also were looking for a correlation between eating disorders and other psychological disorders, such as affective disorder, anti-social personality disorder, and substance abuse. On the subject of sexual orientation, the authors explain, “…although an obvious area of investigation, (sexual orientation) was deemed too sensitive a topic for a government-sponsored survey and unfortunately was not assessed”.
Sixty-two men meeting the DSM-III-R criteria of an eating disorder, 212 women with equivalent eating disorders, and a control group of 3,769 men who had no presence of an eating disorder.
Community survey. Random houses were selected in Ontario. From each household an individual aged fifteen years and older was chosen at random and then administered the Mental Health Supplement to the Ontario Health Survey. The individual was then asked to submit written informed consent prior to the interview. A sample size of 9, 953 individuals was obtained by these means.
Subject reduction. Using the University of Michigan’s version of the World Health Organization Composite International Diagnostic Interview, the subjects were narrowed down. During this process, individuals were interviewed for one to two hours by trained interviewers. The subjects were assessed for anxiety disorders, substance use and or abuse, affective disorders, anti-social personality disorder, and of course eating disorders. To eliminate the burden of the lengthy interview, those subjects over the age of 64 were administered a shorter version of the Composite International Diagnostic Interview.
After completion of both interviews, 4,043 subjects ages 15-64 were remaining. These subjects were analyzed in terms of rates of comorbid psychiatric disorders, family history, childhood experiences, and quality of life.
Results show that men with eating disorders are clinically similar to women with eating disorders, and comparatively different from men without eating disorders. Two percent of men from the initial survey had an eating disorder compared to 4.8 percent of women with a similar disorder. Also, men with eating disorders showed higher rates of having a comorbid psychiatric disorder than men without eating disorders. When comparing family history and childhood experiences, men with and without eating disorders did not differ. However, the women showed higher rates of sexual abuse than either group of men. When evaluating the quality of life, the men with eating disorders rated this variable similar to women with eating disorders. On the other hand, the men without eating disorders rated their quality of life significantly higher than either of the two groups.
The outcome of this study suggests that men with eating disorders are more like women with eating disorders than men without eating disorders. The men with eating disorders are also more likely to have one or more comorbid psychiatric diagnosis than the men in the control group. The men with eating disorders and the control group had a similar rate of traumatic early life experiences. On the other hand, the women showed the highest rates of sexual abuse among the three groups. Finally, both the group of men with eating disorders and the women with eating disorders rated their quality of life to be significantly lower than the group of men without eating disorders. This suggests that a lower quality of life may either be a cause or an effect of such a disorder.