Eating Disorder Exacts a High Toll on Men Too

Megan Brooks

October 28, 2011

October 28, 2011 — Men who binge eat suffer as much distress and impairment in their daily lives as women who binge eat, a new study shows.

Dr. Ruth H. Striegel-Moore

The study suggests that "a considerable subset of men" report binge eating, and that men who binge eat, much like women who binge eat, are "much more likely to be obese and more likely to report problems such as depression, high stress, and decreased workplace productivity," first author Ruth H. Striegel-Moore, PhD, professor of the social sciences, Wesleyan University, Middletown, Connecticut, told Medscape Medical News.

"Yet, from other studies we know that men are far less likely than women to seek or receive help for disordered eating," she said. Dr. Striegel-Moore encourages clinicians, especially those working with obese populations, to ask all their patients about binge eating. This is especially important in men, "who may feel reluctant to seek help for a problem that often is perceived as solely a woman's problem."

Lynn S. Grefe, president and chief executive officer of the National Eating Disorders Association, who was not involved in the study, said: "Sadly, men are overlooked generally when it comes to eating disorders of all kinds."

Echoing Dr. Striegel-Moore, she said stereotypes do exist, "which make it even harder for men to admit to needing help. There is often the myth that anorexia only effects women, or if a man binges, maybe it's a just a 'good appetite,' rather than anyone considering it might be an eating disorder. I believe boys and men have been ignored for too long, and gratefully some attention is now being paid to the problem."

The study was published online October 26 in the International Journal of Eating Disorders.

Comparable Burden

In a cross-sectional sample of 21,743 men and 24,608 women who participated in a health risk self-assessment screening, 1630 men (7.5%) and 2754 women (11.2%) were found to binge eat (ie, experience at least 1 binge episode in the prior month). The mean age of the binge eaters was around 42 years.

Compared with men who did not binge eat, those who did were more apt to be obese and have a range of health problems.

Table. Percentage With Clinical Impairment

Variable Binging Men Nonbinging Men
Obese 64.3% 29.5%
Hypertension 29.1% 21.5%
Dyslipidemia 29.5% 21.2%
Type 2 diabetes 8.7% 5.0%
Depressed 37.1% 12.6%
High stress 33.1% 14.3%

P < .0001 for all.

Men who reported binge eating also had more sleep problems and sick days and were less productive when at work than men who did not report binge eating. Women had similar levels of health problems and clinical impairment resulting from binge eating.

High Mortality Rate

The researchers say their findings are particularly noteworthy, given that their binge groups included anyone with at least 1 binge episode in the past month. "Most prior studies of the clinical significance of binge eating used a more restrictive criterion (at least weekly binge eating for 3 months)," they write.

Dr. Striegel-Moore notes that most studies into eating disorders recruit women. She says the "underrepresentation of men in binge eating research does not reflect lower levels of impairment in men vs women. Efforts are needed to raise awareness of the clinical implications of binge eating for men so they can seek appropriate screening and treatment."

Ms. Grefe told Medscape Medical News that eating disorders have the "highest mortality rate of any mental illness, and that needs to change."

"It is our hope," she said, "that the entire medical field will become much more receptive to learning the early warning signs and symptoms and how to make an appropriate referral. When that happens, when physicians can diagnose as easily as they would with measles, then we could seriously reduce the incidence and severity of chronic eating disorders. And, consequently, we should be able to prevent the deaths," Ms. Grefe said.

Dr. Striegel-Moore was compensated by HealthMedia, Inc, for her work on the study. Her coauthors are employees of HealthMedia, Inc. Ms. Grefe has disclosed no relevant financial relationships.

Int J Eat Disord. Published online October 26, 2011. Full text