Elements of male body image: Prediction of depression, eating pathology and social sensitivity among gay men

Psychology Department, Saint Louis University, MO 63103, United States.
Body image (Impact Factor: 2.19). 09/2010; 7(4):310-6. DOI: 10.1016/j.bodyim.2010.07.006
Source: PubMed

ABSTRACT The aim of the current study was to assess the relative uniqueness of three components of male body image (i.e., muscle, body fat, and height dissatisfaction) in the prediction of indices of psychological distress (i.e., depression, eating restraint, eating concerns, and social sensitivity) among a community sample of 228 gay men. Results indicated that body fat dissatisfaction was predictive of all four criterion variables (controlling for muscle dissatisfaction). Conversely, muscle dissatisfaction was only associated with social sensitivity, while height dissatisfaction failed to significantly predict any of the criterion variables. These findings highlight the relative importance of body fat dissatisfaction among gay men and suggest that researchers and clinicians working with this population should utilize measures which include assessment of both muscularity and body fat.

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Une importance particulière est attribuée à l’orientation sexuelle. Une seule étude concerne l’efficacité d’un traitement des patients boulimiques avec des résultats concluant jusqu’à une année post-traitement. Cette revue de la littérature confirme l’existence de facteurs de risque communs aux deux sexes et souligne certaines particularités des TCA chez les hommes. Elle évoque également la nécessité de mener des études sur les traitements. Aims: Male eating disorders are often overshadowed by the higher incidence of such disorders in the female population. Over the last 10 years, there has been renewed interest in research on this topic, although few studies of male eating disorders have been carried out in France. The aim of this article is to summarize current research in this field. A literature review was conducted on the databases of PsycINFO, MEDLINE and ScienceDirect. Articles on samples of males suffering from obesity were excluded due to the specific nature of eating disorders in this population. In the case of articles containing samples of men and women, only data linked to the male sample was analyzed wherever possible. The results of 34 studies published between 2009 and 2014 were analyzed. Results: The results of studies using self-assessments which define the risk thresholds showed a frequency of eating disorders between 2.7 and 13.3% (Hilbert and Tuschen-Caffier, 2004; Gadalla, 2009; Paulson and Rutledge, 2014) 0060, 0065 and 0070. The frequency of subclinical disorders, in other words eating problems which do not fit all the diagnostic criteria of eating disorders, was 11.8% (Valls et al., in press) [17]. However, few studies indicated the frequency of eating disorders due to the use of self-assessments which do not contain a threshold score. The risk factors observed concerned dissatisfaction with body shape, notably the distinction between dissatisfaction with fat mass and dissatisfaction with muscle mass. However, no study has investigated eating disorders and the associations between dissatisfaction with fat mass and dissatisfaction with muscle mass. Frequent physical exercise was associated with the risk of developing eating disorders. This association was stronger when compulsive (four times greater risk) and compensatory (three times greater risk) dimensions of physical exercise were taken into consideration, regardless of sex (Sanftner, 2011) [25]. In addition, inappropriate eating behaviors alleviated emotional dysfunction such as difficulties in controlling emotions and intolerance of negative mood. Self-silencing, i.e. the denial or minimization of one's own emotions to prioritize others’ needs, was a strong predictor of eating disorders in American students (Dakanalis et al., 2014) [28]. Although men suffering from eating disorders have less cognitions associated to the body than women, cognitive behavioral characteristics were highlighted as risk factors, for example weak cognitive flexibility (inability to adapt to change, rigidity) and central coherence (focusing to details) which could be associated to inappropriate behavior aimed at increasing muscle (Brennan et al., 2011) [22]. Sociocultural factors such as adherence to masculine stereotypes which are associated with a pursuit of weight loss (Baillie and Copeland, 2013) [31], and interpersonal difficulties associated with bulimic behavior (Lavander and Anderson, 2010) [27] were also important. Particular importance was given to sexual orientation. The homosexual population had a significantly higher tendency towards the pursuit of weight loss and was more sensitive to media message, to body objectification and to identity conflicts related to sex (Carper et al., 2010; Dakanalis et al., 2012; Ålgars et al., 2010) 0175, 0190 and 0195. As in the case of women, studies showed an association between high depressive symptomatology and eating disorders (Valls et al., in press; Griffiths et al., 2014) 0085 and 0105. Finally, although there were studies focusing on possible treatments of male eating disorders, only one evaluated the efficiency of cognitive behavioral treatment of bulimic patients. The results of this study indicated a reduction in symptoms up to one year following treatment (Fernández-Aranda et al., 2009) [10]. Conclusion: Although this literature review was not exhaustive, it confirmed the existence of risk factors which are common to both sexes (for example dissatisfaction with weight, difficulties in controlling emotions and depression) and underlined certain peculiarities of male eating disorders (for example, distinction between dissatisfaction with fat mass and dissatisfaction with muscle mass). The importance of risk factors associated with the development of eating disorders in the homosexual population was highlighted. This article also evokes the lack of sensitivity and of information in society and amongst health professionals, as well as the need to carry out studies on the different types of treatment for men suffering from eating disorders.
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