ArticlePDF Available

The prevalence and impact of eating disorder behaviours in Australian men

Authors:

Abstract

Objective To determine sex differences in the prevalence and associated impairment of eating disorder (ED) features over time. Method Cross-sectional surveys of randomly selected adults were carried out in 1998 (n = 3010) and 2008 (n = 3034). Outcomes included self-reported health-related quality of life (HRQoL), objective and subjective binge eating, extreme dieting, purging, and overevaluation of weight or shape. Results Men represented 23-41% of participants who reported ED features. Objective binge eating was associated with greater reductions in mental HRQoL in men compared to women (p < 0.05), whereas overevaluation of weight or shape was associated with greater reductions in HRQoL in women compared to men (p < 0.05). The prevalence of extreme dieting and purging increased at a faster rate in men compared to women (p = 0.03), whereas the rate of increase in objective binge eating was similar between the sexes (p > 0.05). Mental HRQoL impairment associated with binge eating had increased over time for men but not for women (p < 0.05).
ORAL PRESENTATION Open Access
The prevalence and impact of eating disorder
behaviours in Australian men
Deborah Mitchison
1*
, Jonathan Mond
2
, Shameran Slewa-Younan
3
, Phillipa Hay
4
From 2013 ANZAED Conference: Inspiring Change: Person and Context
Melbourne, Australia. 23-24 August 2013
Objective
To determine sex differences in the prevalence and
associated impairment of eating disorder (ED) features
over time.
Method
Cross-sectional surveys of randomly selected adults were
carried out in 1998 (n = 3010) and 2008 (n = 3034).
Outcomes included self-reported health-related quality
of life (HRQoL), objective and subjective binge eating,
extreme dieting, purging, and overevaluation of weight
or shape.
Results
Men represented 23 - 41% of participants who reported
ED features. Objective binge eating was associated with
greater reductions in mental HRQoL in men compared
to women (p < 0.05), whereas overevaluation of weight or
shape was associated with greater reductions in HRQoL
in women compared to men (p < 0.05). The prevalence
of extreme dieting and purging increased at a faster rate
in men compared to women (p = 0.03), whereas the rate
of increase in objective binge eating was similar between
the sexes (p > 0.05). Mental HRQoL impairment asso-
ciated with binge eating had increased over time for men
but not for women (p < 0.05).
Conclusions
The gender gap in the prevalence and impact of ED
behaviours may be closing. Implications include the
need for more gender-neutral public health campaigns
and interventions, and the active inclusion of male parti-
cipants in ED research.
This abstract was presented in the Disordered Eating
Characteristics & Treatment stream of the 2013
ANZAED Conference.
Authorsdetails
1
School of Medicine, University of Western Sydney, Australia.
2
Centre for
Applied Psychology, University of Canberra, Australia.
3
School of Medicine,
University of Western Sydney, Australia.
4
Centre for Health Research, School
of Medicine, University of Western Sydney, Australia.
Published: 14 November 2013
doi:10.1186/2050-2974-1-S1-O23
Cite this article as: Mitchison et al.: The prevalence and impact of
eating disorder behaviours in Australian men. Journal of Eating Disorders
2013 1(Suppl 1):O23.
Submit your next manuscript to BioMed Central
and take full advantage of:
Convenient online submission
Thorough peer review
No space constraints or color figure charges
Immediate publication on acceptance
Inclusion in PubMed, CAS, Scopus and Google Scholar
Research which is freely available for redistribution
Submit your manuscript at
www.biomedcentral.com/submit
* Correspondence: debbie.mitchison@gmail.com
1
School of Medicine, University of Western Sydney, Australia
Full list of author information is available at the end of the article
Mitchison et al.Journal of Eating Disorders 2013, 1(Suppl 1):O23
http://www.jeatdisord.com/content/1/S1/O23
© 2013 Mitchison et al; licensee BioMed Cent ral Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attri bution License (http://c reativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproductio n in any medium, provided the original work is properly cited.
... disorders' (BIDs) category, along with eating disorders (EDs; Mitchison et al., 2013;Phillipou et al., 2015Phillipou et al., , 2018. The focus of concern of individuals with BDD may pertain to any part of the body (Buescher & Buescher, 2006;Phillips et al., 2000;Veale, De Haro, et al., 2003), and they may be simultaneously concerned with multiple body parts . ...
... Moreover, BDD is a psychological disorder characterized by a broad disturbance in body image (Cororve & Gleaves, 2001;Didie et al., 2010;Rosen & Ramirez, 1998), which represents the core feature of the disorder. In accordance, BDD has been suggested to pertain, along with EDs (Mitchison et al., 2013;Phillipou et al., 2015Phillipou et al., , 2018, to an encompassing 'Body Image Disorders' category. Not surprisingly, BDD and EDs are frequently comorbid (Dingemans et al., 2012;Grant et al., 2017;Ruffolo et al., 2006;Schulte et al., 2020), and individuals with BDD are frequently characterized by weight-and shape-related concerns (Kittler et al., 2007;Veale, Kinderman, et al., 2003). ...
Article
Background: Body Dysmorphic Disorder (BDD) is characterized by concerns for perceived defects in physical appearance that appear to others as mild or unobservable. Individuals with BDD frequently refer concerns with their physical appearance being 'not right' (Not Just Right Experiences; NJREs), and BDD related behaviors may be performed until their appearance is perceived as 'right'. The aim of the study was to explore the relationship between BDD and NJREs in cosmetic surgery and aesthetic medicine settings. Methods: Individuals requesting cosmetic procedures with BDD symptoms (BDD-Symptoms group; n = 24), without BDD symptoms (Cosmetic Intervention [CI] group; n = 45), and individuals that have never required these procedures (No Cosmetic Intervention [NCI] group; n = 53) entered the study. Results: Results showed a greater number of past-month NJREs, higher NJREs severity, higher drive for thinness, and greater general distress in the BDD-Symptoms group. Pertaining to features associated with NJREs (perfectionism and obsessive-compulsive disorder symptoms) and ED core features, the BDD-Symptoms group scored higher only with respect to NCI. Regression analyses showed that BDD symptoms were predicted by age, NJREs severity, and drive for thinness above and beyond general distress, perfectionism, obsessive-compulsive disorder symptoms, bulimia and body dissatisfaction related to weight and shape in the BDD-Symptoms group (in comparison with the CI and NCI groups). Conclusions: NJREs may represent a potential vulnerability factor for BDD symptoms in cosmetic settings.
... As eating disorders affects both men and women (Mitchison, Mond, Slewa-Younan, & Hay, 2013), the absence of male participants in this area of research is concerning. Future research should incorporate a broader focus on gender. ...
Article
Participation in friluftsliv has gained increased attention along with the growing concern regarding the extended prominence of mental health challenges. The objective of this study was to conduct a systematic review of various forms of friluftsliv as part of recovery processes for people experiencing eating disorders. Following the PRISMA guidelines, we systematically searched in five databases and 5,994 hits were retrieved. Screening of abstracts according to the inclusion and exclusion criteria identified 13 full-text studies as eligible. The most prominent findings were improved body image and enhanced self-esteem following participation in friluftsliv. However, more high-quality research is necessary for an increased understanding of if, and how, friluftsliv can contribute in the recovery processes and reduction of factors associated with eating disorders.
... Although EDs can occur in people across the gender spectrum, they are still largely considered to be female-gender-bound (Collier, 2013; see also Thapliyal, Mitchison, & Hay, 2017). Despite the commonly cited statistic that men comprise only 10% of ED cases (see Cohn, Murray, Walen, & Wooldridge, 2016), recent studies suggest that 25-33% of those with EDs are male-identified (Akgül et al., 2016;Hudson, Hiripi, Pope, & Kessler, 2007;Murray et al., 2017;Sweeting et al., 2015), and the prevalence of ED behaviors in men has been increasing in recent years (Galmiche et al., 2019;Mitchison, Hay, Slewa-Younan, & Mond, 2014;. Additionally, men who present with EDs are less likely to be recommended for an ED consult and less likely to be diagnosed with an ED than are women who present with similar symptoms (Grillot & Keel, 2018;MacCaughelty, Wagner, & Rufino, 2016). ...
... These findings, and the large effect sizes, suggest that, motivation for AAS use may be important in accounting for adverse body image-related sequelae associated with AAS use. With current evidence suggesting an increasing prevalence of AAS use amongst boys and young men (e.g., Partnership for a DrugFree America, 2013), and similar evidence suggesting an increase in the prevalence of ED behaviors in males (Mitchison et al., 2013), and muscularity-oriented behaviors in particular (Murray et al., 2016), a thorough explication of the relationship between AAS use and body image psychopathology may assist in interventive efforts. The present results are consistent with findings noting the greater prevalence of non-athletic as opposed to athletic-driven motivations for AAS use (Kanayama et al., 2001), although extend our G Model DAD-6078; No. of Pages 5 Table 2Summary statistics for the ANOVAs examining clinical and demographic data as a function of current motivation for anabolic androgenic steroid use. ...
Article
Objective: Anabolic androgenic steroid (AAS) use has been robustly associated with negative body image, and eating- and muscularity-oriented psychopathology. However, with AAS being increasingly utilized for both appearance and athletic performance-related purposes, we investigated whether comorbid body image psychopathology varies as a function of motivation for usage. Method: Self-reported motivation for current and initial AAS use was recorded amongst 122 AAS using males, alongside measures of current disordered eating and muscle dysmorphia psychopathology. Results: Those reporting AAS for appearance purposes reported greater overall eating disorder psychopathology, F(2, 118)=7.45, p=0.001, ηp(2)=0.11, and muscle dysmorphia psychopathology, F(2, 118)=7.22, p<0.001, ηp(2)=0.11, than those using AAS primarily for performance purposes. Additionally, greater dietary restraint, F(2, 116)=3.61, p=0.030, ηp(2)=0.06, functional impairment, F(2, 118)=3.26, p=0.042, ηp(2)=0.05, and drive for size, F(2, 118)=10.76, p<0.001, ηp(2)=0.15, was demonstrated in those using ASS for appearance purposes. Discussion: Motivation for AAS use may be important in accounting for differential profiles of body image psychopathology amongst users. Men whose AAS use is driven primarily by appearance-related concerns may be a particularly dysfunctional subgroup.
... Internationally, disordered eating is more prevalent among girls than boys (Hudson, Hiripi, Pope, & Kessler, 2007). However, EDs are rapidly increasing among men, with some disordered eating practices (such as purging) increasing at a faster rate among males than females (Mitchison, Mond, Slewa-Younan, & Hay, 2013). Male ED cases may be under-detected in research and clinical practice due to standard assessment instruments' concentration on drive for thinness rather than muscularity, which characterises many male presentations of EDs (Compte, Sepulveda, & Torrente, 2015;Griffiths, Murray, & Touyz, 2013). ...
Article
Little research has investigated adolescents’ understanding of eating disorders (EDs) or attitudes towards people affected by EDs. This impedes the development of targeted health promotion interventions. In the current study, 290 adolescents viewed a vignette depicting a target with either anorexia nervosa, bulimia nervosa, binge eating disorder, Depression or Type 1 Diabetes. Subsequent questionnaires assessed understanding of and attitudes towards the disorder described. Adolescents recognised the symptoms of depression significantly more frequently than any ED. Relative to depression and Type 1 diabetes, participants held targets with EDs more personally responsible for their illness and ascribed them more negative personality characteristics. The data revealed a particularly unfavourable view of binge eating disorder, which was conceptualised as a failure of self-discipline rather than a medical condition. The results confirm previous findings that EDs are more stigmatised than other mental or physical health conditions and extend the findings to an adolescent cohort.
... When it comes to subclinical eating disordered behaviors, according to a review of numerous studies (Mond, Mitchison, & Hay, 2014), the percentages are even higher for males in subclinical ED (42-45% binge eat, 28-100% regularly purged, 40% endorsed laxative abuse and fasting for weight loss). Perhaps the most illustrative recent data point to disordered eating practices in the community, for the very first time, increasing at a rate faster in males than females (Mitchison, Mond, Slewa-Younan, & Hay, 2013). Okay, if this rising prevalence now means that about 25-50% of individuals with ED are male, shouldn't we see at least a similar distribution of prevention studies? ...
... Australian & New Zealand Journal of Psychiatry disorder diagnoses, including up to 33% of diagnoses of anorexia and bulimia nervosa (Hudson et al., 2007) and 25% of early-onset eating disorder diagnoses (Madden et al., 2009). Further, among Australian men, the prevalence of eating disorder behaviours has increased during the past two decades (Hay et al., 2008) with some behaviours, namely extreme dieting and purging, increasing faster among Australian men than women (Mitchison et al., 2013). Despite these trends, no research to date has examined whether the link between positive beliefs about anorexia nervosa and eating disorder symptoms generalises from women to men. ...
Article
The ego-syntonic nature of anorexia nervosa means that sufferers often deny their symptoms or experience them as positive or comforting. Positive beliefs about eating disorder symptoms may contribute to the development and/or maintenance of eating-disordered behaviour. To date, however, research in this field has been confined to women and anorexia nervosa. Given increasing scientific interest in muscle dysmorphia, a potential eating disorder with ego-syntonic qualities, there is a need to extend current research to include men and muscle dysmorphia. The present study examined whether positive beliefs about anorexia nervosa and muscle dysmorphia were associated with more marked eating disorder symptoms and explored sex differences in these associations. Male and female university students (n = 492) read descriptions of a male or female character with clinically significant symptoms of anorexia nervosa or muscle dysmorphia. Participants subsequently answered questions about the characters and completed a measure of disordered eating. Knowledge, personal history and interpersonal familiarity with the conditions were assessed. Results from two simultaneous multiple regressions showed that more positive beliefs about anorexia nervosa and muscle dysmorphia were uniquely associated with more eating disorder symptoms for both male and female participants. Effect sizes for these relationships were medium to large (partial eta-squared = 0.09-0.10). The relationships were not moderated by the sex of the participant, nor the sex of the character. Although preliminary, these findings suggest that, among young men and women, positive beliefs about anorexia nervosa and muscle dysmorphia may contribute to the development and maintenance of these conditions. Some symptoms of muscle dysmorphia may be perceived as ego-syntonic, providing another parallel with anorexia nervosa. © The Royal Australian and New Zealand College of Psychiatrists 2015.
... Indeed, we know that the vast majority of people in the community with EDs do not seek or receive treatment, [10][11][12][13] and particularly underrepresented groups may include males, and those who are older, poorer, or more remote-dwelling. 14 Thus, while clinical studies may be representative of a treatment-receiving population, they are likely not representative of the wider ED population. A problem that may arise from this is that any factors found to be significantly correlated with EDs in clinical studies may be artificially so, especially if the impact of characteristics particular to a treatment-receiving group -such as being younger, female, or more motivated -are not carefully partialed out. ...
Article
Full-text available
The aim of this review was to summarize the literature to date regarding the sociodemographic, environmental, and genetic correlates of eating disorders (EDs) in adults. A keyword search was entered into Scopus (SciVerse, Elsevier) to identify relevant articles published in English up until June 2013. Articles were assessed against a range of a priori inclusion and exclusion criteria. A total of 149 full-text articles were found to be eligible for the review and included 86 articles with data on sociodemographic correlates, 57 on environmental correlates, and 13 on genetic correlates. Female sex, younger age, sexual and physical abuse, participation in esthetic or weight-oriented sports, and heritability were found to be most consistently associated with higher ED prevalence and incidence. Conversely, ethnicity, socioeconomic status, education, and urbanicity did not appear to have strong associations with ED epidemiology. More community-based research, with an equal representation of males, needs to be conducted to confirm the current findings and provide evidence for emerging factors that may be related to EDs.
Article
Background: Public opinion research shows that eating disorders (EDs) are a major target of stigmatisation. To understand the implications of this stigma, research investigating how stigma is experienced by individuals with EDs is critical. Aim: This paper aims to collate, evaluate and synthesise the extant empirical research illuminating how people with EDs experience the stigma associated with their condition. Method: A systematic mixed-methods literature search was performed. Articles that met a specified set of inclusion criteria underwent a quality assessment and thematic synthesis. Results: Twenty-nine articles were included in the review. Studies were mostly qualitative and of reasonable methodological quality. The literature was characterised by five research themes, illuminating (i) the nature and prevalence of stigma experienced, (ii) stigma in families, (iii) stigma in healthcare contexts, (iv) self-stigmatisation and illness concealment, and (v) stigma resistance. Conclusions: The reviewed research showed that people with EDs have extensive experience of stigma in diverse settings. They report that stigma has negative implications for their psychological wellbeing and likelihood of help-seeking. However, research also shows that people with EDs actively seek to resist and challenge stigma. The review identifies the outstanding gaps and weaknesses in this literature.
Article
Full-text available
Objective: Lengthy delays in receiving treatment have been reported for people with bulimia nervosa (BN) and binge-eating disorder (BED). This study aimed to investigate healthcare use and predictors of mental health specialist healthcare use in a community sample of individuals with diagnostic threshold symptoms of BN, BED-Broad, or another eating disorder (Other ED). Method: In 2017, 2,977 individuals aged ≥15 years were interviewed in a general population survey. Participants were asked questions relating to sociodemographic, ED symptoms, other clinical features, and healthcare use data. Assessment of ED symptoms was based on diagnostic questions derived from the eating disorder examination. Results: Thirty-six participants with symptoms of BN, 33 participants with BED-Broad, and 369 with an Other ED were identified. Fewer people with symptoms of BN/BED-Broad (23%) or an Other ED (6%) had treatment from a mental health specialist than from a general practitioner (GP; 80%, 71.6%). Healthcare use differed significantly across type of ED only for treatment from a mental health specialist. In multivariate analyses, being asked about a person's mental health by a GP was the best explanatory variable for receiving treatment from a mental health specialist. Discussion: A large treatment gap exists in healthcare for people with EDs. Inquiry about an individual's mental health by a GP was associated with higher rates of treatment from mental health specialists. However, a similar diet/eating inquiry did not have this association. Future research should consider the use of this patient and practitioner consultation in targeting improved detection of EDs.
ResearchGate has not been able to resolve any references for this publication.