Eating Disorders Varies by Men-Consumer Health News

Monday, February 28, 2022 (HealthDay News)-People tend to have a particular image when thinking about eating disorders-a disturbingly slender white girl with slender arms, ribs, and scapulas. ..

I can’t think of a torn, plump muscular guy who grabs a protein shake and worries about carbs between weightlifting sessions. But maybe you should.

Men and some minority groups are significantly underestimated in clinical trials studying treatment options Eating disordersNew research report.

Helen Burton Murray, director of the GI Behavioral Health Program at Massachusetts General Hospital and co-author of the study, said that in the last decade, the percentage of men who participated in eating disorder clinical trials was “less than half of what we expected.” was. Boston hospital.

According to experts, part of the problem is that men are not considered as vulnerable to eating disorders as women, and doctors are reluctant to diagnose them.

But they may also be looking for the wrong symptoms. According to experts, there may be a male-type eating disorder that is completely different from the established condition in women.

Clinical trials Bulimia According to Burton Murray, between 2011 and 2020, about 20% of men are included, which is about half of the men needed for true expression. Recent estimates indicate that men as a whole account for 40% of bulimia nervosa.

Male expression Anorexia/ /Bulimia The study got worse. Men account for 19% of cases of binge eating or bulimia, but in clinical trials of these conditions, male participation was less than 5%.

One possible reason is that doctors rarely find eating disorders in men, Barton Murray said. Men also do not seek treatment as often as women, so they are less likely to be included in treatment trials.

“Other research studies have shown that men are less likely to be diagnosed with or treated for eating disorders than women,” Burton Murray said. “That may be one of the reasons why men weren’t included, probably because the recruitment strategy for these studies was to recruit from a group of clinics already diagnosed with eating disorders.”

The findings were recently published in the journal JAMA network open..

Dr. Timothy Walsh, founder of the Eating Disorders Research Program at the New York State Institute of Psychiatry / Columbia University Irving Medical Center, said that pattern of more women enrolling in the study than men applies to all clinical studies. Said.

Fear that men may distort test results

“In general, women have been found to be overrated in clinical trials,” Walsh said. “In my understanding, women spend more on medical care in this country than men. Women tend to go to the clinic for both general care and research, whatever the combination of reasons. . “

However, it is also true that men have historically been ignored in the treatment and research of eating disorders, said the director of the Eating Disorders Program at the University of Southern California, Keck School of Medicine and Translational Research at the Institute for Eating Disorders. One Stuart Murray said.

According to Murray, the first cases of anorexia reported in 1860 included both men and women.

“From the beginning, we knew this was a disorder that could affect men,” he said.

But even though the field has grown exponentially over the next century with the development of diagnostic criteria, symptom measurements, and even treatments, men have been excluded from the study of eating disorders, Murray said.

“All of these really important developments happened without any research from men,” Murray said.

This has led to women-centric diagnostic criteria. For example, she cannot be diagnosed with loss of appetite unless the menstrual cycle stops, Murray said.

Even if medicine finally admits that men may develop eating disorders, Murray said those cases were considered so rare that they could distort the results of clinical trials. He added. Therefore, men tend to be excluded directly from eating disorder studies.

It is now known that men, like women, can develop anorexia nervosa, bulimia nervosa, and bulimia nervosa.

“They are very similar to women’s symptoms. With the limited data we have, no one thinks they need significantly different treatments or interventions,” Walsh said. ..

However, there are also gender-specific types of eating disorders that affect men and have not been properly defined or studied, Murray said.

Attachment to muscle and protein

“If you believe that eating disorders are somehow related to your ideal body image, your ideal body will be very different for men and women,” Murray said. “The ideal female body is thin, very thin, and very lightweight, which causes the behavior we consider to be a classic eating disorder.

“The ideal male body is often super-muscular and lean, a kind of really torn and really big,” he continued. “The ideal body does not cause the same sequence of actions at all. If you are limiting calories, you are unlikely to achieve such a body.”

That state among men-what he calls Muscle-oriented eating disorders -Murray said it includes protein counting, meal schedules, food preparation, and strict rules that “don’t want to be dragged without protein powder.”

“If they can’t eat enough, these people are often anxious,” Murray said. “These people are often anxious if they are too long between meals, because they are worried that their body is not permanently supplemented with protein to support maximum muscle growth. Because there is.

“It’s stiff. It’s based on rules. It’s a detriment to normal life-it’s all the hallmarks of eating disorders, but it’s aimed at becoming more muscular rather than thinner. It’s the only thing. That’s the difference, “Murray concludes.

Researchers say that the way eating disorder trials deal with minority groups is also problematic, but not well defined.

Researchers have found that many eating disorder studies do not care about race or ethnicity. Only about 62% of the trials reported race and 43% ethnicity.

Among these race-reporting clinical trials, the study found that Hispanics and Asian Americans appear to be underestimated.

This may be because minority groups have less access to health care or are less likely to seek care, Barton Murray and Walsh said.

“People with limited financial resources and people with minorities generally do not have good access to health care,” Walsh said. “It may be reflected by their underestimation in eating disorder treatment trials. These problems are real, but they extend beyond eating disorder trials.”

Burton Murray may have missed a study in which her study focused only on 21 trials published on ClinicalTrials.gov, which did not report results or studies conducted in other countries. I warned that there was.

But she recently studyFocusing on minority representatives in such trials, came to similar conclusions and included both clinical trials and observational studies.

For more information

The National Center of Neurology and Psychiatry, Eating disorders..

Source: Helen Burton Murray, PhD, Director, GI Behavioral Health Program, Massachusetts General Hospital, Boston; B. Timothy Walsh, Doctor of Medicine, Professor of Psychiatry, Columbia University, New York City. Dr. Stuart Murray, Director of Translational Research, Eating Disorders Program and Institute of Eating Disorders, Keck School of Medicine, University of Southern California, Los Angeles. JAMA network openFebruary 21, 2022