Culture and Eating Disorders: A Singaporean Perspective — Part 2

I previously looked at two retrospective studies of anorexia patients in Singapore, which primarily concerned female patients. In this study, Tan et al (2014) looked at 72 male-identified patients diagnosed with all forms of eating disorders.

  • 1% had anorexia nervosa (15.3% binge-purge subtype, 20.8% restrictive subtype)
  • 3% had bulimia nervosa (27.8% purge subtype, 5.6% non-purge subtype)
  • 5% had EDNOS
  • 9% had BED

The mean age at intake was 19.9 years old; patients were mainly students (41.7%) and national servicemen (41.7%). Compulsory army service (National Service) usually takes place in the two years after high school graduation, though some may defer until completing further studies. The typical age range for those in National Service is 19-24.

Of the patients in the study, 88.9% identified a precipitating factor for their eating disorder, including being overweight (59.7% reported pre-morbid obesity) and having people make comments about their body. 68.1% of patients … Continue reading →

Beyond Thinness: Men, Muscularity and Eating Disorders

Eating disorder research tends to focus on girls and women. Which makes sense: eating disorders disproportionately affect women. However, it isn’t just the research on eating disorders that focuses on women: it’s the entire history of eating disorders as a diagnosis. The first descriptions of anorexia nervosa by William Gull and bulimia nervosa by Gerald Russell were both based primarily on observations of female patients (although Russell did include two men). Therefore, it’s possible that our basic construction of eating disorders is based on a specifically female experience.

One example of this is the focus on weight loss as a cardinal component of eating disorders (barring binge eating disorder). This is often attributed to the pursuit of a “thin ideal” created by our culture; however, this thin ideal doesn’t necessarily apply to men. Whilst women encounter pressure to be thin, evidence suggests that men encounter pressure to be more muscular—a … Continue reading →

Gendering the Pro-Anorexia Paradox: Men in Pro-Ana Spaces

When someone says “pro-ana,” what comes to mind? Likely, given the strong reactions pro-anorexia websites provoke, you may be able to conjure up an image of what would take place in such a forum. Thoughts of “thinspiration,” emaciated and waif-like images, and starving tips likely spring to mind, alongside considerations of the dangers of a community that would encourage behaviors that can be very harmful to health.

I’d venture to say that it is unlikely that you have pictured a man participating in these sites. Given that we know that men get eating disorders too, and that they may feel alienated in their struggles, is it surprising that some might seek out online communities, including pro-ana?

As Tetyana noted in previous posts on pro-ana (here and here), these sites can serve a harm reduction purpose and/or provide a space for sufferers to openly and honestly share their struggles … Continue reading →

Impossible Binaries? Eating Disorders Among Trans Individuals

Recently I was doing some research for an upcoming (and very exciting)  endeavour that involves exploring eating disorders among LGBTQ individuals. As one does, I set about scouring the research literature in this area in the hopes of stumbling across some prior articles on which to hang my proverbial research hat.

As I sifted through the databases, however, my searches kept coming up short. After sending out a call to a list-serv enquiring about the state of the field in this area, I received many responses highlighting the gap that surrounds trans individuals in particular. While this is good news for arguing for the value in conducting research in this area, it is discouraging news when it comes to understanding and attending to the experiences of trans people with eating disorders.

All this is to say, it seems as though now is as good a time as any to dip … Continue reading →

Life After Recovery for Men with Eating Disorders

While there is growing recognition that (surprise, surprise!) men are not immune to eating disorders, men are still underrepresented in the literature about eating disorders. We know comparatively little about what it is like to be a man with an eating disorder, and less still about recovery and life after recovery for these individuals. Recently, Björk, Wallin, & Pettersen (2012) conducted a qualitative study that asked men who had been diagnosed with an eating disorder and completed treatment to describe how recovery factors into their present lives. The researchers interviewed 15 men aged 19-52 (mean age 23) in Norway and Sweden, 10 of whom had been diagnosed with AN, 4 with BN, and 1 with EDNOS. The authors did not specify duration of illness.


The authors used a phenomenographical approach to study recovery among men. Though I am familiar with qualitative methods, this approach was new to … Continue reading →

Eating Disorders Among Lesbian and Bisexual Women

The hardest part of science blogging is picking an article to blog about. In times when I’m indecisive–when I spend hours sifting through the literature, inevitably creating several draft posts before deciding each article isn’t interesting enough–I turn to the list of topics that have been suggested by readers. The last suggestion I received was “eating disorders in the lesbian community.” It is a great suggestion, but I thought my search wouldn’t turn up much. But, to my surprise, it did turn up some studies.

But please, don’t expect too much: it is not a well-studied area, and most of the data comes from self-reported questionnaires, which are not particularly reliable:

  • First, there’s selection bias: the 50% or so of people who return the surveys could be different in significant ways from the 50% that don’t. For example, in a survey about mental health, perhaps individuals that have had
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Understanding Disordered Eating in Trans People

Gender nonconformity is the second most popular search term that leads people to Science of Eating Disorders. (After “science of eds” and beating “science of eating disorders”.) Not far behind are variants of “FtM/MtF/transsexual/transgender” combined with “eating disorder/anorexia/bulimia”. That’s telling. It means there is little information on this topic. And it is not just that there’s too little information available to the public – there are only a handful of published studies in the peer-reviewed literature.

One study (which I discussed in my previous post: Gender Nonconformity, Transsexuality and Eating Disorders) published by Vocks et al (2009), compared disordered eating patterns, body image disturbances and self-image scores among trans women and men (131 participants in both groups) and cis female and male controls as well as to females with eating disorders.

Overall, they found disordered eating patterns reported by trans women and trans men were in the middle of those diagnosed … Continue reading →

Eating Disorders: Do Men and Women Differ?

Given that eating disorders disproportionately affect women, it is not unreasonable to assume that men differ from women in clinical presentation, personality and psychological characteristics. My guess would be that they differ. My reasoning is this: males and females grow up facing different pressures and expectations. Given that, I’d think there would be (perhaps only slightly) different risk factors that predispose men and women to develop eating disorders. Thus, I’d think that different groups of men and women (i.e. with different personality characteristics, psychiatric comorbidities, and life experiences) would be susceptible to EDs. (Hopefully that makes sense.) To answer that question, Dr. D. Blake Woodside and colleagues compared men with eating disorders vs. women with eating disorders vs. men without eating disorders.

Why are females much more likely to suffer from eating disorders than males? It appears that (at least) two arguments have been put forth:

One argument has been that because eating disorders

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What’s it Like to be a Man with an Eating Disorder?

What is it like for men to live with an eating disorder? What is it like for men to seek and receive treatment for an eating disorder? These are the questions that Kate Robinson and colleagues asked a group of eight men who were receiving treatment (inpatient, day patient or outpatient) at two ED treatment centers in the UK. Their goal was to find out if and how men’s experiences with an eating disorder differ from women with eating disorders.

Men account for roughly 10% of eating disorder patients (when considering anorexia and bulimia, not including binge eating disorder, which is not yet part of the DSM). I suspect this number is actually higher – as less men probably realize they have an ED, admit to having an ED or seek treatment, precisely due to the issues raised in this article (and others). Given that men form a sizeable … Continue reading →

Gender Nonconformity, Transsexuality and Eating Disorders

Too many people still mistakenly believe that eating disorders are for the Mary-Kates, Nicole Richies and Lara-Flynn Boyles, or vain adolescent and teenage girls aspiring to be just like them. Actually, as I’ve blogged earlier, even male veterans in late middle age are not immune to struggling with anorexia and bulimia nervosa. All in all, males make up ~ 5-10% of all eating disorder sufferers.

But what about those that dread having to check off “male” or “female” on a data form? What about individuals who feel their gender identity is not the same as their assigned birth sex. Perhaps they were born in a female body, with two XX chromosomes, but they feel and prefer to think of themselves as males, or the reverse? There’s some research (albeit limited, due to the rarity of both gender dysphoria and eating disorders) that suggests these individuals face an increased … Continue reading →