Anorexia nervosa in the male: A review of clinical, epidemiological and biological findings

Abstract

This paper collates previous reports of anorexia nervosa in males. Although as inclusive as possible, greater emphasis is given to certain papers in order to illustrate particular aspects of the male condition. Reasons are proposed as to why the diagnosis in males has been overlooked by many practitioners and theorists. The clinical picture and epidemiological features are described. The main endocrinological factors are presented and compared with those occurring in females. A sociocultural model is offered as one best integrating our knowledge of male anorexics. Running throughout is the general impression that anorexia nervosa within males is a counterpart to female anorexia. The applicability of the Feighner criteria to males is queried.

Gynecomastia as a precipitant of eating disorders in adolescent males

“…There is some question in the literature as to whether male patients with eating disorders tend to have concern over their sexual identity (Bruch, 1971;Beumont, Beardwood, & Russell, 1972;Herzog, Norman, Gordon, & repose, 1984;Burns & Crisp, 1984;Scott, 1986;Schneider & Agras, 1987;Yager, Kurtzman, Landsverk, & Wiesmeier, 1988). This seemed to be the case with one of the two patients, although on-going psychiatric evaluation showed this to be less of an issue than originally thought.…”

The involvement of psychosexual factors in the causation of eating disorders: Time for a reappraisal

“…Recently, Scott (1986) has collated previous reports of AN in males, that general impression being that this was indeed the counterpart to female anorexia. As such, comparable psychosexual disturbances should be apparent.…”

“…Absence of sexual activity at either the behavioral or fantasy level was also observed in Crisp and Toms' (1972) male group. Of the 59 cases spanning more than the past half century reviewed by Scott (1986), 32% exhibited some form of sexual disturbance.…”

“…Several authors have commented on homosexual confiicts preceding the onset of anorexia i n up to 50% of males, and Crisp (1970) has suggested that this may play a comparable role to the alleged heterosexual threat in the female. However, the possible homosexual factor is probably not some specific sexual indination bur rather a general lack of sexuality (Scott, 1986). It has not yet been established if there is a greater proportion of homosexuals within the male anorexic population than within the general population.…”

“…The increased inadence of female anorexics seen in recent years supports this cultural hypothesis and invites speculation regarding particular soda1 changes that may have heightened females' vulnerability. The heightened pressure on women to meet the current thinner standard for physical attractiveness has likely provided the growing impetus for dieting and consequent AN (Scott, 1986).…”