Including the excluded: Males and gender minorities in eating disorder prevention Leigh Cohn, Stuart B. Murray, Andrew Walen, and Tom Wooldridge
National Association for Males with Eating Disorders, Naples, Florida, USA
By operating under the outdated premise that eating disorders (ED) predo- minantly affect females, prevention efforts have been disproportionately aimed at girls and young women. This article will show how one-sided the research and program development has been, and present recommendations for how to expand curricula and policy to be more gender inclusive. Ultimately, ED and related issues (e.g., body image dissatisfaction, obesity, comorbid conditions, weight prejudice, etc.) cannot be expected to decrease unless everyone is involved, regardless of gender. We wouldn’t only inoculate girls for measles—preventing ED across the board is the only fully effective approach.
Adolescent girls: The face of a disorder
Try telling a stranger that you specialize in “males and eating disorders,” and the typical response is, “You mean like those poor starving girls. I didn’t know guys got eating disorders.” It’s infuriating, but somehow worse when it is members of the ED field thinking that way. This kind of ignorance starts with inaccuracies. Since the 1980s, the oft-repeated, not-cited statistic has been that 10% of individuals with ED are male. Erroneous to begin with, the number originated from a study that counted 241 people referred for ED at one hospital over a period of 3.5 years, prior to 1985. Twenty-four were males, some of which didn’t meet ED criteria, but because it wasn’t clear how many of the women fully met the criteria, the 10% is somewhat vague (Andersen, 1985). The figure does not represent other treatment providers’ admissions or the general population, and it was not replicated. Further, few physicians or members of the general public knew much about ED in the early 80s, and the admissions in those years predated the field’s emergence that soon followed. It is likely that the actual male prevalence at that time was much higher, as became evident in later studies.
Nonetheless, 10% has been parroted in books, professional articles, on ED organizations’ websites, and in popular media for the nearly 30 years, and it
CONTACT Leigh Cohn Leigh@gurze.net Eating Disorders: The Journal of Treatment and Prevention, P.O. Box 2238, Carlsbad, CA 92018, USA.