Q. Is anorexia ever a problem for men?
A. Anorexia nervosa—the name means “nervous lack of appetite”—is a disorder that involves intense fear of gaining weight and a distorted body image, leading to selfstarvation and emaciation. About 90% of people with anorexia are female, so the disorder is oft en overlooked when it occurs in men and boys.
Researchers are only beginning to understand the imbalance between the sexes. One explanation they consider: Women are more likely to seek psychiatric care for the disorder and receive the diagnosis. But that is certainly not the whole story. In fact, some researchers think that men who develop this largely female disorder are more open to seeking treatment than most men.
Female hormones are certainly one factor. Anorexia nervosa oft en starts in puberty, when levels of the female hormone estrogen increase in girls (and to a lesser extent in boys). In experiments, animals eat less if they are given estradiol, a form of estrogen. Genetic variations in receptors for estrogen are associated with eating disorders. Estrogen also aff ects recep tors for the neurotransmitter serotonin, and people with eating disorders sometimes have abnormal serotonin function. So interactions between estrogen and serotonin may aff ect vulnerability to the illness.
Like most psychiatric disorders, anorexia nervosa has both environmental and genetic causes. In one common pattern, a mother passes on a hereditary vulnerability to her daughter, while also teaching, mostly by example, attitudes toward eating, fi tness, and sexuality that promote anorexia. Th e child of a mother with anorexia therefore bears a doubled burden.
Culture is also important. At least in Western cultures, girls oft en receive praise for watching what they eat and losing weightЧpraise that makes up for feelings of insecurity in other spheres.
But the Y chromosome is not an impervious shield against anorexia. Boys in general may be less concerned about their body shape than girls, but they too can inherit a vulnerability to the disorder, and recent research shows that upbringing and culture can also predispose them to anorexia.
Boys who want to be big and muscular are more susceptible than girls to Уmuscle dysmorphia,Ф a condition that compels them to work out compulsively. Some authorities now regard this as a male equivalent of anorexia nervosa. (See Mental Health Letter, July 2005). But many boys also say they want to be thinner. In one study, three-fi ft hs of girls and twofift hs of boys expressed that wish. So boys too can develop anorexia in the classic sense. As in women, the illness usually begins in adolescence and persists well into adulthood. Th esymptoms are as severe and last as long. Males with anorexia are just as concerned about their body shape as anorexic women, and just as vulnerable to low self-esteem, depression, anxiety, social isolation, and suicidal thinking. Selfstarvation can interfere with the menstrual cycle of adolescent girls, and it can stunt growth in adolescents of both sexes.
Th ere is evidence that boys and men with anorexia are more likely than average to be homo sexually oriented. Some believe the disorder is unusually common in men with an atypical gender identity (for example, biological males who think of themselves as women).
Research in this area is still in its early stages. We have much more to learn about biological and environmental infl uences on appetite, body image, and sexuality. In the meantime, it is good to be aware that men as well as women suff er from anorexia, and the suff ering is similar in both sexes.
Researchers are only beginning to understand the imbalance between the sexes. One explanation they consider: Women are more likely to seek psychiatric care for the disorder and receive the diagnosis. But that is certainly not the whole story. In fact, some researchers think that men who develop this largely female disorder are more open to seeking treatment than most men.
Female hormones are certainly one factor. Anorexia nervosa oft en starts in puberty, when levels of the female hormone estrogen increase in girls (and to a lesser extent in boys). In experiments, animals eat less if they are given estradiol, a form of estrogen. Genetic variations in receptors for estrogen are associated with eating disorders. Estrogen also aff ects recep tors for the neurotransmitter serotonin, and people with eating disorders sometimes have abnormal serotonin function. So interactions between estrogen and serotonin may aff ect vulnerability to the illness.
Like most psychiatric disorders, anorexia nervosa has both environmental and genetic causes. In one common pattern, a mother passes on a hereditary vulnerability to her daughter, while also teaching, mostly by example, attitudes toward eating, fi tness, and sexuality that promote anorexia. Th e child of a mother with anorexia therefore bears a doubled burden.
Culture is also important. At least in Western cultures, girls oft en receive praise for watching what they eat and losing weightЧpraise that makes up for feelings of insecurity in other spheres.
But the Y chromosome is not an impervious shield against anorexia. Boys in general may be less concerned about their body shape than girls, but they too can inherit a vulnerability to the disorder, and recent research shows that upbringing and culture can also predispose them to anorexia.
Boys who want to be big and muscular are more susceptible than girls to Уmuscle dysmorphia,Ф a condition that compels them to work out compulsively. Some authorities now regard this as a male equivalent of anorexia nervosa. (See Mental Health Letter, July 2005). But many boys also say they want to be thinner. In one study, three-fi ft hs of girls and twofift hs of boys expressed that wish. So boys too can develop anorexia in the classic sense. As in women, the illness usually begins in adolescence and persists well into adulthood. Th esymptoms are as severe and last as long. Males with anorexia are just as concerned about their body shape as anorexic women, and just as vulnerable to low self-esteem, depression, anxiety, social isolation, and suicidal thinking. Selfstarvation can interfere with the menstrual cycle of adolescent girls, and it can stunt growth in adolescents of both sexes.
Th ere is evidence that boys and men with anorexia are more likely than average to be homo sexually oriented. Some believe the disorder is unusually common in men with an atypical gender identity (for example, biological males who think of themselves as women).
Research in this area is still in its early stages. We have much more to learn about biological and environmental infl uences on appetite, body image, and sexuality. In the meantime, it is good to be aware that men as well as women suff er from anorexia, and the suff ering is similar in both sexes.
By: Miller, Michael Craig. Harvard Mental Health Letter, Sep2006
posted by James at 5:39 AM
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