Treatment Notes by Sari Fine Shepphird

Athletes and Anorexia Nervosa: An Elite Athlete's Story

On the heels of my last post, which featured guest Blogger Patrick Bergstrom sharing about his experience as a male athlete with anorexia nervosa, we have another athlete's story for us today.

Lynn Bjorklund, an elite, record-setting distance runner who writes of her journey in my book, 100 Questions and Answers about Anorexia Nervosa, joined me on a radio broadcast a few weeks ago. The Dr. Casey Show on AM830 in Los Angeles is a sport psychology program and Dr. Casey dedicated the morning hour in November to the topic of eating disorders in athletes.

You can listen to the entire broadcast with Dr. Casey, Dr. Sari Shepphird and Lynn Bjorklund here... (just give the file a few moments to download...)

Dr Casey Show 11_15_2009_ AM830 KLAA

After the broadcast concluded, Lynn and I had a conversation about what she wished she would have shared had the nervousness of her first radio appearance not been a distraction to her. With gratitude to Lynn, she shares her "afterthoughts" with you here, and I am sure you will agree that they are an eloquent, powerful, and helpful account of her journey. 

Male Eating Disorders, Part 5: the "Iron Man" Who Chose to Live

Rounding out our brief look at male eating disorders (at least for now), I am pleased to share a guest Post today, written by Patrick Bergstrom. Patrick shares a must-read Post that is eye-opening, educating, and inspiring. 

Thanks to Patrick for his efforts to dispel the myths of "female only" eating disorders, for his work with althetes and EDs, and for his continued support of eating disorders recovery.

Male Eating Disorders, Part 4: Media Influence

I am sure that few of you escaped the recent headlines about Kate Moss and her stated motto, "Nothing tastes as good as skinny feels", an oft-repeated slogan by those in the Pro-Ana and Pro-Mia movements (see Treatment Notes dated May 14, 2008).

Experts and non-experts alike have long debated the media's influence on eating disorders. Recent research has highlighted the affect that media can have on body image and disordered eating behaviors.

However, the focus on the effect of media on male body image and eating disorders is far less prevalent.

Males and Eating Disorders Part 3: Gender stereotyping?

Are eating disorders "just a female problem?"

Studies say "no", and eating disorder professionals know that to be true, but many factors nevertheless leave many cases of eating disorders undiagnosed in many males.

Factor One: Diagnostic Criteria

While eating disorder professionals believe that anorexia is under-diagnosed in both genders, certain diagnostic considerations may make this of particular concern for males. For example, the DSM-IV-TR diagnostic criteria for anorexia includes amenorrhea, which is, of course, a strictly female concern (the
ICD-10does include a male gender counterpart criterion of abnormal gonadotropin functioning).

As simple as it sounds, this may be one reason why healthcare professionals are less accustomed to
suspecting anorexia in their male patients. Regardless, the danger is that some doctors may overlook, ignore, or misdiagnose male patients with this disorder.

Factor Two: Socialization

Leigh Cohn, author of Making Weight: Men's conflicts with food, weight, shape, and appearance, along with other noted specialists, suggest that some men with disordered eating behaviors may be unaware that they have an eating disorder, viewing symptoms such as excessive exercise and body shape concerns as just “a guy thing.” When does "working out hard" become a problem of disordered eating for men? is the standard different for men than for women?

Studies do highlight some differences in males versus female eating disorder symptoms. For example,  research shows that men are more likely to engage in excessive exercise and less likely to engage in self-induced vomiting, use laxatives, or take diet pills to achieve desired weight loss.

Factor Three: Gender stereotyping

As much as we might like to think otherwise, gender stereotyping (e.g., regarding anorexia nervosa as a “female” condition) may be the root of what invariably is the underdiagnosis of eating disorders in males and which also causes some males to refrain from seeking treatment. And unfortunately, when men and boys do seek treatment, they find that there are far fewer residential treatment programs available to men than to women.

Some co-ed programs do offer specially designed treatment “tracks” that address uniquely male concerns, but there is a need for many more such programs. Consequently, males with eating disorders often report feeling isolated in treatment support groups composed of predominantly female patients.

Nevertheless, the course of treatment for males is similar to treatment for female patients and generally has the same rates of efficacy. We have been making strides in recent years toward improving
the diagnosis and treatment of males with eating disorders, and this is indeed promising.

Source: Shepphird (2010). 100 Questions and Answers about Anorexia Nervosa. Sudbury, MA: Jones & Bartlett Publishers.

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