Sex Differences in Psychosocial Impairment Associated with Eating Disorder Features

Abstract

Recent epidemiological research suggests that the prevalence of eating disorder features (EDF), namely, binge eating, extreme weight-control behaviors (i.e., extreme dietary restriction, purging and/or excessive exercise), and key cognitive features, such as the overvaluation of body weight/shape, may be increasing in both men and women. There is also some evidence that men, like women, experience significant psychosocial impairment associated with the occurrence of EDF. If so, then there may be important implications for prevention and health promotion initiatives, which currently focus exclusively or primarily on female audiences. The current research comprised two, community-based studies designed to further understanding of sex differences in psychosocial impairment associated with EDF. A third study, included in an appendix, was conducted in fulfillment of the University’s DPsych Program’s Research Practicum requirement. All three studies have been published in peer-reviewed scientific journals.

Study 1 examined sex differences in psychosocial impairment associated with EDF in adults (N = 2,856), whereas Study 2 examined potential sex differences in psychosocial impairment associated with EDF in adolescents (N = 1,666). In both studies, binge eating, purging (i.e., self-induced vomiting and/or laxative misuse) and overvaluation of weight/shape were associated with similarly high levels of impairment in males and females. In adolescents, extreme dietary restriction and excessive exercise were also associated with similarly high levels of impairment in male and female participants. In adults, extreme dietary restriction was associated with greater impairment in females than in males, whereas excessive exercise was not associated with impairment in either males or females.

Findings from these studies suggest that the occurrence of EDF is associated with similarly high levels of impairment for males and females and that this is the case for both adults and adolescents. The primary implication of these findings, when taken with evidence for increases in the prevalence of EDF in both males and females, is that health promotion and prevention programs will need to: (a) include both male and female participants; and (b) improve community mental health literacy relating to males’ experiences of EDF in particular. These steps will be needed in order for progress to be made in reducing the individual and community health burden of EDF moving forward. Future research examining the help-seeking behavior of males experiencing EDF would be of interest.

Study 3 examined young men’s (n = 35) and women’s (n = 141) perceptions of psychosocial impairment associated with EDF, as well as the effect on these perceptions of an eating disorders “mental health literacy” intervention. Participants generally perceived binge eating, purging and extreme dietary restriction to be associated with significant psychosocial impairment and this did not change with the provision of the intervention. Overvaluation of weight/shape and excessive exercise were initially perceived to be less impairing than other EDF, though perceptions of impairment increased following the intervention. Few sex differences were present. These findings suggest that failure to recognize the adverse impact of overvaluation of weight/shape and excessive exercise on quality of life may warrant particular attention in health promotion and preventive interventions. Show more