A mixed method exploration of treatment experiences of men with eating disorders

Abstract

Eating disorders (EDs) are generally considered a female problem, despite the fact that the proportion of men with EDs is increasing. The objective of this thesis was firstly to investigate and compare a community sample of men and women with EDs quantitatively on different parameters and secondly, to explore the treatment experiences of men with an ED using qualitative data i.e., autobiographies, interviews and metasynthesis of research papers. The aim of the first study, presented in Chapter Four, was to investigate the status of mental health treatment and the use of antidepressants in men and women with EDs. The study in Chapter Five sought to compare gender differences in help-seeking for an ED. It examined the role of gender as a predictor of help-seeking while controlling for other putative determinants, namely, ED self-identification, the core ED feature of overvaluation of weight/shape, age, BMI, education and impairment in role functioning. Chapter Six is a metasynthesis that explored available qualitative research studies in order to broadly understand the diverse experiences and treatment of people with EDs. In Chapter Seven, the treatment experiences of those who had previously suffered an ED were investigated using autobiographical data. Chapter Four found that when compared to women, men with an ED were significantly less likely to receive treatment for a mental health problem or be taking an antidepressant. As reported in Chapter Five, regarding gender, self-identification and help-seeking, it was found that gender may not be the primary factor influencing help-seeking for an ED and BMI appeared to better account for help-seeking behaviours than gender or any other features. Men and women with an ED had similar levels of functional health impacts but men were younger, less likely to employ purging and had lower levels of weight/shape overvaluation. The metasynthesis in Chapter Six resulted in three broad themes with sub-themes within: 1) out of sight, out of mind; 2) lack of health literacy amongst healthcare providers; 3) pathways into treatment that address stigma. The main findings from Chapter Seven were that for men, the concern of staff members, the therapist's expertise and a collaborative treatment approach were considered optimal to treatment. In contrast, apathy of staff members, the author's own negative preconceptions, perceptions of treatment providers as prioritising financial concerns, being incompetent or judgmental, as well as the time limitations of sessions, were considered unfavourable treatment experiences. The studies in this thesis supplement the limited research in the field of EDs relating to men and their treatment experiences. The utilisation of different datasets increases the value of the research. The primary implications of the findings include recommendations for health care practitioners treating men with EDs, along with valuable insights into areas where improvement is clearly required.

Date of Award	2018
Original language	English