Gender Differences in Eating Disorder Symptoms

Because anorexia nervosa and bulimia nervosa are far more common in women than in men, most studies in the field focus exclusively upon women. Much less is known about patterns of disordered eating among men.

In a study at Oregon Research Institute, Eugene, OR, Peter M. Lewinsohn, PhD and co-workers used a self-report questionnaire (Eating Disorders Symptoms Questionnaire, or EDSQ) and interviews to survey eating behaviors and attitudes among a community sample of 1,056 students from 14 to 18 years of age at nine senior high schools in western Oregon (Int J Eat Dis 2002;32:458). Most students were White (89%), with 1.1% Black, 3.0% Hispanic, and 2.6% Asian or American Indian, and 1.8% other.

The authors sought to answer four basic questions: (1) Do women have more eating disorders than do men? (2) Are certain eating disorder symptoms specifically increased in men and others specifically elevated in women? (3) Is the structure of eating disorder symptoms different among men than among women? (4) Are men with comparable levels of disordered eating less likely to seek treatment than women?

Differences on the EDSQ

Significant gender differences were noted on all five EDSQ scales. Women scored higher than men on Drive for Thinness, Bulimia, Body Dissatisfaction, and Inappropriate Compensatory Behaviors. Men had elevated scores on the Excessive Exercise Subscale.

Compared with women, men were significantly more likely to report an overeating episode within the past 3 months (28% vs. 14%, respectively). However, of the 205 students who reported an overeating episode, only 36% were confirmed to have had an objective overeating episode. As for reports of overeating and binge eating in the 3-month period, several interesting gender effects were found. Although comparable rates of overeating were found among men and women, women were more likely than men to report that overeating was associated with a sense of loss of control, to feel bad about these episodes, and to consider their eating habits as abnormal. The authors hypothesize that female gender role socialization (especially the emphasis on thinness) contributes to the higher risk for women to feel bad about overeating because of its association with weight gain; this might explain why women are at relatively greater risk of developing bulimia nervosa.

Women were significantly more likely than men to report ever wanting to have treatment (16% vs. 2%, respectively) and to report having been treated for an eating problem in the past (5% vs. 1 %, respectively).

A suggestion for one subscale

According to the authors, the significantly lower correlation between Body Dissatisfaction and BMI for men compared with women suggests that this particular subscale may be better suited for measuring weight dissatisfaction among women than among men. Future studies need to add questions pertaining to feeling fat that are less oriented toward female fat patterns, according to Dr. Lewinsohn.