Gender-based Differences in Attitudes toward Eating Disorders

Eating disorders are commonly seen as a “woman’s illness,” and in the U.S. and Europe, people with eating disorders are often blamed for being ill, at least somewhat in contrast to patients with schizophrenia and mood disorders. Only a few researchers have examined the impact of gender on attitudes toward eating disorders.
There has been some evidence that gender does not impact knowledge about eating disorders, but perhaps men appear more stigmatizing.

A group of German researchers decided to test public attitudes toward eating disorders and to determine if there were any differences in attitude by gender. Dr. Anna Christin Makowski and a group at the University Medical Centre, Hamburg, Germany, used data from telephone interviews with men and women to examine attitudes about people with eating disorders (Eat Behav. 2015; 16:78). The interviewers used vignettes with typical signs and symptoms suggestive of AN and BN or depression or schizophrenia. The patient’s gender in the vignettes for depression and schizophrenia were varied, while those of patients with AN or BN were female. The interviewers measured causal attribution, emotion reactions, and social distance (in the social distance portion of the survey, for example, the respondents indicated, via a Likert-like scale, whether they would recommend the person for a job, or as a caregiver for a child).

The interviews revealed some interesting gender-dependent differences in attitudes toward AN. Women were more likely than men to state that AN could be caused by sexual abuse during childhood. Men more often attributed AN to an individual having a weak will. The women respondents tended to associate BN with weak willpower. The authors found a potentially important effect wherein the belief that BN is self-inflicted (translation: the individual with BN has a “weak will”) and was linked to a greater desire for social distance among female respondents.

Also of potential importance, among males attributing BN to a biogenetic cause (“brain disease”) was the finding that this was a significant predictor for men to distance themselves socially from women with BN. The authors note that this is an important finding because it highlights that endorsing a possible cause for eating disorders as something inherent can actually be detrimental. In AN, an earlier study showed that having a biogenetic cause for an eating disorder reduces blaming.

In the case of AN, fear emerged as a significant predictor of a desire for social distance among female respondents, while males’ desire for social distance was associated with anger. The respondents distanced themselves far less from females afflicted by eating disorders than from persons with schizophrenia or depression.

How the findings might be used to reduce stigma

The authors argue that their results can inform stigma reduction effects. For campaigns aimed at women, the authors suggest that messages that emphasize the person over the diagnosis, and not using stereotypes, can be effective. For information campaigns aimed at male audiences, messages that emphasize social inclusion and recovery-oriented messages would be most effective.