Gender Differences in Eating Disorders Patients?

The results of two studies have provided a little more information on differences and similarities between male and female eating disorders patients.

Most studies have shown that men have clinical symptoms similar to those of women patients with eating disorders. Noting that an increasing number of males with eating disorders are being reported in Spain, Araceli Nunez-Navarro and colleagues designed a case-control study of 60 males and 60 females with eating disorders and 120 healthy controls (60 males and 60 females). Among the male patients, 10 had anorexia nervosa (AN), 25 had bulimia nervosa (BN), and 25 had eating disorders not otherwise specified (EDNOS). All had consecutively attended the outpatient department of the University Hospital of Bellvitge-IDIBELL, in Barcelona (Eur Eat Disorders Rev 2011; published online; DOI: 10.1002/erv.1146).

This is the first study using a large sample of male eating disorder patients compared with female eating disorder patients and a large healthy control group. This study also is assessed gender differences in diverse eating disorder subgroups. All patients were diagnosed according to the DSM-IV. The patients were also assessed with the Eating Disorder Inventory-2 Symptom Checklist-Revised and Temperament and Character Inventory-revised, as well as other clinical and psychopathological indices. The mean age of the total sample was 24 years.

Many similarities, but a few differences

Overall, the authors found many similarities between the male and female eating disorder patients; however, there were some differences by gender. Male eating disorder patients reported a higher mean number of weekly vomiting episodes than did the women (16.4 vs. 2.9 episodes, respectively) and a lower mean frequency of laxative use than females (mean weekly frequency was 1.0 vs. 5.5, respectively). Male patients with EDNOS had had significantly fewer previous treatment sessions than did females and a higher age at onset of their symptoms than did women (20.0 years versus 17.2 years, respectively).

Decision-making by male AN patients

In a second study, Dr. Kate Tchanturia and colleagues at King’s College, London, investigated decision-making among 48 individuals with AN (19 males and 29 female patients) and 61 healthy controls (20 males and 41 females). The researchers used the Iowa Gambling Task (IGT). The IGT, originally developed to help detect decision-making impairment in patients with prefrontal cortex injuries, is a computerized assessment that is carried out in real-time and is designed to resemble real-life situations. The task involves selecting cards from four decks displayed on the computer screen. Examinees are instructed that the selection of each card will result in winning money but that, every so often, a card selection also will result in losing money. Examinees are told to attempt to accumulate as much money as possible.

Both male and female AN patients performed significantly worse than did healthy controls on the gambling task. No gender differences in IGT performance were found across groups. Overall, male patients had higher impulsivity scores than did women, but impulsivity did not predict poor decision-making performance (Eur Eat Disorders Rev 2011; published online; DOI:10.1002/erv.1154).

The authors concluded that both males and females with AN have impaired decision-making capabilities. Their data suggest that male patients with AN are very similar to female patients in decision-making and as a result treatment approaches to improving decision-making should be similar for both genders.