I’m on a plane heading back to Baltimore after attending the International Academy for Eating Disorders Professionals (IAEDP) conference near Las Vegas. As is my habit, I use this time traveling home to process what I’ve seen and heard at the conference. Sadly, I’m no more hopeful for the field as it relates to men and boys being an ongoing concern from the treatment, research, or advocacy communities.
The list of conference sessions didn’t include anything about males and eating disorders. The programs I attended used language that focused on women and girls almost universally. I asked researchers and speakers to discuss what the latest studies say about males at a variety of presentations such as the transdiagnostic utility of seeing eating disorders as an anxiety disorder, the role of including exercise as a component of treatment of eating disorders, medical co-morbidities to eating disorders (with the lion’s share of the conversations being about pregnancy), mothers and daughters in recovery for an eating disorder (parents and daughters?), and on and on. The response – nobody is looking at males. If males are included in research researchers are not dissecting the data.
As I walked the main hall where treatment centers hawked their programs I asked marketing folks, clinical directors, and CEOs how they are screening males, treating males in mixed milieus, acknowledging their unique needs and etiology, and making males feel a part of the treatment community. Nobody was doing anything differently for males than for females. Interestingly one clinical director brought up the point that male therapists at their centers have to ask all female clients if they are comfortable working with a male therapist, but nobody I talked to said they ask male clients if they are comfortable working with female therapists. The inequity and male gender ambivalence remains an unmoved rock in the path of progress in the field of eating disorders treatment.
I maintain that the first step forward is for more males who have felt like an “other,” been mistreated, undertreated, and dismissed by the eating disorders community to make their voices heard. Only when grassroots efforts reach a critical mass will the powers that be finally adjust and start identifying males with eating disorders appropriately, create better research for prevention and treatment, and train more males to be clinical practitioners and leaders in this field.
The result of increased dollars for research and treatment protocols will be better identification of males at risk or well into the disease state; investors will spend money to create centers of excellence for males with eating disorders; hopefully we’ll see better outreach to get males to come to treatment, giving families who currently struggle to find help real hope for seeing their loved one recover; and those centers will demonstrate expertise in helping men and boys with both the physical and psychological recovery necessary to have a long and fruitful life.
As I’ve said often, while males must find the courage to speak out about their experience and create their tribe of support, the women in our treatment community must work diligently to become inclusive in their language of eating disorders. Presentations must embrace language that does not rely solely on female pronouns and case examples; pictures and videos must include male, female and non-binary gender examples; language in treatment must include language that reflects both masculine and feminine norms for body image, emotions, and behaviors; and where possible an effort needs to be made to help female patients in groups understand the nuances of males with eating disorders so a sense of perspective and comradery can flourish.
It’s my hope that in the next decade we will see a significant change to inclusivity of males and non-binary genders in the eating disorders community. Again, it starts with those of us in the field speaking up and calling out the inequity and ambivalence where we see it, and for those who are in treatment and recovery to find your voice and join the tribe of outspoken individuals and say, “I’m here with you!”
By Andrew Walen, LCSW-C, LICSW, CEDS - Founder and CEO at The Body Image Therapy Center. If you would like to get in touch with Andrew please call 877-674-2843 or email firstname.lastname@example.org.