“LESS OF A MAN”: STIGMA,
MASCULINITY, AND THE MALE EXPERIENCE OF
EATING DISORDERS
Scott Griffiths | Prof. Stephen Touyz | ...
DSM V – “Feeding and eating disorders”
› Anorexia nervosa
- Restriction of energy
intake relative to
requirements leading ...
Sex differences in eating disorder prevalence
100%

10%
50%
75%

70%

60%

50%

90%

50%
25%

30%

Anorexia
Nervosa

Bulim...
The ideal male body
› Like women, men desire a
body that is low in body fat
› Unlike women, men rarely
describe their idea...
Muscle dysmorphia
› "Discovered" in 1993 and named "reverse
anorexia" (Pope, Katz & Hudson, 1993)
› Renamed "muscle dysmor...
Muscle dysmorphia
› Mean age: 25 years
› Insight into their preoccupation: 50%
› Steroid use: ~36% (21.4%, 43%, 44%)
› Gay...
Muscle dysmorphia: the “male” eating disorder?
› Both involve pathological preoccupations with body image, diet and
exerci...
Body dissatisfaction and disordered eating in men: A
worsening problem
› 100% increase in binge
eating, purging and strict...
What’s causing all this?
› Men are being exposed to increasingly muscular bodies

9
What’s causing all this?
› Video games feature hypermuscular male bodies (Barlett& Harris, 2008)

10
What’s causing all this?
› Advertisements increasingly emphasise aesthetic attributes of men
(Farquhar & Wasylkiw, 2007) ....
What’s causing all this?
› Playgirl centrefolds from 1973 to 1997 have gained 12kg of muscle, lost
5kg of fat, on average ...
What’s causing all this?
› Advertising on campus at the University of Sydney

13
What’s causing all this?
› Captain America: $370 million USD worldwide

14
Could masculinity somehow be responsible?
› The theory of threatened masculinity (Mishkind et al. 1986)
- Proposes that ma...
But what, exactly, is masculinity?
› Traditional masculine ideals are thought to include: (Mahalik et al. 2003)
- Winning
...
Men are excised from the eating disorder narrative
› "Disordered eating" has become synonymous with calorie
restriction, c...
Muscularity-oriented disordered eating
Definition of muscularity-oriented
disordered eating:

“Problematic eating attitude...
Assessment of muscularity-oriented disordered eating
0
5
0
0

?

6

1

0
6

2

3

1
6

0
6

Thinness-oriented disordered e...
Associations with muscularity-oriented disordered
eating
Emotion
regulation deficits

Attentional biases

Cognitive defici...
Stigma and eating disorders
› In general, eating disorders are stigmatised
› People with anorexia are viewed as attention-...
Masculinity, stigma and eating disorders
› Adherence to masculine norms is consistently negatively associated with
men’s w...
Exploring stigma toward anorexia and muscle
dysmorphia

Anorexia Nervosa
N = 343

Anorexia Nervosa

Muscle
Dysmorphia

Mus...
Main effects of participant sex (male or female)
Higher for female participants

Higher for male participants

Large Mediu...
Main effects of character sex (male or female)
Higher for female characters

Higher for male characters

Large Medium

Sma...
Main effects of character diagnosis (anorexia or muscle dysmorphia)
Higher for muscle dysmorphia

Higher for anorexia nerv...
Stigma and gender-role expectations
Mean perceived masculinity

5

Male

*p< .001
4

participants
n = 113

› To what exten...
Mean conformity to masculine role

Masculinity in men with anorexia and muscle
dysmorphia

150

100

50

Healthy
controls
...
Gender role stigmatisation reported by people with
eating disorders

Mean frequency

5

Males
n=7

4.57

Females
n = 21

4...
The stigma “double bind”
› Men with anorexia nervosa

- Immersed in gym culture; surrounded
by other men who tend to be mo...
Upcoming SlideShare
Loading in …5
×

“Less of a man”: Stigma, masculinity, and the male experience of eating disorders.

1,403 views

Published on

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
1,403
On SlideShare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
16
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • Hi, I’m Scott Griffiths, I’m a PhD student at the University of Sydney. I’m studying eating and body image disorders in males under the supervision of Stephen Touyz.
  • Mr. B. is a 22-year-old, single, white, business-school student. He is 71.5 inches tall and weighs 252 pounds. His body fat is measured at 25%, and his FFMI is a very muscular 25.9 kg/m2, suggesting possible anabolic steroid use, although he denies this. He feels very dissatisfied with the way his body is proportioned. Since the age of 18, Mr. B. has spent 6 days a week lifting weights and at least 4 hours a day being preoccupied with thoughts of becoming more muscular. He weighs himself 10 times weekly and checks mirrors almost every time he passes one. He wishes that he would not look in mirrors constantly but feels as if he has little control over this behavior. His belief in his &quot;small size&quot; leads him to wear baggy sweatshirts, always with long sleeves, for fear that someone may comment on his lack of muscularity. Mr. B. reports that he has lost many friends and sexual partners because he feels compelled to go to the gym rather than spend time with them. When he is with friends, he frequently questions them about his appearance. He constantly compares himself to other men at the gym and wishes that he could look as big as he perceives the other men to look. Lifting weights preempts all other activities in Mr. B’s life. He reports feeling frustrated and anxious when he is not able to go to the gymnasium. He reports that he would feel &apos;&apos;uncomfortable&apos;&apos; if he could not exercise for a day and &quot;extremely uncomfortable&quot; if he could not work out for a week. He often forces himself to eat, even when he is clearly not hungry, for fear that not eating will result in a decrease in muscularity.
  • This is a modified version of the EDE-Q completed by a young male diagnosed with muscle dysmorphia.
  • I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
  • Lots of males, especially young males, suffer from body dissatisfaction. In fact, we might be approaching a point at which body dissatisfaction in young men is normative. The blue and red graphs are frequency histograms depicting the mean scores of 286 male psychology undergraduates who completed the Male Body Attitudes Scale for a related but separate study to the one I am presenting today. The blue graph is the frequency histogram for mean scores on the Muscle Dissatisfaction subscale of the Male Body Attitudes Scale, which measures males’ dissatisfaction with their muscularity. Similarly, the body fat dissatisfaction subscale measures dissatisfaction with body fatBoth scales ask participants to rate their level of agreement with statements about the body, such as “I think my arms should be more muscular” or “I think I have too much fat on my body”. Both measures use the 6-point Likert scales at the bottom of each histogram. The mean level of muscle dissatisfaction in these 286 males is 3.14, which corresponds to someone agreeing “sometimes” to “often” with questions such as “I wish my chest was broader” and “I think I have too little muscle mass on my body.” Worryingly, almost 1 in 5 or 20% are, on average, agreeing “often” to “always” with these statements.Body fat concerns appear less marked overall than muscle concerns, but high nonetheless.Thus, amongst University of Sydney psychology graduates at least, muscle dissatisfaction is almost the norm.
  • I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
  • I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
  • I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
  • I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
  • I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
  • I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
  • I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
  • I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
  • I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
  • When we discuss disordered eating we rarely refer to just eating behaviours and body image. We often talk about, or measure, laxative use, diuretic use, vomiting, purging and excessive exercise under the umbrella of disordered eating. Similarly, a framework of muscularity-oriented disordered eating
  • When we discuss disordered eating we rarely refer to just eating behaviours and body image. We often talk about, or measure, laxative use, diuretic use, vomiting, purging and excessive exercise under the umbrella of disordered eating. Similarly, a framework of muscularity-oriented disordered eating
  • When we discuss disordered eating we rarely refer to just eating behaviours and body image. We often talk about, or measure, laxative use, diuretic use, vomiting, purging and excessive exercise under the umbrella of disordered eating. Similarly, a framework of muscularity-oriented disordered eating
  • When we discuss disordered eating we rarely refer to just eating behaviours and body image. We often talk about, or measure, laxative use, diuretic use, vomiting, purging and excessive exercise under the umbrella of disordered eating. Similarly, a framework of muscularity-oriented disordered eating
  • “Less of a man”: Stigma, masculinity, and the male experience of eating disorders.

    1. 1. “LESS OF A MAN”: STIGMA, MASCULINITY, AND THE MALE EXPERIENCE OF EATING DISORDERS Scott Griffiths | Prof. Stephen Touyz | Dr. Stuart Murray | A/Prof Jonathan Mond | Chris Thornton
    2. 2. DSM V – “Feeding and eating disorders” › Anorexia nervosa - Restriction of energy intake relative to requirements leading to significantly low weight › Bulimia nervosa - Recurrent episodes of binge eating › Binge eating disorders - Recurrent episodes of binge eating - Recurrent inappropriate - The binge eating is not compensatory associated with - Intense fear of gaining behaviours to preent recurrent inappropriate weight or persistent weight gain, e.g. purging compensatory behaviour that interferes behaviours as in bulimia - Self-evaluation unduly with weight gain nervosa influenced by body - Self-evaluation unduly shape and weight influenced by body shape and weight 2
    3. 3. Sex differences in eating disorder prevalence 100% 10% 50% 75% 70% 60% 50% 90% 50% 25% 30% Anorexia Nervosa Bulimia Nervosa 40% 0% Binge Eating Disorder Men EDNOS Muscle Dysmorphia Women (Hoek&Hueken, 2003; Hudson et al. 2007; Madden et al. 2009; Muise et al. 2003) 3
    4. 4. The ideal male body › Like women, men desire a body that is low in body fat › Unlike women, men rarely describe their ideal body as "skinny" or "thin" › The ideal male body combines low body fat with well-developed muscles › Both components are equally important to male body image (Bergeron & Tylka, 2007) 4
    5. 5. Muscle dysmorphia › "Discovered" in 1993 and named "reverse anorexia" (Pope, Katz & Hudson, 1993) › Renamed "muscle dysmorphia" in 2001 › Criteria - Preoccupation with being lean and muscular - At least 2 of the following: - Giving up important activities due to a compulsive need to work out and diet - Avoiding body exposure/enduring body exposure with intense anxiety and distress - The preoccupation with body size/musculature causes impairments in important activities - Continuing to work out, diet or use steroids/PEDs despite knowledge of adverse physical or psychological outcomes 5
    6. 6. Muscle dysmorphia › Mean age: 25 years › Insight into their preoccupation: 50% › Steroid use: ~36% (21.4%, 43%, 44%) › Gay: varies; 21%, 0% › Current or past history of an eating disorder: ~18% (4%, 29%, 21.4%) › Lower quality of life; poorer mental health and interpersonal functioning, › Suicide attempts: 50% › Lifetime history of substance abuse: 85.7% › Lifetime history of a mood disorder: 74% to 85.7% › On average, report spending 4 hours per day thinking about getting bigger › On average, check mirrors 13 times per day 6
    7. 7. Muscle dysmorphia: the “male” eating disorder? › Both involve pathological preoccupations with body image, diet and exercise › Similar scores on measures of eating disorder pathology › Diagnostic crossover: One in five have previously suffered from a clinical eating disorder 7
    8. 8. Body dissatisfaction and disordered eating in men: A worsening problem › 100% increase in binge eating, purging and strict dieting in men from 1995 to 2005 (Hay et al. 2008) › In Australia, rates of extreme dieting, purging and binge eating amongst are increasing faster in men than in women (Hay et al. submitted) Muscle dissatisfaction (mean scores) N = 286 Mean = 3.14 Often to Always = 20% › Young Australian men rate body image amongst their most significant concerns (Mission Australia, 2010, 2011, 2012) 8
    9. 9. What’s causing all this? › Men are being exposed to increasingly muscular bodies 9
    10. 10. What’s causing all this? › Video games feature hypermuscular male bodies (Barlett& Harris, 2008) 10
    11. 11. What’s causing all this? › Advertisements increasingly emphasise aesthetic attributes of men (Farquhar & Wasylkiw, 2007) . 11
    12. 12. What’s causing all this? › Playgirl centrefolds from 1973 to 1997 have gained 12kg of muscle, lost 5kg of fat, on average (Leit et al. 2001) 12
    13. 13. What’s causing all this? › Advertising on campus at the University of Sydney 13
    14. 14. What’s causing all this? › Captain America: $370 million USD worldwide 14
    15. 15. Could masculinity somehow be responsible? › The theory of threatened masculinity (Mishkind et al. 1986) - Proposes that masculinity has become harder for young men to claim and define as parity between the sexes has increased - Men no longer able to solely define their masculinity through being the “breadwinner” or “protector” - Muscles are an overt way to signal masculinity and status as a man - Women are unlikely to achieve parity with men in terms of muscle mass due to substantial sex differences in the level of muscle-building hormones. › Some support for the theory - Men who fail a non-physical task whilst in the presence of females feel more dissatisfied with their bodies, less muscular, and less capable (Mills & D'alfonso, 2007) - No effect for failure in the presence of males.
    16. 16. But what, exactly, is masculinity? › Traditional masculine ideals are thought to include: (Mahalik et al. 2003) - Winning - Emotional control - Risk-taking - Violence - Power over women - Dominance - Playboy - Self-reliance - Primacy of work - Disdain for homosexuality - Pursuit of status
    17. 17. Men are excised from the eating disorder narrative › "Disordered eating" has become synonymous with calorie restriction, calorie expunging, weight loss, and fat loss › Eating Disorders Examination - Questionnaire (EDE-Q; Fairburn & Beglin, 1984) - "Have you been deliberately trying to limit the amount of food that you eat?" - "Have you wanted your stomach to be empty?" - "Have you gone for long periods of time (8 hours or more) without eating anything in order to influence your shape or weight?" - "Have you had a definite fear that you might gain weight or become fat?" - "Have you definitely wanted your stomach to be flat?" - "Have you had a strong desire to lose weight?" - "Have you felt fat?" - "Have you taken diuretics to control your shape or weight?" - "Have you taken laxatives to control your shape or weight?" 17
    18. 18. Muscularity-oriented disordered eating Definition of muscularity-oriented disordered eating: “Problematic eating attitudes and behaviours motivated by the desire to become more muscular” What makes an eating attitude or behaviour disordered/problematic? The attitude or behaviour must be 1. Rule-driven, or 2. Compensatory 18
    19. 19. Assessment of muscularity-oriented disordered eating 0 5 0 0 ? 6 1 0 6 2 3 1 6 0 6 Thinness-oriented disordered eating 6 =0+0+0+6+0+0+0+0+?+ 2+1 0 0 = 9(15 if I gift him a 6) Muscularity-oriented disordered eating 4 =6+6+0+6+6+4+5+0+3+1+6 = 42 19
    20. 20. Associations with muscularity-oriented disordered eating Emotion regulation deficits Attentional biases Cognitive deficits (Griffiths, Angus, Murray, &Touyz, unde r review in Body Image) (Griffiths, Angus, Murray, &Touyz, unde r review in Body Image) (Griffiths, Murray, & Touyz, published in Body Image) MUSCULARITY MUSCULARITY -ORIENTED ORIENTED DISORDERED DISORDERED EATING EATING Masculinity Admiration of muscle dysmorphia (Griffiths, Murray, &Touyz, under review in Psychology of Men & Masculinity) (Griffiths, Mond, Murray &Touyz, under review in International Journal of Eating Disorders) Thinness-oriented disordered eating
    21. 21. Stigma and eating disorders › In general, eating disorders are stigmatised › People with anorexia are viewed as attention-seekers who could pull themselves together if they wanted and as personally responsible for their illness › (Crisafulli; Holle, &Bulik, 2008; Crisp, Gelder, Rix, Meltzer, &Rowlands, 2000; Mond, RobertsonSmith, &Vetere, 2006; Roehrig& McLean, 2010) › Stigma is widely touted as a reason for why so few males are in treatment › Men with eating disorders believe that society treats eating disorders as a “girl's problem" (Robinson et al. 2012) › Studies examining undergraduates’ stigma toward male and female eating disorder sufferers have found few, if any differences (Wingfield, Kelly, Serdar, Shivy, &Mazzeo, 2011) 23
    22. 22. Masculinity, stigma and eating disorders › Adherence to masculine norms is consistently negatively associated with men’s willingness to seek professional help (Addis &Mahalik, 2003; Courtenay, 2000; Levant & Richmond, 2007; Manfield, Addis &Mahalik, 2003; O’Neil, 2008) › Especially resistant to taking medication (Berger et al. 2013) › Men prefer talk-therapy with a psychotherapist over other forms of professional help-seeking (Berger et al. 2013) › Men react more positively to seeking professional treatment at the suggestion of a psychotherapist compared with a medical doctor or romantic partner (Berger et al. 2013) 24
    23. 23. Exploring stigma toward anorexia and muscle dysmorphia Anorexia Nervosa N = 343 Anorexia Nervosa Muscle Dysmorphia Muscle Dysmorphia
    24. 24. Main effects of participant sex (male or female) Higher for female participants Higher for male participants Large Medium Small X The character is… Weird X X X X Narcissistic An attention-seeker Less likely to be talked to about their problem by the participant Less likely to be watched or monitored by the participant X Less likely to be watched or monitored by others Small Medium Large
    25. 25. Main effects of character sex (male or female) Higher for female characters Higher for male characters Large Medium Small X The character is… Small Medium Large Masculine Feminine X More likely to be watched/monitored X More uncomfortable to talk to X More psychologically fragile Less likely to recover easily X X X Less likely to be discriminated against
    26. 26. Main effects of character diagnosis (anorexia or muscle dysmorphia) Higher for muscle dysmorphia Higher for anorexia nervosa Large Small The character is… X Unintelligent X Medium Less competent than their peers X Self-destructive X Will put strain on your friendship X Likely to be watched or monitored by the participant X Likely to be watched or monitored by others Likely to recover easily X Likely to be talked to about their problem by the participant X X Small Going to require caution so as to not upset them Physically fragile X Medium Large
    27. 27. Stigma and gender-role expectations Mean perceived masculinity 5 Male *p< .001 4 participants n = 113 › To what extent do you agree with the following statement: Kelly/Michael is masculine Female participants n = 230 3 - 5 = strongly agree - 4 = agree - 3 = neither agree nor disagree - 2 = disagree - 1 = strongly disagree 2 › Size of this effect size is very large (η2 = .23) 1 Anorexia Muscle nervosa dysmorphia Character diagnosis - Even stronger for male participants (interaction η2 = .03, p = .002)
    28. 28. Mean conformity to masculine role Masculinity in men with anorexia and muscle dysmorphia 150 100 50 Healthy controls n = 30 Anorexia nervosa n = 24 › Men with anorexia are just as masculine as the average man › Men with muscle dysmorphia are more masculine than the average man and men with anorexia Muscle dysmorphia n= 21 0 Murray, Rieger, Karlov& Touyz (2013)
    29. 29. Gender role stigmatisation reported by people with eating disorders Mean frequency 5 Males n=7 4.57 Females n = 21 4 3 › How often are you subjected to the attitude or belief that you are “less of a man/woman” because of your eating disorder? - 5 = always 2.67 - 4 = often - 3 = sometimes - 2 = rarely 2 - 1 = never 1 0 *p< .001
    30. 30. The stigma “double bind” › Men with anorexia nervosa - Immersed in gym culture; surrounded by other men who tend to be more - Perceived as less masculine by others stigmatising towards eating disorders than women - Report being stigmatised as less of a man "often" to "always" - Exhibit greater adherence to masculine norms than the average - Report that this stigmatisation is very male damaging - Exhibit a level of adherence to masculine norms that is equal to the average male › Men with muscle dysmorphia - The fear of losing muscle size is linked to the a fear of becoming less of a man - "femiphobia"

    ×