Eating disorders underdiagnosed in men: study

Eating disorders may go undiagnosed in men and people of colour, depriving them of getting proper health care, a study has found.

In a survey of college-age students, researchers from the University of Michigan in the US found great disparities in who was getting both diagnosis and treatment for eating disorders, including anorexia nervosa, bulimia, binge eating disorder and overconsumption.

"While many people assume that eating disorders affect 'skinny, white, affluent girls,' we found that among college students with eating disorders, just two per cent were underweight, most were not affluent, and a sizeable portion were male and nonwhite," said Kendrin Sonneville, assistant professor at University of Michigan.

"We also found that stereotypes about who develops eating disorders could contribute to disparities in diagnosis and treatment, with males, those of higher weight, people of colour, and the non affluent most likely to be slipping through the cracks," said Sonneville.

In the analysis of over 1,700 young people, researchers found that females were almost five times more likely to get diagnosed than males, white students were nearly two times more likely to get diagnosed than students of colour, and underweight students were more than six times more likely to get diagnosed than those students with a health body weight.

Students who were overweight or obese were about half as likely to get diagnosed.

When it came to treatment, females were almost 1.5 times more likely to get help compared with males, and affluent students were nearly two times more likely to get treatment compared to non-affluent.

Underweight students were almost six times more likely to get treatment compared to students with a healthy body weight.

Estimates are that nearly five per cent of the population in the US has an eating disorder at some point in their lives, yet only one third of individuals receive treatment.

Among the college students in the current study with an eating disorder, nearly 31 per cent perceived a need for treatment, 10.5 per cent had received a diagnosis and nearly 14 per cent had received treatment in the past year.

"Most people with an eating disorder never get diagnosed and never get treatment, even though successful treatments that can reduce suffering, health consequences and cost are available," Sonneville said.

"Most media coverage about eating disorders has focused on cases of anorexia among thin, white female celebrities. Many individuals with eating disorders do not recognize themselves in these stereotyped portrayals of eating disorders in the media and may not recognize the need for treatment," he said.

In fact, the team found that anorexia was much more likely to get diagnosed (73 per cent) compared to individuals with binge eating disorder (seven per cent).

This disparity could perpetuate stereotypes because anorexia will be the most common diagnosis encountered, even though it is the least common eating disorder.

Sonneville said universal screening and prevention, led by clinicians, could help reduce these disparities.