As a disorder, anorexia nervosa is associated mainly with young women. For centuries, girls have exhibited symptoms of anorexia nervosa and the disorder has exploded into a cultural, "female" problem. Feminist psychotherapy treatments address the problem of anorexia nervosa from a sociocultural perspective, which has been very effective for female patients. However, the number of cases found among men is rising and a gender-specific treatment that focuses on men's issues related to anorexia nervosa is not available. Psychologists must begin to look at anorexia nervosa as a cultural issue for men that has unique features and issues related to the social construction of masculinity. By incorporating these ideas into a newly adapted feminist treatment approach that also employs concepts of empowerment and acceptance, psychologists will be able to treat male anorexia nervosa more effectively and possibly change the social stigmas that have plagued anorexic men for so long.
Keywords: male anorexia nervosa, masculinity, feminist therapy, social stigma, DSM-IV
Anorexia nervosa is typically understood as a culturally motivated psychological disorder of young women, with 90 percent of diagnosed cases typically found in the female population according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychological Association, 1994). As a result of this association as a "female" problem, and the low incidence of anorexia nervosa in men, past research on the disorder has mainly been done with female subjects. Various ways in which anorexia nervosa can be treated are also part of this past research and these treatments mainly focus on the medical, psychological, and social conditions of female anorexics. Current scholars are now finding that this research on the many facets of anorexia may not be applicable to the male anorexic population, and consequently have implications for treatment of the disorder. Anorexia nervosa among men is, in and of itself, a unique problem that must be addressed in a way that is appropriate for the male patient and his gender-specific emotional, psychological, social, and cultural issues.
It is impractical to think that men completely escape social pressures of aestheticism, especially as more and more evidence points to an intensified connection between men and their bodies: how their bodies are represented and how men feel about their bodies. In light of the gender specificity of anorexia nervosa and increasing attention to the male body as an aesthetic object, I believe the path to successful treatment of anorexia nervosa in males is to regard it as its own disorder with treatment that addresses the gender bias which surrounds it. By incorporating related concepts of masculinity theory and body image, as well as attending to the related pressures that some athletes and homosexual men confront, the basis for a male-centered approach to the treatment of anorexia nervosa can be developed by addressing concepts previously ignored.
One of the reasons for the lack of an effective, psychosocial approach to anorexia nervosa in males is that psychologists rarely considered the disorder to be a valid diagnosis in men. Physicians, as well as men who suffer from the disorder, are often unaware that anorexia nervosa could occur in both genders (Goodman, Blinder, Chaitin, & Hagman, 1988). The very notion that anorexia nervosa is not acknowledged as a legitimate problem for young men must be addressed in future treatment developments for anorexia nervosa. Furthermore, whereas the obsession with thinness is seen as "normal" for a woman, a man's preoccupation with his body is seen as an abnormal identification with the feminine (McVittie, Cavers, & Hepworth, 2005). McVittie et al. (2000) examined the ways in which male college students comprehend anorexia nervosa in men and supported the notion that society as a whole still views this disorder as a condition predominantly found in women. …