Eating Disorders and Gender

Research on the prevalence of eating disorders has identified distinct gender differences among those diagnosed. Specifically, many studies have documented that anorexia nervosa, bulimia nervosa, and, to a lesser extent, binge-eating disorder are more common among women. Anorexia and bulimia are found primarily in women, while men make up a more substantial, though not equal, portion of those diagnosed with binge-eating disorder. While the precise reason for this discrepancy is unknown, many believe that societal pressure on women to be thin and the general value placed on appearance in society play an important role.

Eating disorders like anorexia nervosa and bulimia nervosa are far more predominant in women.

A recent survey examining the prevalence of eating disorders in the United States reported that the lifetime prevalence estimate of anorexia is 0.9 percent among women and 0.3 percent among men, of bulimia is 1.5 percent among women and 0.5 percent among men, and of binge-eating disorder is 3.5 percent among women and 2 percent among men. Thus, the lifetime prevalence for any of the three eating disorders, according to this study, was 1¾ to 3 times as high among women compared to men. The prevalence of bulimia and anorexia in men reported by this study is actually high compared to other studies. For example, clinical and case registry studies by Fairburn and Beglin and Hoek and van Hoeken reported that men make up less than 10 percent of those diagnosed with an eating disorder. Population-based studies by Garfinkel et al. reported that less than 15 percent of those diagnosed with anorexia and less than 10 percent of those diagnosed with bulimia are men. Spitzer [Page 209]and colleagues found that in patient samples, the ratio of women to men with binge-eating disorder was 3:2; however, in community samples, binge-eating disorder was found to be equally prevalent in men and women.

A study conducted by Lewinsohn and colleagues looked at disordered eating behaviors and attitudes in a community sample of young adults. They reported greater eating disorder symptomatology among women compared to men. The biggest gender differences were in body dissatisfaction and drive for thinness. Women were more likely to endorse both of these symptoms as well as to have much higher scores on scales that measure these two traits, both of which were identified as anorexic-related dimensions. Men scored slightly higher on measures of excessive exercise. Lewinsohn et al. also reported roughly equal rates of overeating in the past three months for men and women. With respect to overeating episodes, however, women were more likely to report experiencing a sense of loss of control, feeling bad about these episodes, and considering their eating habits abnormal. In addition, men were both less likely to report wanting treatment and having been treated for their eating disorder. Many believe that there are gender differences with regard to the expression of specific eating disorder symptoms, and these findings encourage future research to look at specific eating disorder symptoms and behaviors as well as subthreshold eating disorders to better understand and identify these gender differences.

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