Clinicians' views on treatment adaptations for men with eating disorders: a qualitative study

Objectives Despite traditional views of eating disorders as a female illness, there is a growing body of evidence that the incidence rate of eating disorders in men is rising. Research suggests that these men may experience unique symptoms and difficulties, however, it is unclear how these unique needs may impact treatment. The aim of this study was to explore clinicians' views on whether men have gender-specific treatment needs, and how far these needs require treatment adaptations. Design Qualitative interview study using framework analysis to explore the experiences of clinicians working with men with eating disorders. Setting Outpatient National Health Service eating disorder service in London. Participants Ten clinicians from a variety of clinical backgrounds participated in the study. Results The following three themes emerged: male-specific issues identified by clinicians, treatment approaches used for this population and the importance of creating a male-friendly environment. Male-specific issues identified by participants included an increased focus on muscularity and difficulty expressing or discussing emotion. Clinicians also suggested that men may be more likely to adopt a performance-based approach to. This was linked by clinicians to the impact of cultural perceptions of masculinity on their patients. Clinicians in this study felt that these individual needs could be met by adapting existing approaches within a supportive, male-friendly environment. However, there was not consensus over specific adaptations, including identifying risk, the need for male-only groups, or whether male patients needed access to male clinicians. Conclusions Although men do present with specific treatment needs, these can typically be met within the framework of typical treatment approaches by experienced clinicians in an environment sensitive to the presence of men in an otherwise female-dominated space. However, there are a lack of explicit guidelines for this process, and areas such as male-only treatment spaces require further research.