OBJECTIVE: The goal of this study was to better understand the etiology,
clinical characteristics, and prognosis of eating disorders in males.
METHOD: All males with eating disorders who had been treated at
Massachusetts General Hospital from Jan. 1, 1980, to Dec. 31, 1994, were
identified. Hospital charts and psychiatric departmental records were
reviewed to verify that the eating disorders met DSM-IV criteria and to
abstract demographic and clinical data. RESULTS: One hundred thirty-five
males with eating disorders were identified, of whom 62 (46%) were bulimic,
30 (22%) were anorexic, and 43 (32%) met criteria for an eating disorder
not otherwise specified. There were marked differences in sexual
orientation by diagnostic group; 42% of the male bulimic patients were
identified as either homosexual or bisexual, and 58% of the anorexic
patients were identified as asexual. Comorbid psychiatric disorders were
common, particularly major depressive disorder (54% of all patients),
substance abuse (37%), and personality disorder (26%). Many patients had a
family history of affective disorder (29%) or alcoholism (37%).
CONCLUSIONS: While most characteristics of males and females with eating
disorders are similar, homosexuality/bisexuality appears to be a specific
risk factor for males, especially for those who develop bulimia nervosa.
Future research on the link between sexual orientation and eating disorders
would help guide prevention and treatment strategies.