Barriers to Help-Seeking for Eating Disorders in Men: A Mixed-Methods Systematic Review

摘要

Increased prevalence and interest in male eating disorders (EDs) suggests that EDs are no longer conceptualized as a uniquely female experience. Nonetheless, rates of male help-seeking for EDs are worryingly low and empirical efforts to understand the reasons for this gender disparity have thus far been limited. This review aimed to identify and examine published literature reporting on male barriers to help-seeking for EDs, to facilitate access to timely and appropriate care. A systematic literature search identified eight papers meeting eligibility criteria. Narrative synthesis was used to integrate the elicited mixed-methods data and several higher order themes (individual, socio-environmental, organizational, contextual factors) and lower order themes (e.g., internalized stigma and shame, delayed social recognition, feminized services and information) were generated. Barriers to help-seeking included a variety of internal and external factors, operating across socioecological systems. Gender-specific barriers related to the wider cultural context and influence of normative constructions of masculinity. Despite overlap with female ED literature, men do appear to encounter (and require targeted support to overcome) unique challenges in accessing quality healthcare for EDs. Recommendations for the design of clinical interventions and future research are outlined. Public Significance Statement Men experience both general and gender-specific barriers when seeking help for eating disorders (EDs). Restrictive sociocultural constructions of masculinity and EDs present the main barriers to care. Interventions should center on dispelling gender-specific myths and portraying more diverse EDs across social media, healthcare, and education settings.