Review articleGender roles, eating pathology, and body dissatisfaction in men: A meta-analysis
Introduction
Lifetime prevalence rates for eating disorders are estimated at 5.6% (Hudson, Hiripi, Pope, & Kessler, 2007). Although females are 1 ¾ to 3 times more likely to be diagnosed with anorexia nervosa, bulimia nervosa, and binge eating disorder, males are 3 times more likely to exhibit subthreshold binge eating disorder and are roughly equal to females in regard to the number of cases of any binge eating (Hudson et al., 2007). Further, clinically, there has recently been an increase in the awareness of males with eating disorders (Greenberg & Schoen, 2008). Relatedly, the prevalence of men's dissatisfaction with their bodies has increased over the last few decades (e.g., Gray and Ginsberg, 2007, Keel et al., 2007) with some reports noting that 43% of men are dissatisfied with their bodies (Garner, 1997). For decades researchers have questioned whether gender differences in eating pathology and body dissatisfaction are a function of sex or rather a function of gender role orientation (e.g., Paxton and Sculthorpe, 1991, Sitnick and Katz, 1984). However, only recently have these investigations focused more thoroughly on men (e.g., Pritchard, 2008). Studying gender roles in men not only adds to the knowledge base on the development and correlates of eating and body-related dysfunction, but it also has clear implications for the treatment of such concerns, via an integration of gendered perspectives in therapy (e.g., Mahalik et al., 2003a, Mahalik et al., 2005b). Thus, having a nuanced understanding of the association between gender roles and eating and body concerns among men is important in both theory and clinical practice.
Section snippets
Gender roles
Gender role orientation has been defined as “behaviors, expectations, and role sets defined by society as masculine or feminine which are embodied in the behavior of the individual man or woman and culturally regarded as appropriate to males or females” (O’Neil, 1981, p. 203). The vast majority of studies that have examined gender roles with eating pathology and body dissatisfaction have used instruments such as the Bem Sex Role Inventory (BSRI; Bem, 1974) or the Personal Attributes
Eating pathology
Although numerous studies have examined gender role orientation and eating pathology in samples of women (cf. Murnen & Smolak, 1997), fewer (although increasingly) researchers have focused on these constructs in men. One may question the validity of utilizing eating disorder instruments that were designed for women with men. However, men with eating disorders generally mirror their female counterparts in regard to phenomenology of the condition, rates of comorbidity, and levels of body
Body dissatisfaction
Relatedly, researchers have also investigated the association between gender role orientation and body dissatisfaction in men. Similar to the above findings regarding eating pathology, research on body dissatisfaction and gender roles in men has yielded mixed results. For instance, Russell and Keel (2002) found that among young men, instrumentality was negatively related to body dissatisfaction (producing a medium effect size), whereas expressivity had no significant association with body
Muscle dissatisfaction
Research over the last decade has revealed that men typically desire a shape marked by lean muscularity, whereas women typically aim for thinner bodies and to lose weight (e.g., Bergeron and Tylka, 2007, Cafri and Thompson, 2004, McCreary and Sasse, 2000, Ridgeway and Tylka, 2005, Tiggemann et al., 2008). However, only recently have instruments been developed that capture this unique experience of men's body image. Measures such as the Male Body Attitudes Scale (MBAS; Tylka, Bergeron, &
Sexual orientation
The literature reviewed above has largely focused on heterosexual men; however, proportionally speaking, many studies investigating eating pathology and body dissatisfaction amongst men have done so with gay samples. Perhaps this is justified given that, on average, gay men report more body dissatisfaction and eating pathology compared to their heterosexual counterparts (e.g., Feldman and Meyer, 2007, Morrison et al., 2004). Alluded to earlier, gender roles may have varying effects on gay vs.
Measurement of gender roles
Another factor that may influence the impact of gender roles on eating pathology and body dissatisfaction amongst men is the conceptual manner in which gender roles are measured. As mentioned earlier, most studies that have examined gender roles in the context of eating pathology and body dissatisfaction have used trait-based instruments (e.g., BSRI, PAQ); however, more recently, broader, multidimensional measures have gained popularity (e.g., CMNI, Occupations, Activities, and Traits—Personal
The current study
Although past literature has summarized the association between gender roles and eating pathology (Murnen & Smolak, 1997), this work focused exclusively on women. With the growing attention clinically and empirically regarding men's eating concerns, it seems timely that a review of gender roles and eating pathology be examined in this population. In addition to examining eating pathology, this meta-analysis explored the relationship between body and muscle dissatisfaction and gender roles among
Data collection
Multiple strategies were utilized to locate potential studies for the meta-analysis. First, computer-based searches were conducted via PsycINFO and Medline using the following keywords gender roles, sex roles, masculinity, femininity, instrumentality, expressivity, eating disorders, anorexia nervosa, bulimia nervosa, binge eating disorder, body image, muscle dysmorphia, muscles, body image disturbance, body dissatisfaction, body dysmorphic disorder, and eating pathology. Second, the references
Relationship between femininity and eating pathology
Nine effect sizes were included in the analysis of the relationship between femininity and eating pathology, resulting in a total sample size of 2423. A random effects model was used to calculate the average effect size and confidence interval (95%). Results revealed a medium effect size, which was not significantly different from zero, r = .11, CI = −.08, .28, z = 1.15, p = .25; however, significant heterogeneity was found, Q = 108.48, p ≤ .00001. When sexual orientation was investigated as a potential
Discussion
This was the first known meta-analysis to investigate the relationships of gender roles with eating pathology, body dissatisfaction, and muscle dissatisfaction amongst men. Results indicated that femininity had no significant association with eating pathology, body dissatisfaction, or muscle dissatisfaction. However, sexual orientation did moderate the relationship between femininity and muscle dissatisfaction, with femininity producing a significant (large effect size) negative association for
Conclusions
In summary, the current study was the first to quantitatively summarize the literature on gender roles and eating and body-related issues among men. Although past meta-analytic reviews have explored gender roles and eating disorders among women (e.g., Murnen & Smolak, 1997), the current study assessed eating pathology in addition to body and muscle dissatisfaction. Further, two variables (sexual orientation and type of gender role measure) were examined as potential moderators. Results revealed
Acknowledgements
I would like to express my gratitude to Jillon Vander Wal for her comments on an earlier draft of this manuscript and to Elisha Mitchell for her help in coding primary studies.
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