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Gender is a powerful factor in the experience of one's body, the ability to understand and meet its needs, and the degree to which it symbolizes nonphysical characteristics related to self- esteem, identity, and emotional well-being. It remains a major risk factor in the constellation of factors contributing to and sustaining EDs in both women and men. Although the clinical features of EDs are similar between men and women, awareness of how gender can affect the prevention, detection, diagnosis, and treatment of these disorders is growing. Clinicians working with these patients need to practice gender-informed care by incorporating knowledge of the unique features of eating pathology in men and women. They must also build a sophisticated appreciation for how their own gender beliefs and biases affect their clinical work.


• EDs are serious and pervasive illnesses that affect millions of men and women.

• More women than men have EDs, but the disparity is shrinking.

• A persons sense of gender is the product of a complex interaction between genetic endowment and lived experience. Culture shapes one's gender experience.

• Culture- and gender-based experiences are critical factors in the etiology and maintenance of ED psychopathology.

Detection and diagnosis of EDs in boys and men can be complicated by differences in the nature of ED symptoms in men and women. For instance, the body image concerns of men with EDs often differ from those of women. Men's concerns focus on leanness and muscularity as opposed to thinness.

• For girls, the onset of puberty can radically alter body image. Virtually all girls in U.S. culture experience high levels of body dissatisfaction during their adolescence. For boys, teasing and shaming about body image are often important factors in the development of EDs.

• Most of the clinical features of EDs are similar in men and women, although subde variations often occur in the nature of body image concerns, drive for thinness, and reluctance to gain weight. The treatment priorities for men and women with EDs are essentially similar. Weight restoration and normalization of eating are the most important treatment goals.

• Clinicians can use awareness of gender dynamics to foster engagement in psychotherapy. Understanding one's own gender-based beliefs, biases, and stereotypes is an important part of a counselor's professional development.

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