(PS7-32) Engaging Men in Psychotherapy for Eating Disorders: A Mixed-methods Study

Nearly one third of adults with binge-spectrum eating disorders (BSEDs, including bulimia nervosa (BN) and binge-eating disorder (BED)) are men. Cognitive behavioral therapy is fairly effective for men’s EDs, but men with EDs are much less likely than women to seek psychological help. Evidence from treatment-seeking men with EDs suggests that several factors, including adherence to masculine norms (e.g., self-reliance and avoidance of femininity) and low mental-health literacy, might account for men’s low rates of treatment-seeking. Humor has facilitated deeper engagement with mental-health promotional content among men with depression, but such an approach has not been evaluated among men with EDs. Thus, this mixed-methods study pilot-tested six theory-driven messages encouraging men with BSEDs to go to therapy. The messages varied in tone (humorous or serious) and focus (reconsidering self-reliance, questioning avoidance of femininity, or providing ED psychoeducation). This study also solicited men’s qualitative feedback about those messages. Participants were 15 cisgender men (M [SD] age: 47 [16]) with BSEDs (BN: 4; BED: 11) diagnosed via the Eating Disorder Examination. None had ever gone to therapy for their eating problems; all (8 White, 4 Black, 3 Asian, 12 heterosexual) were recruited via ResearchMatch. First, participants answered open-ended questions about how a public-health initiative could raise men’s awareness of EDs and willingness to seek psychological help. Then, they chose their top three messages. Three themes stood out in the interviews: 1) These men voiced a preference for serious, not humorous, messages; they argued that if the purpose of the messaging campaign is to get men to take their health seriously, then the messages need to convey the gravity of the situation. 2) The ideal message would be simple and relatable and persuade men that seeking therapy makes them more, not less, manly. Therapy could be presented as a masculine way to regain control of one’s life, improve one’s mental strength, or increase one’s capacity to support one’s family. 3) Not all men are the same, so no single message could resonate with all men. Participants’ choice of messages told a slightly different story: Despite their prediction that they would prefer serious messages, they chose serious and humorous messages equally often (22 times vs. 21; two men only ranked two messages). They also chose messages focused on self-reliance, femininity, and psychoeducation at comparable rates (16, 15, and 12 times, respectively). These results underscore that no single line of messaging will appeal to all men. Nonetheless, all men expressed enthusiasm for at least one message, which should inspire hope that men can be moved to consider therapy for their EDs.