How to promote therapy-seeking for men with binge-spectrum eating disorders: a qualitative study

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How to promote therapy-seeking for men with binge-spectrum eating disorders: a qualitative study 1

doi: 10.1186/s40337-026-01571-4.

Online ahead of print.

Affiliations

¹ Department of Psychological and Brain Sciences, Drexel University, 3201 Chestnut St, Philadelphia, PA, 19104, USA. rs3725@drexel.edu.
² Center for Weight, Eating and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St, Philadelphia, PA, 19104, USA. rs3725@drexel.edu.
³ Department of Psychological and Brain Sciences, Drexel University, 3201 Chestnut St, Philadelphia, PA, 19104, USA.
⁴ Center for Healthcare Delivery Service, Nemours Children’s Health, 1600 Rockland Rd, Wilmington, DE, 19803, USA.
⁵ Military Cardiovascular Outcomes Research Program (MiCOR), Department of Medicine, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
⁶ Department of Medicine, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
⁷ The Metis Foundation, 84 NE Interstate 410 Loop # 325, San Antonio, TX, 78216, USA.

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Ross M Sonnenblick et al.

J Eat Disord.

2026.

doi: 10.1186/s40337-026-01571-4.

Online ahead of print.

Affiliations

¹ Department of Psychological and Brain Sciences, Drexel University, 3201 Chestnut St, Philadelphia, PA, 19104, USA. rs3725@drexel.edu.
² Center for Weight, Eating and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St, Philadelphia, PA, 19104, USA. rs3725@drexel.edu.
³ Department of Psychological and Brain Sciences, Drexel University, 3201 Chestnut St, Philadelphia, PA, 19104, USA.
⁴ Center for Healthcare Delivery Service, Nemours Children’s Health, 1600 Rockland Rd, Wilmington, DE, 19803, USA.
⁵ Military Cardiovascular Outcomes Research Program (MiCOR), Department of Medicine, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
⁶ Department of Medicine, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
⁷ The Metis Foundation, 84 NE Interstate 410 Loop # 325, San Antonio, TX, 78216, USA.

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Abstract

Objective:

Most men with binge-spectrum eating disorders (BSEDs) never receive psychological treatment for their conditions, and research on BSEDs typically includes disproportionately low numbers of men. Qualitative information is needed to shape the development of messaging strategies to engage this population in both treatment and research.

Method:

Fifteen men (53% White, 80% heterosexual, age range 26-69) who had never gone to therapy for their BSEDs provided semi-structured qualitative feedback about strategies to engage men like them in psychological treatment for and research about BSEDs.

Findings:

Reflexive thematic analysis identified four key themes: (1) Serious messages convey the seriousness of BSEDs (2). The ideal message would be simple and relatable and persuade men that seeking therapy makes them more manly, not less (3). Men’s intersectional identities shape their reasons for not pursuing therapy (4). Men expressed spontaneous excitement about a messaging campaign to raise awareness of disordered eating in men.

Discussion:

These findings demonstrate that no single messaging strategy will appeal to all men. Nonetheless, all men expressed enthusiasm for targeted campaigns that promote the entry of more men into psychological treatment for their BSEDs. Researchers and clinicians could use these findings to increase men’s uptake of BSED treatment.

Keywords:

Binge eating; Masculinity; Men; Qualitative; Stigma; Treatment.

Plain language summary

Many men struggle with binge eating, meaning that at times, they lose control over their eating, eat more than most people would under the same circumstances, and experience strong negative emotions about how they eat. Most men who struggle with binge eating never receive medical or psychological treatment for it. In this study, men with high levels of binge eating described how healthcare professionals could encourage men in their situation to seek psychotherapy. They emphasized that messaging promoting treatment would need to be simple, relatable, and aligned with their views of themselves as men. They also stated that such messaging would need to convey the seriousness of the health consequences of binge eating. The men in this study recognized the need to raise awareness of binge eating in men. These findings can help researchers, therapists, and other healthcare providers tailor their messaging for men who experience frequent binge eating but might not realize that they could benefit from proven medical treatments.

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Conflict of interest statement

Declarations. Ethics approval and Consent to Participate: The Drexel University Institutional Review Board approved all study procedures (protocol #2307010005), and all participants provided their informed consent. Competing interests: The authors declare no competing interests.

References

1. American Psychological Association. Diagnostic and statistical manual of mental disorders, fifth edition, text revision. 5th ed. American Psychiatric Association Washington, DC; 2022.
1. Ahorsu DK, Lin CY, Imani V, Griffiths MD, Su JA, Latner JD, et al. A prospective study on the link between weight-related self‐stigma and binge eating: role of food addiction and psychological distress. Int J Eat Disord. 2020;53(3):442–50.
1. Lydecker JA, Grilo CM. Psychiatric comorbidity as predictor and moderator of binge-eating disorder treatment outcomes: an analysis of aggregated randomized controlled trials. Psychol Med. 2022;52(16):4085–93.
1. Streatfeild J, Hickson J, Austin SB, Hutcheson R, Kandel JS, Lampert JG, et al. Social and economic cost of eating disorders in the United States: evidence to inform policy action. Int J Eat Disord. 2021;54(5):851–68.
1. Mehler PS, Rylander M. Bulimia Nervosa–medical complications. J Eat Disord. 2015;3(1):12.

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