Presentation at PHABC Public Health Reducing Health Inequities Conference, Vancouver, British Columbia, Canada. Also see several additional slideshares of mine about males and eating disorders and an excerpt from Global National TV 16x9 news documentary, Canadian national television. Brief excerpt (2.5 minutes) here: https://www.youtube.com/watch?v=ctlGqM0ekOY Full 23 mins show here: https://www.youtube.com/watch?v=OwhyB8mR-U8

1. Improving Engagement of Stigmatized Stakeholders: Access to Healthcare Experiences for 10 BC Males with Eating Disorders Paul W. Gallant, CHE, PhD(c), MHK 1,2 C. Laird Birmingham, MD, MHSc 1 Peter R.E. Crocker, PhD 1 1 The University of British Columbia & 2 Gallant HealthWorks Presented at: Public Health Association of British Columbia “ Action Towards Reducing Health Inequities” Conference November 23, 2009 Gallant, Birmingham & Crocker

5. Gallant, Birmingham & Crocker VANCOUVER - For years, anorexia and bulimia were considered strictly female disorders. But doctors say men are getting caught up in the quest for the perfect body, and they may have fewer treatment options. Recent studies suggest up to 16 per cent of those treated for anorexia are male, and doctors suspect the number may be higher for bulimia. For David Hurst of Vancouver, food was his worst enemy for nearly 30 years. He exercised constantly, ate next to nothing and developed a serious drug problem. "I was always checking myself," said Hurst. "'OK, am I thin enough?' Pinch for the inch." Eating disorder specialist Dr. Laird Birmingham said the chance of getting an eating disorder, increases with societal pressures. More men with eating disorders seek treatment programs Last Updated Fri, 07 Feb 2003 10:47:13 EST

6. Another male who has struggled with an eating disorder Gallant, Birmingham & Crocker For David Beckwermert, president and CEO of a Calgary oil and gas company, suffered from bulimia. He only disclosed his condition to a doctor when he underwent a colonoscopy because of rectal bleeding.

8. “ My Life as a Male Anorexic” Michael Krasnow, Age 26 in 1995, Weight 75lbs, 5-foot, nine-inches In 1995 “ Michael published a book on Male Anorexia and had the courage to explicitly share his story. He was thoughtful, courageous, good, and kind to all who knew him.” Michael died shortly after his book was published. Gallant, Birmingham & Crocker

9. Other public males who have struggled with eating disorders… Gallant, Birmingham & Crocker When Dennis Quaid confessed he had suffered a long, difficult and secret bout with "manorexia," there was a collective sigh of relief from specialists working in the world of men and eating disorders.A man, and a famous one at that, had finally come forward. Denise Ryan, Vancouver Sun Thursday, March 15, 2007 Ron Saxen, fashion model gained 70 pounds in six months. In his new book, The Good Eater chronicles his secret struggle to overcome binge eating disorder (BED). A recent Harvard Medical School study recognized binge eating as the most widespread eating disorder in the United States. http://www.ronsaxen.com/inthenews.htm

23. Results Gallant, Birmingham & Crocker “ I was told males are not seen here… and there isn’t anything for males with eating disorders” (Interview MWED) “ For the first time I saw another man with an eating disorder. I saw that I was not the only one” (Focus Group Member) “ The eating disorders’ resource centre was helpful…I also have a good relationship with my MD for 12 years…he didn’t know about my eating disorder” (Interview MWED) “ I was told males are not seen here… and there isn’t anything for males with eating disorders” (Interview MWED) “ For the first time I saw another man with an eating disorder. I saw that I was not the only one” (Focus Group Member) “ The eating disorders’ resource centre was helpful…I also have a good relationship with my MD for 12 years…he didn’t know about my eating disorder” (Interview MWED) “ I was told males are not seen here… and there isn’t anything for males with eating disorders” (Interview MWED) “ For the first time I saw another man with an eating disorder. I saw that I was not the only one” (Focus Group Member) “ The eating disorders’ resource centre was helpful…I also have a good relationship with my MD for 12 years…he didn’t know about my eating disorder” (Interview MWED) “ I was told males are not seen here… and there isn’t anything for males with eating disorders” (Interview MWED) “ For the first time I saw another man with an eating disorder. I saw that I was not the only one” (Focus Group Member) “ The eating disorders’ resource centre was helpful…I also have a good relationship with my MD for 12 years…he didn’t know about my eating disorder” (Interview MWED) “ The eating disorders’ resource centre was helpful…I also have a good relationship with my MD for 12 years…he didn’t know about my eating disorder” (Interview MWED)

24. Quality of Life Inventory Findings Gallant, Birmingham & Crocker

25. Gallant, Birmingham & Crocker Results: Summary Table of Additional Health and Demographic Data Measure Finding Mean Age of Eating Disorder Onset 19 years Mean Age at Time of Study 45 years Mean Duration of Eating Disorder 26 years Age Range at Time of Study 25-74 years Age of Onset Range 8-40 years *Sexuality 1 Bisexual,4 Straight,*5 Gay Employment status 6 Unemployed,3 Working,1 Retired Desire for Treatment All rated High/Very High Desire for Recovery All rated High/Very High Received Treatment N=4 Teased as a Child N=6 Childhood Abuse N=3 Married or in a relationship N=2 Exercises/control weight or shape N=6 Additional mental health diag. N=5 Poor Libido N=4 HIV + N=3

26. Gallant, Birmingham & Crocker Themes Participant (P) Comments Social Isolation “ There is not much to talk about regarding friends. My friend today is my wife. We keep to ourselves and our small community . I don ’ t get along with my relatives. ” Poverty “ I live on disability in sub poverty and one in one of the richest countries in the world . Poverty is a nice, genius word for a lot of social ills that continue to be ignored or neglected. ” Community Pressure to Fit in “ There is pressure in the gay community around body image . The ideal gay is young, athletic, and spelt. As I am older now, 74 years, there is less pressure to meet others ideals. ” “ I was a chubby child and teased all the time in school because of my looks. ” Stigma “ When I spoke about my concerns the doctor told me men can ’ t have eating disorders. ” “ I don ’ t look for eating disorders stuff because it is not for men. I can ’ t relate to the stuff about women. The male body and female body are different. How my body reacts to my eating disorder such as sex drive, relates to being a man. ” Therapeutic Alliance “ I have worked with many doctors/specialists. One thing I find was working with someone who does not understand eating disorders. [It] can be very damaging and even a negative experience. ”

30. Value of Community Engagement Practices Gallant, Birmingham & Crocker Adapted from Weinstein et al, 2006