Do we need to "man up" feeding and eating disorders treatments? Protocol for a systematic review and individual patient data meta-analysis of gender effects on intervention outcomes.

Abstract

<h4>Background</h4>Feeding and eating disorders lead to serious health impairments. Boys and men are increasingly affected and may account for a fourth of clinical cases. Current evidence suggests that symptoms and health care needs differ between men and women (e.g., related to muscularity concerns), and that men delay seeking treatment due to the traditional understanding of eating disorders as "women's disease". Treatment guidelines recommend psychotherapy as first-line intervention, but potential gender differences in treatment responses have not been considered. This is due to the lack of systematic evaluations of gender differences related to treatment outcomes for feeding and eating disorders.<h4>Methods</h4>This systematic review with Individual Patient Data Meta-Analysis (IPDMA) will compare the effects of psychotherapeutic interventions for feeding and eating disorders between gender groups. The focus of the analysis is on eating disorders-related psychopathology. For this purpose, randomized-controlled clinical studies will be identified in scientific databases and examined for their methodological quality. Primary investigators will be contacted to deliver anonymized data of their studies. Study results will then be summarized and compared in a two-staged IPDMA. Gender groups will be compared regarding different types of interventions and further relevant intervention characteristics, as identified by men with lived experience.<h4>Discussion</h4>The results will help to formulate treatment recommendations and identify the treatment contexts that are associated with unfavorable outcomes related to patient gender. This may fuel efforts of adapting established interventions to best meet the health care needs of men and women in the context of eating disorders.<h4>Systematic review registration</h4>PROSPERO CRD42022372712.